Novel growth stent for the permanent treatment of vessel stenosis in growing children: an experimental study.
Stent implantation in stenotic vessels of infants and small children is problematic because there is no ideal stent model that is small enough to be easily introduced into the infant femoral vein or artery and, at the same time, large enough to be dilated during growth to adult vessel diameters. To overcome this problem, we designed a new stent, the growth stent. This growth stent is a balloon-expandable metal stent. Two longitudinal halves are connected with bioabsorbable sutures so that a circular stent is created. It was postulated that after absorption of the sutures the stent would not impede growth. Twenty of these stents were implanted in the aorta, pulmonary arteries, and inferior vena cava of piglets (average weight 6.9 kg). After 18 weeks (14-23 weeks) and a mean weight gain of 59 kg, none of the stented vessels showed any significant stenosis or pressure gradient, documented by angiography and catheter pullback. During fluoroscopy, the two halves of the stent were clearly separated in all animals. The growth stent has the potential to be nonrestrictive during vessel growth, and thus is a promising new device for the permanent treatment of stenotic vessels in infancy and childhood.
Deutsches Herzzentrum Berlin, Abteilung für Angeborene Herzfehler/Kinderkardiologie, Berlin, Germany. ewert@dhzb.de
Peter
P
Ewert
Eugénie
E
Riesenkampff
Malte
M
Neuss
Oliver
O
Kretschmar
Nicole
N
Nagdyman
Peter E
PE
Lange
D000375:Aging; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D000818:Animals; D001011:Aorta / Q000254:growth & development* / Q000473:pathology; D001027:Aortography; D018376:Cardiovascular Abnormalities / Q000628:therapy*; D002404:Catheterization / Q000009:adverse effects; D003251:Constriction, Pathologic / Q000628:therapy; D006801:Humans; D008670:Metals; D023421:Models, Animal; D010690:Phlebography; D011474:Prosthesis Design; D011651:Pulmonary Artery / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology; D012107:Research Design; D015607:Stents; D013552:Swine; D013997:Time Factors; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000254:growth & development* / Q000473:pathology
D008670:Metals