title: Stenting for curved lesions using a novel curved balloon: Preliminary experimental study.
abstract: BACKGROUND
  Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion.
  
  
  METHODS
  In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo.
  
  
  RESULTS
  In vitro experiments: Although the stent was dilated in a curved fashion, stent and balloon assembly also rotated conjointly during expansion of its curved portion.
  In the primary stenting of the short stent, the stent was dilated with rotation of the curved portion. The excised stent conformed to the curved vessel. As the long stent could not be negotiated across the mid-portion with the balloon in expansion when it started curving, the mid-portion of the stent failed to expand fully. Furthermore, the balloon, which became entangled with the stent strut, could not be retrieved even after complete deflation.
  
  
  CONCLUSIONS
  This novel curved balloon catheter might be used for implantation of the short stent in a curved lesion; however, it should not be used for primary stenting of the long stent. Post-dilation to conform the stent to the angled vessel would be safer than primary stenting irrespective of stent length.
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. Electronic address: tomitah@med.showa-u.ac.jp.
authors.forename: Hideshi
authors.initials: H
authors.lastname: Tomita
authors.affiliation: Department of Pediatric Cardiology, Children's Medical Center, Ehime University Hospital, Toon, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Higaki
authors.affiliation: Department of Pediatric Cardiology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Takanari
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Fujimoto
mesh_terms: D000800:Angioplasty, Balloon / Q000295:instrumentation* / Q000379:methods; D000818:Animals; D004867:Equipment Design; D006330:Heart Defects, Congenital / Q000601:surgery*; D007564:Japan; D023421:Models, Animal; D015607:Stents; D013552:Swine
keywords: Congenital heart disease; Curved balloon; Curved lesion; Stenting; Systemic-pulmonary shunt