Funneling: enhancing results of small-vessel stenting.
Until October 2008, coronary drug-eluting stents with a diameter of < or =2.5 mm were not approved by the FDA. Target vessels of < or =2 mm in diameter pose a major challenge in view of high restenosis rates when stented bare metal stents (BMS) are used and distal edge dissection when oversized stents are deployed. Described is a method ("funneling") to optimize stenting of small vessels. This strategy combines stenting the distal part of the lesion with short (8-12 mm length) 2-mm bare metal stent while stenting with a larger-diameter (> or =2.5 mm) drug-eluting stent (DES) with considerable DES-BMS overlap (leaving only the distal 4-6 mm of the BMS not overlapped by a DES). The two stents create a funnel that is for the most part drug eluting. With funneling, both drug elution and larger diameter are attained, minimizing both edge dissection and restenosis.
Kaluski
Edo
E
Department of Cardiology, University of Medicine and Dentistry, Newark, NJ, USA. ekaluski@gmail.com
Gerula
Christine
C
Randhawa
Preet
P
Klapholz
Marc
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008670:Metals; D011474:Prosthesis Design; D011859:Radiography; D015607:Stents; D016896:Treatment Outcome
D008670:Metals