title: Early clinical experience with the implantation of a novel synthetic coronary stent graft.
abstract: Coating stents with autologous venous grafts has been suggested to prevent problems associated with conventional stenting, but the need for surgical vessel harvest hampered broad application. A novel synthetic coronary stent graft (CSG) overcomes this limitation by a synthetic membrane, fixed between two thin metallic stents. We successfully implanted 21 CSGs in 18 patients for treatment of acute coronary rupture, thrombus-containing lesions, and lesions with plaque rupture or adjacent pseudoaneurysm. Substantial residual angiographic diameter stenoses were seen in seven CSGs (25% +/- 10% vs. 8% +/- 6%; P < 0.01), which were implanted with relatively small balloon catheters (balloon-to-artery ratio 1.00 +/- 0.09 vs. 1.24 +/- 0.18; P = 0.01) and required postdilatation. Overall, the largest balloon catheter applied measured 4.0 +/- 0.7 mm (balloon-to-artery ratio 1.21 +/- 0.20) and the inflation pressure was 16 +/- 3 atm. Final intravascular ultrasound imaging demonstrated adequate and symmetrical expansion of the CSG (> or = 85% +/- 15% of the reference lumen). Elective implantation was associated with two small non-Q-wave myocardial infarctions, resulting from unavoidable occlusions of side branches. Thus, implantation of CSG is feasible and safe. Adequate expansion can be achieved by the use of relatively large low-compliant balloon catheters inflated with high pressure.
authors.affiliation: Department of Cardiology, University Hospital Essen, Germany. von.birgelen@uni-essen.de
authors.forename: C
authors.initials: C
authors.lastname: von Birgelen
authors.forename: M
authors.initials: M
authors.lastname: Haude
authors.forename: J
authors.initials: J
authors.lastname: Herrmann
authors.forename: C
authors.initials: C
authors.lastname: Altmann
authors.forename: W
authors.initials: W
authors.lastname: Klinkhart
authors.forename: D
authors.initials: D
authors.lastname: Welge
authors.forename: H
authors.initials: H
authors.lastname: Wieneke
authors.forename: D
authors.initials: D
authors.lastname: Baumgart
authors.forename: S
authors.initials: S
authors.lastname: Sack
authors.forename: R
authors.initials: R
authors.lastname: Erbel
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D018084:Ultrasonography, Interventional