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Implantation of the peripheral Wallstent for diffuse lesions in coronary arteries and vein grafts
Insights
Peripheral Wallstent implantation using intravascular ultrasound guidance is feasible for diffuse coronary and vein graft lesions. This approach demonstrated successful stent deployment and favorable lumen dimensions in selected patients.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- The Wallstent offers various lengths with maintained flexibility and radial support.
- Diffuse coronary and vein graft lesions present treatment challenges.
Observation:
- Intravascular ultrasound-guided peripheral Wallstent implantation was performed in 26 vessels across 24 patients.
- Average balloon pressure for stent optimization was 16.4 +/- 2.7 atm.
- Successful stent implantation was achieved in all 24 treated vessels.
Findings:
- Post-stenting, minimal lumen diameter averaged 3.60 +/- 0.62 mm with a -8 +/- 13% diameter stenosis.
- The average stent length used was 63.7 +/- 22.7 mm.
- One procedure-related complication occurred, and one case of subacute stent thrombosis was noted during 1-month follow-up.
Implications:
- This preliminary study suggests the feasibility of intravascular ultrasound-guided Wallstent implantation for specific lesion types.
- Further research is warranted to confirm long-term efficacy and safety.
- Antiplatelet therapy was the sole adjunctive treatment post-procedure.
Abstract:
The Wallstent (Schneider, Bulach, Switzerland) is available in different lengths without much compromise in flexibility and radial support compared to some other stents. We treated 24 patients (26 vessels) with diffuse coronary lesions or vein graft lesions with intravascular ultrasound-guided peripheral Wallstent implantation. Average balloon pressure during stent optimization was 16.4 +/- 2.7 atm. The stents could be successfully implanted in 24 vessels. Minimal lumen diameter and percent diameter stenosis after stenting were 3.60 +/- 0.62 mm and -8 +/- 13%, respectively. Average stent length was 63.7 +/- 22.7 mm. There was one procedure-related complication. After stenting, all patients were treated only with antiplatelet agents. During 1-month follow-up, there was one subacute stent thrombosis due to incomplete coverage of a distal dissection. These preliminary results show the feasibility of this novel approach in selected lesions.