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Title: The current status of biodegradable stent to treat benign luminal disease

Authors:
; ; ; ; ; ; ;
Publication Date:
Sponsoring Org.:
USDOE Office of Nuclear Energy (NE), Fuel Cycle Technologies (NE-5)
OSTI Identifier:
1395900
Resource Type:
Journal Article: Published Article
Journal Name:
Materials Today
Additional Journal Information:
Related Information: CHORUS Timestamp: 2017-09-30 03:08:40; Journal ID: ISSN 1369-7021
Publisher:
Elsevier
Country of Publication:
United Kingdom
Language:
English

Citation Formats

Zhu, Yueqi, Yang, Kai, Cheng, Ruoyu, Xiang, Yi, Yuan, Tianwen, Cheng, Yingsheng, Sarmento, Bruno, and Cui, Wenguo. The current status of biodegradable stent to treat benign luminal disease. United Kingdom: N. p., 2017. Web. doi:10.1016/j.mattod.2017.05.002.
Zhu, Yueqi, Yang, Kai, Cheng, Ruoyu, Xiang, Yi, Yuan, Tianwen, Cheng, Yingsheng, Sarmento, Bruno, & Cui, Wenguo. The current status of biodegradable stent to treat benign luminal disease. United Kingdom. doi:10.1016/j.mattod.2017.05.002.
Zhu, Yueqi, Yang, Kai, Cheng, Ruoyu, Xiang, Yi, Yuan, Tianwen, Cheng, Yingsheng, Sarmento, Bruno, and Cui, Wenguo. Mon . "The current status of biodegradable stent to treat benign luminal disease". United Kingdom. doi:10.1016/j.mattod.2017.05.002.
@article{osti_1395900,
title = {The current status of biodegradable stent to treat benign luminal disease},
author = {Zhu, Yueqi and Yang, Kai and Cheng, Ruoyu and Xiang, Yi and Yuan, Tianwen and Cheng, Yingsheng and Sarmento, Bruno and Cui, Wenguo},
abstractNote = {},
doi = {10.1016/j.mattod.2017.05.002},
journal = {Materials Today},
number = ,
volume = ,
place = {United Kingdom},
year = {Mon May 01 00:00:00 EDT 2017},
month = {Mon May 01 00:00:00 EDT 2017}
}

Journal Article:
Free Publicly Available Full Text
Publisher's Version of Record at 10.1016/j.mattod.2017.05.002

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  • Venous stenting has been shown to effectively treat iliofemoral venous obstruction with good short- and mid-term results. The aim of this study was to investigate long-term clinical outcome and stent patency. Twenty patients were treated with venous stenting for benign disease at our institution between 1987 and 2005. Fifteen of 20 patients (15 female, mean age at time of stent implantation 38 years [range 18-66]) returned for a clinical visit, a plain X-ray of the stent, and a Duplex ultrasound. Four patients were lost to follow-up, and one patient died 277 months after stent placement although a good clinical resultmore » was documented 267 months after stent placement. Mean follow-up after stent placement was 167.8 months (13.9 years) (range 71 (6 years) to 267 months [22 years]). No patient needed an additional venous intervention after stent implantation. No significant difference between the circumference of the thigh on the stented side (mean 55.1 cm [range 47.0-70.0]) compared with the contralateral thigh (mean 54.9 cm [range 47.0-70.0]) (p = 0.684) was seen. There was a nonsignificant trend toward higher flow velocities within the stent (mean 30.8 cm/s [range 10.0-48.0]) and the corresponding vein segment on the contralateral side (mean 25.2 cm/s [range 12.0-47.0]) (p = 0.065). Stent integrity was confirmed in 14 of 15 cases. Only one stent showed a fracture, as documented on x-ray, without any impairment of flow. Venous stenting using Wallstents showed excellent long-term clinical outcome and primary patency rate.« less
  • Purpose: To evaluate the effect on dilatation of three types of covering materials used for endovascular stent-grafts.Methods: Stent-grafts with three types of covering material [0.1-mm polytetrafluoroethylene (PTFE), 0.2-mm PTFE, and 0.15-mm woven polyester] were placed in a fluid circuit. For the pulsatile pressure test, the luminal pressure of 190/130 mmHg was loaded up to 300,000 pulses. For the static pressure test, the luminal pressure was increased from 50 to 300 mmHg at 50-mmHg increments. The percent of dilatation of each stent-graft was compared.Results: The 0.1-mm PTFE stent-graft was significantly more dilated than the 0.2-mm PTFE and the 0.15-mm woven polyestermore » stent-graft (p < 0.005) in both examinations. There was no significant difference between the 0.2-mm PTFE and the 0.15-mm woven polyester stent-grafts. The dilatation of the 0.1-mm PTFE stent-graft was irreversible.Conclusion: The 0.15-mm woven polyester and the 0.2-mm PTFE stent-grafts may be preferable to the 0.1-mm PTFE stent-graft with regard to dilatation and deformity.« less
  • Purpose: The lifelong persistence of foreign bodies within the arteries may contribute to restenosis. Thus,biodegradable devices might decrease recurrence rates. Methods: Eleven polyhydroxybutyrate biodegradable stents and 13 tantalum stents were implanted into the iliac arteries of New Zealand white rabbits for up to 30 weeks. After killing the animals,the specimens were harvested, fixed in formalin, processed in paraffin,and stained. Results: Polyhydroxybutyrate instigated intense inflammatory and proliferative reactions with an increase in collagen (2.4- to 8-fold vs native segments), thrombosis and in-stentlumen narrowing (375.5-606.6 mm vs 655.6 {+-} 268.8 mm in native segments). The elastic membranes were destroyed in all specimens.more » The tantalum stents increased the in-stent lumen progressively (769.7 {+-} 366.6 mm vs 1309.9 {+-} 695.3 mm),penetrated the external elastic membrane, and increased mural collagen content (6- to 8.6-fold vs native segments). Neither restenoses nor thromboses occurred. Conclusions: In the rabbit iliacartery, polyhydroxybutyrate stents caused intensive inflammatory vascular reactions which ban them from clinical use.« less
  • Purpose: This study was designed to evaluate our experience with the treatment of postoperative anastomotic leaks and benign esophageal perforations with covered biodegradable stents. Materials and Methods: From 2008 to 2010, we treated five men with either an anastomotic leak or benign esophageal perforation by implanting of covered biodegradable Ella-BD stents. The average age of the patients was 60 (range, 38-74) years. Postoperative anastomotic leaks were treated in four patients (1 after esophagectomy, 1 after resection of diverticulum, 2 after gastrectomy). In one patient, perforation occurred as a complication of the treatment of an esophageal rupture (which occurred during amore » balloon dilatation of benign stenosis) with a metallic stent. Results: Seven covered biodegradable stents were implanted in five patients. Primary technical success was 100%. Clinical success (leak sealing) was achieved in four of the five patients (80%). Stent migration occurred in three patients. In two of these patients, the leak had been sealed by the time of stent migration, therefore no reintervention was necessary. In one patient an additional stent had to be implanted. Conclusion: The use of biodegradable covered stents for the treatment of anastomotic leaks or esophageal perforations is technically feasible and safe. The initial results are promising; however, larger number of patients will be required to evaluate the capability of these biodegradable stents in the future. The use of biodegradable material for coverage of the stent is essential.« less
  • Aortic stent-grafts were introduced at the beginning of the 1990s as a less invasive method of dealing with aortic aneurysms in patients with poor cardiovascular reserve. The numbers of procedures performed worldwide has increased exponentially despite the current lack of any substantial evidence for long-term efficacy in comparison with the gold standard of open surgical grafting. This review summarizes the evolution of the abdominal aortic stent-graft, the techniques used for assessment and deployment, and the effect of the procedure on both the patient and the device. The recent publication of two national multicenter trials has confirmed that the endovascular techniquemore » confers a 2.5-fold reduction in 30-day mortality in comparison with open surgery. However, over 4 years of follow-up, there is a 3-fold increase in the risk of reintervention and the overall costs are 30% greater with endovascular repair. Although the improvement in aneurysm-related mortality persists in the mid-term, because of the initial reduction in perioperative mortality, the all-cause mortality rate at 4 years is actually no better than for open surgery. Longer-term data from the randomized trials are awaited as well as results from the latest trials utilizing state-of-the-art devices. Whilst the overall management of abdominal aortic aneurysms has undoubtedly benefited from the introduction of stent-grafts, open repair currently remains the gold standard treatment.« less