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[Experience of implantation of prefitted Palmaz Corinthian stents]
G Agnoletti1, Y Boudjemline, Y Aggoun
1Service de cardiologie pédiatrique, groupe hospitalier Necker-Enfants malades, 149, rue de Sèvres, 75743 Paris. gabriella.agnoletti@nck.ap-hop-paris.fr
Insights
The Palmaz Corinthian stent is a viable option for pediatric patients, demonstrating simple implantation and good initial results for treating stenotic lesions in pulmonary arteries. Its use is best suited for peripheral pulmonary branches or surgically treatable lesions.
Area of Science:
- Pediatric cardiology
- Interventional cardiology
- Biomedical engineering
Context:
- Stent implantation in pediatric patients presents unique challenges.
- The Palmaz Corinthian stent is a specific device used in vascular interventions.
- Previous experiences with this stent in pediatric populations are limited.
Purpose:
- To evaluate the safety and efficacy of the Palmaz Corinthian stent in pediatric patients.
- To assess the procedural success and complications associated with Palmaz Corinthian stent implantation in children.
- To determine the suitability of the Palmaz Corinthian stent for various pediatric cardiovascular conditions.
Summary:
- Eighteen Palmaz Corinthian stents were implanted in 12 pediatric patients (median age 5.6 years) for conditions including pulmonary atresia with ventricular septal defect.
- Indications included stenosis of pulmonary branches, ductus arteriosus, and systemic veins.
- The procedure involved pre-mounted stents, a 6F introducer, and hand inflation, with no procedural complications reported. Stent positioning was accurate, though distal injection was not possible.
Impact:
- The Palmaz Corinthian stent offers a relatively simple implantation technique in children due to pre-mounted availability and short 6F sheaths.
- Good primary results were observed regarding delivery and absence of complications.
- Limitations include difficulty in site selection due to lack of distal injection and restricted over-dilation, suggesting use for peripheral pulmonary branches or surgically treatable lesions.
Abstract:
We report our recent experience with the Palmaz Corinthian stent in children. Since 1/10/01 to 1/11/02 we implanted 18 Palmaz Corinthian stents in 12 children. Median age and weight of patients were 5.6 years (range 0.25-13) and 17.9 kg (range 3-36), respectively. Primary diagnosis were: pulmonary atresia with ventricular septal defect (n = 7), complex transposition of the great arteries (n = 2) and others (n = 3). Indications to stent implantation were: pulmonary branches stenosis (n = 9), stenosis of the ductus arteriosus (n = 1), stenosis of systemic veins (n = 2). All stents were pre-mounted and co-axially advanced over a standard guidewire across the stenotic site, using a 6F short introducer. Stent deployment was performed by hand inflation of the balloon. Final angiography confirmed correct positioning and ruled out complications. Median fluoroscopy time was 18 minutes (range 12-56). All stents reached their nominal diameter; 2 were post-dilated to 125 and 150%. No procedural complications occurred. Despite the impossibility of distal injection, stent positioning was always correct. In conclusion, due to the availability of pre-mounted stents, and the need of short 6F sheaths, the use of the Palmaz Corinthian stent in children is relatively simple. Primary results are generally good in terms of adequate delivery and absence of complications. However, the impossibility of distal injection makes more difficult the choice of the deployment site. Due to the limited possibility of over-dilation, the use of this stent has to be limited to the stenosis of peripheral pulmonary branches or to lesions that can be surgically treated during further surgical procedures.
