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Sample records for ptfe covered stent

  1. Treatment of Malignant Biliary Obstruction with a PTFE-Covered Self-Expandable Nitinol Stent

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    Han, Young-Min; Kwak, Hyo-Sung; Jin, Gong-Yong; Lee, Seung-Ok; Chung, Gyung-Ho [Chonbuk National University Medical School and Hospital, Chonju (Korea, Republic of)

    2007-10-15

    We wanted to determine the technical and clinical efficacy of using a PTFE-covered self-expandable nitinol stent for the palliative treatment of malignant biliary obstruction. Thirty-seven patients with common bile duct strictures caused by malignant disease were treated by placing a total of 37 nitinol PTFE stents. These stents were covered with PTFE with the exception of the last 5 mm at each end; the stent had an unconstrained diameter of 10 mm and a total length of 50 80 mm. The patient survival rate and stent patency rate were calculated by performing Kaplan-Meier survival analysis. The bilirubin, serum amylase and lipase levels before and after stent placement were measured and then compared using a Wilcoxon signed-rank test. The average follow-up duration was 27.9 weeks (range: 2 81 weeks). Placement was successful in all cases. Seventy-six percent of the patients (28/37) experienced adequate palliative drainage for the remainder of their lives. There were no immediate complications. Three patients demonstrated stent sludge occlusion that required PTBD (percutaneous transhepatic biliary drainage) irrigation. Two patients experienced delayed stent migration with stone formation at 7 and 27 weeks of follow-up, respectively. Stent insertion resulted in acute elevations of the amylase and lipase levels one day after stent insertion in 11 patients in spite of performing endoscopic sphincterotomy (4/6). The bilirubin levels were significantly reduced one week after stent insertion (p < 0.01). The 30-day mortality rate was 8% (3/37), and the survival rates were 49% and 27% at 20 and 50 weeks, respectively. The primary stent patency rates were 85%, and 78% at 20 and 50 weeks, respectively. The PTFE-covered self-expandable nitinol stent is safe to use with acceptable complication rates. This study is similar to the previous studies with regard to comparing the patency rates and survival rates.

  2. Management of malignant biliary obstruction: Technical and clinical results using an expanded polytetrafluoroethylene fluorinated ethylene propylene (ePTFE/FEP)-covered metallic stent after 6-year experience

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    Fanelli, Fabrizio; Orgera, Gianluigi; Bezzi, Mario; Rossi, Plinio; Allegritti, Massimiliano; Passariello, Roberto [University of Rome, Department of Radiological Sciences, Rome (Italy)

    2008-05-15

    To evaluate the efficacy and safety of an expanded polytetrafluoroethylene-fluorinated ethylene-propylene (ePTFE/FEP)-covered metallic stent in the management of malignant biliary obstruction. Eighty consecutive patients with malignant common bile duct strictures were treated by placement of 83 covered metallic stents. The stent-graft consists of an inner ePTFE/FEP lining and an outer supporting structure of nitinol wire. Clinical evaluation, assessment of serum bilirubin and liver enzyme levels were analyzed before biliary drainage, before stent-graft placement and during the follow-up period at 1, 3, 6, 9 and 12 months. Technical success was obtained in all cases. After a mean follow-up of 6.9{+-}4.63 months, the 30-day mortality rate was 14.2%. Survival rates were 40% and 20.2% at 6 and 12 months, respectively. Stent-graft patency rates were 95.5%, 92.6% and 85.7% at 3, 6 and 12 months, respectively. Complications occurred in five patients (6.4%); among these, acute cholecystitis was observed in three patients (3.8%). A stent-graft occlusion rate of 9% was observed. The percentage of patients undergoing lifetime palliation (91%) and the midterm patency rate suggest that placement of this ePTFE/FEP-covered stent-graft is safe and highly effective in achieving biliary drainage in patients with malignant strictures of the common bile duct. (orig.)

  3. Feasibility, safety, and preliminary efficacy of a novel ePTFE-covered self-expanding stent in saphenous vein graft lesions: the Symbiot II trial.

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    Laarman, Gerrit J; Kiemeneij, Ferdinand; Mueller, Ralf; Guagliumi, Giuglio; Cobaugh, Michael; Serruys, Patrick W

    2005-03-01

    Compared with percutaneous interventions in native coronary arteries, revascularization of saphenous vein graft (SVG) lesions is associated with increased rates of immediate and long-term major adverse cardiac events (MACE). The Symbiot II trial was a multicenter prospective study designed to evaluate the feasibility and safety of a novel self-expanding polytetrafluoroethylene (ePTFE)-covered stent in the treatment of de novo and restenotic SVG lesions. The primary endpoint was MACE through 30 days postprocedure. Successful Symbiot stent deployment was achieved in 75 of 77 patients (97.4%) with SVG lesions < or = 35 mm in length (visual assessment). The procedural success rate (defined as < 30% residual stenosis at the target site and no clinical complications) was 83%, and all study device procedures provided grade 3 TIMI flow postprocedure. Within the first 30 days postprocedure, four patients (5.2%) experienced MACE (defined as death, Q-wave or non-Q-wave myocardial infarction, and clinically driven target vessel revascularization), of whom three patients (3.9%) experienced periprocedural non-Q-wave myocardial infarction. No subacute stent thrombosis was observed over the 6-month follow-up period. No relevant luminal loss at the target site (mean, 0.3 +/- 0.9 mm) was observed in the 58 patients (77.3% of enrolled patients) who underwent quantitative coronary angiography at 6 months. The incidences of binary in-stent restenosis, in-segment restenosis, and target vessel failure (defined as acute and late-term MACE through 6 months postprocedure) were low (7.0%, 8.6%, and 14.3%, respectively). The Symbiot self-expanding ePTFE membrane-covered stent was associated with a high procedural success rate (97.4%), low incidences of MACE at 30 days (5.2%) and 6 months (14.3%), suggesting that it is safe and effective in the treatment of SVG disease.

  4. Treatment of carotid artery aneurysms with covered stents; Aneurysmabehandlung der Arteria carotis interna mit gecoverten Stents

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    Rohr, A.; Alfke, K.; Doerner, L.; Jansen, O. [UKSH Kiel (Germany). Neurochirurgie Neuroradiologie; Bartsch, T.; Stingele, R. [UKSH Kiel (Germany). Neurologie

    2007-10-15

    Purpose: Evaluation of the use of covered stents in treating pseudoaneurysms of the cervical and intracranial/extradural carotid artery and determination of the periprocedural and short- to mid-term complication rate. Materials and Methods: 8 patients with 9 spontaneous dissecting aneurysms of the cervical carotid artery - 5 of which were symptomatic - plus one patient with ofthalmoplegia due to an aneurysm of the cavernous carotid artery were studied. While the latter was treated with a PTFE-covered balloon-mounted stainless steel stent (Jostent/Graftmaster), a self-expanding PTFE-covered Nitonol Stent (Symbiot) was used in all other cases. Intervention was performed with local anesthesia. Aspirin and Clopidogrel were both used as antiplatelet drugs. Clinical signs and symptoms and vascular imaging with DS, MR, CT angiography and ultrasound were recorded during patient follow-up, with a mean follow-up period of 14.6 months (4 - 30). Results: We were able to treat 8 out of 10 aneurysms (80 %) using covered stents. The aneurysms were immediately occluded and the associated stenoses of the parent vessel were eliminated. No clinically relevant complications occurred during the procedure or in the follow-up interval. In two cases, elongation of the carotid artery prevented the stent from being positioned over the aneurysm neck. These cases were shown to be stable with the use of antiplatelet drugs. Conclusion: Covered stents can be used in the treatment of pseudoaneurysms of the carotid artery as an alternative to long-term antithrombotic medication or surgery. In our study treatment was effective (80 %) and free of complications in the short- and mid-term follow-up. Possible indications, technique and the use of imaging modalities for patient follow-up are discussed. (orig.)

  5. Sellado de aneurisma coronario con stent cubierto de PTFE (stent graft)

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    Portero Pérez,Ma Pilar; Ortas Nadal,Ma Rosario; Ruiz Arroyo,José Ramón; Escota Villanueva,Javier; Peleato Peleato,Antonio

    2008-01-01

    Los aneurismas coronarios son muy raros, su frecuencia oscila entre el 1 y el 2%, siendo la aterosclerosis la enfermedad más asociada, aunque se han descrito los de origen congénito, los asociados a la enfermedad de Kawasaki, a enfermedades del tejido conectivo, a enfermedades infecciosas y a traumatismos torácicos. También se observan los relacionados con la implantación del stent, con la braquiterapia intracoronaria y con los "stents" recubiertos de fármacos. Su evolución no es muy bien con...

  6. Usefulness of flexible covered stent in malignant colorectal obstruction

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    Kang, Jee Hee; Kang, Sung Gwon; Kim, Hyung Jin; Noh, Hong Gi; Woo, Jae Hong; Suh, Chang Hae [Inha Univ. Hospital, Inchon (Korea, Republic of)

    1998-07-01

    To evaluate the usefulness of flexible covered stent in the treatment of acute colorectal obstruction secondary to colorectal carcinoma. Materials and Methods : Flexible covered stents were placed in 11 patients with clinical and radiologic signs of acute colonic obstruction secondary to colorectal carcinoma. The purposes of stent insertion were pre-operative bowel preparation in seven patients and palliative treatment in four. A fistula was present in two;in one this was between the proximal jejunum and colon, and the other was rectovaginal. The usefulness of stent insertion for the purpose of preoperative bowel preparation was evaluated according to the feasibility and status of bowel preparation, as decided by the operator. Palliative treatment for the relief of symptoms of acute bowel obstruction was evaluated according to the number and amount of defecation,bowel dilatation in simple abdomen radiography, and the presence of complications. Results : Bowel preparation for the purpose of preoperative bowel cleansing was easy in seven patients;the fecal materials remaining in the colon presented no problems during surgery. In one of four patients palliative treatment involved a colostomy;this was due to recurrent stent obstruction by fecal materials after three months, and in two other patients there was stent obstruction after two and five months, respectively. The stent in one of four patients who underwent palliative treatment was removed because of stent migration three days after insertion;the stents in two patients with fistulas covered the fistulas successfully. Complications after stent insertion were anal pain in three patients, anal bleeding in three and stent migration in one. Conclusion : The flexible covered stent was an effective device for the relief of acute colonic obstruction secondary to malignant rectosigmoid neoplasia. It allowed for single-stage operation and covered the fistula. We believe however that for further evaluation of the

  7. Repair of an Atherosclerotic Coronary Artery Aneurysm by Implantation of a Coronary Covered Stent

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    Antenor Portela

    2002-05-01

    Full Text Available An atherosclerotic aneurysm of the right coronary artery complicated by a recent myocardial infarction was successfully treated with coronary artery stenting, using a device consisting of 2 stents with a layer of expandable polytetrafluorethylene (PTFE placed between them. A follow-up angiograph 5 months after the procedure showed sustained initial results.

  8. Endovascular retrieval of a prematurely deployed covered stent

    Institute of Scientific and Technical Information of China (English)

    Jefferson; T; Miley; Gustavo; J; Rodriguez; Ramachandra; P; Tummala

    2015-01-01

    Several techniques have been reported to address different endovascular device failures. We report the case of a premature deployment of a covered balloon mounted stent during endovascular repair of a posttraumatic carotid-cavernous fistula(CCF). A 50-year-old male suffered a fall resulting in loss of consciousness and multiple facial fractures. Five weeks later, he developed decreased left visual acuity, proptosis, chemosis, limited eye movements and cranial/orbit bruit. Cerebral angiography demonstrated a direct left CCF and endovascular repair with a 5.0 mm × 19 mm covered stent was planned. Once in the lacerum segment, increased resistance was encountered and the stent was withdrawn resulting in premature deployment. A 3 mm × 9 mm balloon was advanced over an exchange length microwire and through the stent lumen. Once distal to the stent, the balloon was inflated and slowly pulled back in contact with the stent. All devices were successfully withdrawn as a unit. The use of a balloon to retrieve a prematurely deployed balloon mounted stent is a potential rescue option if leaving the stent in situ carries risks.

  9. Balloon-expandable covered stent therapy of complex endovascular pathology.

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    Giles, Heath; Lesar, Christopher; Erdoes, Luke; Sprouse, Richard; Myers, Stuart

    2008-11-01

    The current study was designed to investigate our hypotheses that balloon-expandable covered stents display acceptable function over longitudinal follow-up in patients with complex vascular pathology and provide a suitable alternative for the treatment of recurrent in-stent restenosis. All stents were Atrium iCast, which is a balloon-mounted, polytetrafluoroethylene-covered stent with a 6F/7F delivery system. A retrospective review was performed of 49 patients with 66 stented lesions. Data were analyzed with life tables and t-tests. The most commonly treated vessels were the iliac (61%) and renal (24%) arteries. Indications for covered stent placement were unstable atheromatous lesions (50%), recurrent in-stent restenosis (24%), aneurysm (8%), aortic bifurcation reconstruction (7.5%), dissection (4.5%), endovascular aneurysm repair-related (4.5%), and stent fracture (1.5%). Patency was assessed by angiogram or duplex ultrasonography. The primary end point was patency and secondary end points were technical success and access-site complications. Mean follow-up was 13 months (range 1.5-25). The technical success rate was 97%. Unsuccessful outcomes were due to deployment error (n=1) and stent malpositioning (n=1). The cohort (n=64) 6- and 12-month primary patency rates were 96% and 84%, respectively. Twelve-month assisted primary patency was 98%. Iliac artery stents (n=38) had a primary patency of 97% at 6 months and 84% at 12 months with an assisted primary patency of 100% at 12 months. Renal artery stents (n=16) had a primary patency of 92% at 6 months and 72% at 12 months with an assisted primary patency of 92% at 6 and 12 months. Stents placed for recurrent in-stent restenosis (n=16) had a primary patency of 85%, assisted primary patency of 93%, and a 15% restenosis rate at 12 months. Specifically, stents placed for renal artery recurrent in-stent restenosis (n=10) had a primary patency of 73%, assisted primary patency of 82%, and a restenosis rate of 27%. The

  10. Covered metallic stents for the palliation of colovesical fistula.

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    Ahmad, Mukhtar; Nice, Colin; Katory, Mark

    2010-09-01

    Colovesical fistula is a distressing condition that is usually managed surgically. For some patients in whom surgery is not feasible, covered colonic stents offer palliation. We present two challenging cases with contrasting outcomes. The first case is a colovesical fistula secondary to malignancy with a successful outcome after stenting and the second a complex diverticular fistula with a poor outcome. From our limited experience, it is a useful technique but careful patient selection is essential to its safe application. There is little published experience of the use of these stents for colovesical fistula.

  11. DISCOVER: Dutch Iliac Stent trial: COVERed balloon-expandable versus uncovered balloon-expandable stents in the common iliac artery: study protocol for a randomized controlled trial

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    Bekken Joost A

    2012-11-01

    Full Text Available Abstract Background Iliac artery atherosclerotic disease may cause intermittent claudication and critical limb ischemia. It can lead to serious complications such as infection, amputation and even death. Revascularization relieves symptoms and prevents these complications. Historically, open surgical repair, in the form of endarterectomy or bypass, was used. Over the last decade, endovascular repair has become the first choice of treatment for iliac arterial occlusive disease. No definitive consensus has emerged about the best endovascular strategy and which type of stent, if any, to use. However, in more advanced disease, that is, long or multiple stenoses or occlusions, literature is most supportive of primary stenting with a balloon-expandable stent in the common iliac artery (Jongkind V et al., J Vasc Surg 52:1376-1383,2010. Recently, a PTFE-covered balloon-expandable stent (Advanta V12, Atrium Medical Inc., Hudson, NH, USA has been introduced for the iliac artery. Covering stents with PTFE has been shown to lead to less neo-intimal hyperplasia and this might lower restenosis rates (Dolmatch B et al. J Vasc Interv Radiol 18:527-534,2007, Marin ML et al. J Vasc Interv Radiol 7:651-656,1996, Virmani R et al. J Vasc Interv Radiol 10:445-456,1999. However, only one RCT, of mediocre quality has been published on this stent in the common iliac artery (Mwipatayi BP et al. J Vasc Surg 54:1561-1570,2011, Bekken JA et al. J Vasc Surg 55:1545-1546,2012. Our hypothesis is that covered balloon-expandable stents lead to better results when compared to uncovered balloon-expandable stents. Methods/Design This is a prospective, randomized, controlled, double-blind, multi-center trial. The study population consists of human volunteers aged over 18 years, with symptomatic advanced atherosclerotic disease of the common iliac artery, defined as stenoses longer than 3 cm and occlusions. A total of 174 patients will be included. The control group will undergo

  12. Coronary perforation and covered stents: An update and review

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    Mohammed Al-Mukhaini

    2011-01-01

    Full Text Available Coronary perforation is a rare complication of percutaneous coronary intervention. We present two different types of coronary intervention, but both ending with coronary perforation. However, these perforations were tackled successfully by covered stents. This article reviews the incidence, causes, presentation, and management of coronary perforation in the present era of aggressive interventional cardiology. Coronary perforations are classified as type I (extraluminal crater, II (myocardial or pericardial blushing, and III (contrast streaming or cavity spilling. Types I and II coronary perforations are caused by stiff or hydrophilic guidewires. Type I has a benign prognosis, whereas type II coronary perforations have the potential to progress to tamponade. Type III coronary perforations are caused by balloons, stents, or other intracoronary devices and commonly lead to cardiac tamponade necessitating pericardial drainage. However, type III perforations can be managed with covered stents without need for surgical intervention.

  13. Effect of Covered Metallic Stents Compared With Plastic Stents on Benign Biliary Stricture Resolution

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    Coté, Gregory A.; Slivka, Adam; Tarnasky, Paul; Mullady, Daniel K.; Elmunzer, B. Joseph; Elta, Grace; Fogel, Evan; Lehman, Glen; McHenry, Lee; Romagnuolo, Joseph; Menon, Shyam; Siddiqui, Uzma D.; Watkins, James; Lynch, Sheryl; Denski, Cheryl; Xu, Huiping; Sherman, Stuart

    2017-01-01

    IMPORTANCE Endoscopic placement of multiple plastic stents in parallel is the first-line treatment for most benign biliary strictures; it is possible that fully covered, self-expandable metallic stents (cSEMS) may require fewer endoscopic retrograde cholangiopancreatography procedures (ERCPs) to achieve resolution. OBJECTIVE To assess whether use of cSEMS is noninferior to plastic stents with respect to stricture resolution. DESIGN, SETTING, AND PARTICIPANTS Multicenter (8 endoscopic referral centers), open-label, parallel, randomized clinical trial involving patients with treatment-naive, benign biliary strictures (N = 112) due to orthotopic liver transplant (n = 73), chronic pancreatitis (n = 35), or postoperative injury (n = 4), who were enrolled between April 2011 and September 2014 (with follow-up ending October 2015). Patients with a bile duct diameter less than 6 mm and those with an intact gallbladder in whom the cystic duct would be overlapped by a cSEMS were excluded. INTERVENTIONS Patients (N = 112) were randomized to receive multiple plastic stents or a single cSEMS, stratified by stricture etiology and with endoscopic reassessment for resolution every 3 months (plastic stents) or every 6 months (cSEMS). Patients were followed up for 12 months after stricture resolution to assess for recurrence. MAIN OUTCOMES AND MEASURES Primary outcome was stricture resolution after no more than 12 months of endoscopic therapy. The sample size was estimated based on the noninferiority of cSEMS to plastic stents, with a noninferiority margin of −15%. RESULTS There were 55 patients in the plastic stent group (mean [SD] age, 57 [11] years; 17 women [31%]) and 57 patients in the cSEMS group (mean [SD] age, 55 [10] years; 19 women [33%]). Compared with plastic stents (41/48, 85.4%), the cSEMS resolution rate was 50 of 54 patients (92.6%), with a rate difference of 7.2% (1-sided 95% CI, −3.0% to ∞; P < .001). Given the prespecified noninferiority margin of −15%, the

  14. Infolding of covered stents used for aortic coarctation: report of two cases.

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    Wan, Andrea W; Lee, Kyong-Jin; Benson, Lee N

    2014-01-01

    Covered stents have been used for the treatment of aortic coarctation to protect the arterial wall during dilation. Early results have shown them to be safe and effective. We report two cases of infolding of the proximal edge of a covered aortic coarctation stent. Management required implantation of a second stent. Poor stent apposition to the vessel wall and/or recoil may allow conditions for these events to occur.

  15. A Novel Thin Film Nitinol Covered Neurovascular Stent Significantly Decreases Intra-Aneurysmal Flow In Vitro

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    Chun, Youngjae; Hur, Soojung; Shayan, Mahdis; Kealey, Colin; Levi, Daniel; Mohanchandra, Kp; di Carlo, Dino; Carman, Gregory

    2013-11-01

    A novel thin film nitinol (TFN) stent has been developed to promote aneurysm quiescence by diminishing flow across the aneurysm's neck. Laboratory aneurysm models were used to assess the flow changes produced by stents covered with different patterns of TFN. Flow diversion stents were constructed by covering Wingspan stents (Boston Scientific, DxL:4x20mm) with TFNs (i.e., 77 and 82 percent porosity). The flow changes that occur after deployment of two different porous TFN covered stent in intracranial aneurysm models were evaluated in vitro. The 82 percent porous TFN covered stent reduced the intra-aneurysmal mean flow velocity by 86.42 percent, while a 77 percent porous TFN covered stent reduced to intra-aneurysmal mean flow velocity to 93.44 percent compared to a nonstented model. Local wall shear rates were also significantly reduced in wide-neck aneurysm model (i.e., 97.52 - 98.92 percent) with TFN stent placement. The results showed that TFN covered stents significantly reduced intra-aneurysmal flow velocity magnitudes and local wall shear rates. This suggests that TFN covered stents with both 77 and 82 percent porosity have great potential to promote thrombosis in both wide-necked and fusiform aneurysm sacs.

  16. Bronchial stump fistula :treatment with covered retrievable hinged metallic stents-preliminary clinical experience

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    LI Yong-dong; HAN Xin-wei; WU Gang; LI Ming-hua

    2007-01-01

    Objective To evaluate the preliminaily clinical efficacy and retrievability of a retrievable hinged covered metallic stent in the treatment of the bronchial stump fistula (BSF). Methods Between April 2003 and March 2005, 8 patients with bronchial stump fistula after pneumonectomy or lobectomy were treated with two types (A and B) of retrievable hinged covered metallic stents. Type A stent was placed in 6 patients and type B in 2 under fluoroscopic guidance. The stent was removed with a retrieval set when BSF was healed or complications occurred. Results Stent placement in the bronchial tree was technically successful in all patients, without procedure-related complications. Immediate closure of the BSF was achieved in all patients after the procedure. Stents were removed from all patients but one. Removal of the stents was difficult in two patients due to tissue hyperplasia. Patients were followed up for 6 - 21 months. Placement of the stents remained stable in all patients except one due to severe cough. Permanent closure of BSF was achieved in 7(87.5%) of 8 patients. Conclusion Use of a retrievable hinged covered expandable metallic stent is a simple,safe, and effective procedure for closure of the BSF. Retrieval of the stent seems to be feasible. (J Intervent Radiol, 2007, 16: 253-257)[ Key words ] Fistula, pulmonary; Bronchialpleural fistula; Stents and prostheses; Computed tomography

  17. Biocompatibility of a new device of self-expandable covered and non-covered tracheal stent: comparative study in rats

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    Olavo Ribeiro Rodrigues

    2013-01-01

    Full Text Available PURPOSE: To investigate the compatibility of a new model of self-expandable tracheal stent in rats. METHODS: A new device of polyurethane covered and non - covered stent was placed in the trachea of Wistar rats. Animals were distributed in two groups: the polyurethane covered and non-covered group. Macroscopic parameters included position within the tracheal lumen, adherence to the mucosa, degree of dilatation, permeability and internal diameter. Microscopic findings evaluated were: incorporation, inflammatory activity, granulation tissue and epithelial revetment injuries. The observation follow-up was six weeks. All parameters were quantified based on determined score values. Incorporation of the stents was evaluated based on the observation if the stent was fixed into the trachea or if it could be removed. Degree of dilatation was performed by external diameter measurements. Granulation tissue was evaluated by measurements of height of the tissue growing into the tracheal lumen. RESULTS: 100% of non-covered stents had total attachment to mucosa and 100% of polyurethane covered type had adherence only. Regarding dilatation, granulation tissue, inflammatory activity and internal diameter measurements, there were no significant differences between the groups. Pathological tracheal wall injuries were present in both groups. CONCLUSION: Both models of stent demonstrated biocompatibility with the trachea. Rats are suitable for an experimental model of tracheal stent study.

  18. Temporary partially-covered metal stent insertion in benign esophageal stricture

    Institute of Scientific and Technical Information of China (English)

    Ying-Sheng Cheng; Ming-Hua Li; Wei-Xiong Chen; Ni-Wei Chen; Qi-Xin Zhuang; Ke-Zhong Shang

    2003-01-01

    AIM: To study the therapeutic efficacy of temporary partiallycovered metal stent insertion on benign esophageal stricture.METHODS: Temporary partially-covered metal stent was inserted in 83 patients with benign esophageal stricture. All the patients had various dysphagia scores.RESULTS: Insertion of 85 temporary partially-covered metal stents was performed successfully in 83 patients with benign esophageal stricture and dysphagia was effectively remitted in all the 83 cases. The dysphagia score was 3.20±0.63(mean±SD) and 0.68±0.31 before and after stent insertion,and 0.86±0.48 after stent removal. The mean diameter of the strictured esophageal lumen was 3.37±1.23 mm and 25.77±3.89 mm before and after stent insertion, and 16.15±2.96 mm after stent removal. Follow-up time was from 1 week to 96 months (mean 54.26±12.75 months). The complications were chest pain (n=37) after stent insertion,and bleeding (n=12) and reflux (n=13) after stent removal.CONCLUSION: Temporary partially-covered metal stent insertion is one of the best methods for treatment of benign esophageal stricture.

  19. Endovascular Treatment of Occlusive Lesions in the Aortic Bifurcation with Kissing Polytetrafluoroethylene-Covered Stents

    NARCIS (Netherlands)

    Grimme, Frederike A. B.; Spithoven, J. Hans; Zeebregts, Clark J.; Scharn, Dirk M.; Reijnen, Michel M. P. J.

    Purpose: To determine the clinical outcomes of polytetrafluoroethylene covered balloon expandable stents (CBESs) in occlusive lesions of the aortic bifurcation in a kissing stent configuration. Materials and Methods: The study included 69 consecutive patients (29 men, 40 women) who underwent kissing

  20. Endovascular Treatment of Occlusive Lesions in the Aortic Bifurcation with Kissing Polytetrafluoroethylene-Covered Stents

    NARCIS (Netherlands)

    Grimme, F.A.B.; Spithoven, J.H.; Zeebregts, C.J.A.; Scharn, D.M.; Reijnen, M.M.

    2015-01-01

    PURPOSE: To determine the clinical outcomes of polytetrafluoroethylene covered balloon expandable stents (CBESs) in occlusive lesions of the aortic bifurcation in a kissing stent configuration. MATERIALS AND METHODS: The study included 69 consecutive patients (29 men, 40 women) who underwent kissing

  1. Emergency and elective implantation of covered stent systems in iatrogenic arterial injuries

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    Goltz, J.P.; Kickuth, R. [Universitaetsklinikum Wuerzburg (Germany). Inst. fuer Roentgendiagnostik; Bastuerk, P.; Hoppe, H.; Triller, J. [Universitaetsspital Bern (Switzerland). Inst. fuer Diagnostische, Interventionelle und Paediatrische Radiologie

    2011-07-15

    Purpose: To evaluate the effectiveness and safety of covered stents for the management of iatrogenic arterial injury. Materials and Methods: Between 03/1998 and 12/2009, 31 patients underwent selective covered stent implantation after iatrogenic arterial injury. 12/31 of these patients (38.7 %) were hemodynamically unstable. Six different endovascular covered stent types were utilized. The primary endpoints of this study were technical and clinical success and rates of minor and major complications. Results: Initial angiograms demonstrated active extravasation in 19 (61.3 %) patients and pseudoaneurysms in 12 (38.7 %) patients. The following sites of bleeding origin were detected: axillary artery, subclavian artery, common iliac artery, external iliac artery, internal iliac artery, common femoral artery, superficial femoral artery, popliteal and fibular artery, femoro-popliteal and popliteo-crural bypasses, common hepatic artery, aberrant hepatic artery, cystic and gastroduodenal artery. In all patients bleeding was effectively controlled by covered stent implantation resulting in an immediate technical success of 100 %. Clinical success attributed to covered stent implantation was documented in 30 of the 31 patients (96.8 %). Major complications included death in four patients (11.1 %), acute thrombosis with arm ischemia in one patient (2.8 %) and stent fracture with associated pseudoaneurysm in another patient (2.8 %). In 2/31 patients (6.5 %) covered stent failure was detected and successfully treated by implantation of a second covered stent. Conclusion: Emergency and elective implantation of covered stents may be used for minimally invasive and effective management of iatrogenic arterial injury. (orig.)

  2. Outcomes of Prosthetic Hemodialysis Grafts after Deployment of Bare Metal versus Covered Stents at the Venous Anastomosis

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    Kim, Charles Y., E-mail: charles.kim@duke.edu; Tandberg, Daniel J.; Rosenberg, Michael D.; Miller, Michael J.; Suhocki, Paul V.; Smith, Tony P. [Duke University Medical Center, Division of Vascular and Interventional Radiology (United States)

    2012-08-15

    Purpose: To compare postintervention patency rates after deployment of bare metal versus covered stents across the venous anastomosis of prosthetic arteriovenous (AV) grafts. Methods: Review of our procedural database over a 6 year period revealed 377 procedures involving stent deployment in an AV access circuit. After applying strict inclusion criteria, our study group consisted of 61 stent deployments in 58 patients (median age 58 years, 25 men, 33 women) across the venous anastomosis of an upper extremity AV graft circuit that had never been previously stented. Both patent and thrombosed AV access circuits were retrospectively analyzed. Within the bare metal stent group, 20 of 32 AV grafts were thrombosed at initial presentation compared to 18 of 29 AV grafts in the covered stent group. Results: Thirty-two bare metal stents and 29 covered stents were deployed across the venous anastomosis. The 3, 6, and 12 months primary access patency rates for bare metal stents were not significantly different than for covered stents: 50, 41, and 22 % compared to 59, 52, and 29 %, respectively (p = 0.21). The secondary patency rates were also not significantly different: 78, 78, and 68 % for bare metal stents compared to 76, 69, and 61 % for covered stents, respectively (p = 0.85). However, covered stents demonstrated a higher primary stent patency rate than bare metal stents: 100, 85, and 70 % compared to 75, 67, and 49 % at 3, 6, and 12 months (p < 0.01). Conclusion: The primary and secondary access patency rates after deployment of bare metal versus covered stents at the venous anastomosis were not significantly different. However, bare metal stents developed in-stent stenoses significantly sooner.

  3. Telescoping Dual Covered Stent Graft Construct for Endovascular Treatment of a Giant Extracranial Carotid Artery Pseudoaneurysm.

    Science.gov (United States)

    Ding, Dale; Starke, Robert M; Moriarty, Maurice; Brew, Stefan

    2016-12-01

    Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA) pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA) bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA). The patient underwent endovascular intervention, during which a balloon-expandable covered stent was deployed within a heparin-bonded covered stent, such that the overall construct spanned from the CCA to the lower cervical ICA. The employment of a telescoping dual covered stent technique can successfully treat appropriately selected patients with large or giant ECCA pseudoaneurysms, with the concomitant goals of excluding the pseudoaneurysm and restoring the luminal caliber of the parent artery.

  4. Endovascular Treatment of Occlusive Lesions in the Aortic Bifurcation with Kissing Polytetrafluoroethylene-Covered Stents.

    Science.gov (United States)

    Grimme, Frederike A B; Spithoven, J Hans; Zeebregts, Clark J; Scharn, Dirk M; Reijnen, Michel M P J

    2015-09-01

    To determine the clinical outcomes of polytetrafluoroethylene covered balloon expandable stents (CBESs) in occlusive lesions of the aortic bifurcation in a kissing stent configuration. The study included 69 consecutive patients (29 men, 40 women) who underwent kissing stent procedures with CBESs between January 2003 and April 2009 in a single center. Patients who were previously treated with a CBES were excluded. Follow-up consisted of clinical investigation and duplex ultrasound examination. The primary patency was 88.1% at 1 year and 71.5% at 4 years, with secondary patency rates of 88.1% and 75.3%, respectively. For patients receiving a stent for the first time, primary patency was 91.3% at 1 year and 77.1% at 4 years. For patients who had received previous stents, patency was 83.6% at 1 year and 65.2% at 4 years (P = .83). There were no differences in secondary patency and freedom from target lesion reintervention (TLR). Loss of primary patency was mainly caused by stent occlusions (14 cases [78%]). The freedom from TLR at 4 years was 76.8%. Patency rates and freedom from TLR of CBESs in the kissing stent configuration with up to 4 years of follow-up were satisfying and mainly affected by stent occlusions. Studies focusing on optimizing stent configuration and medical care to reduce the incidence of thrombosis are indicated to improve results further. Copyright © 2015 SIR. Published by Elsevier Inc. All rights reserved.

  5. Management of airway involvement of oesophageal cancer using covered retrievable nitinol stents

    Energy Technology Data Exchange (ETDEWEB)

    Lee, K.E. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Shin, J.H. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)], E-mail: jhshin@amc.seoul.kr; Song, H.Y. [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Kim, S.B. [Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Kim, K.R.; Kim, J. Hyoung [Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2009-02-15

    Aim: To assess the efficacy and safety of covered retrievable nitinol stents in oesophageal cancer patients with airway involvement. Materials and methods: Under fluoroscopic guidance, covered retrievable nitinol airway stents were placed in 23 oesophageal cancer patients with airway stricture and/or oesophagorespiratory fistula (ERF) over a long period of 12 years. Six patients only had aspiration by ERF and three patients had both airway stricture and asymptomatic ERF. Technical aspects, dyspnoea improvement, and/or resolution of ERF symptoms, complications, reinterventions, and survival data were evaluated. Results: A total of 27 airway stents (14 tracheal, 11 bronchial, and two hinged) were placed successfully in 23 patients with airway stricture or ERF. Dyspnoea score decreased significantly after stent placement (p < 0.001). ERF were sealed off in all nine patients. Complications included stent migration or expectoration (n = 4), haemoptysis (n = 2), sputum retention (n = 7), and tumour overgrowth (n = 1). All three migrated stents were easily removed. Twenty-one patients died, with the median survival period of 76 days (range 2-197 days). Conclusion: Placement of covered retrievable expandable nitinol stents was safe and effective for the palliative treatment of airway strictures and/or ERF, with a reasonable range of complications, in patients with advanced oesophageal cancer.

  6. Early and long-term clinical and radiological follow-up results of expanded-polytetrafluoroethylene-covered stent-grafts for transjugular intrahepatic portosystemic shunt procedures

    Energy Technology Data Exchange (ETDEWEB)

    Maleux, Geert; Heye, Sam; Thijs, Maria; Wilms, Guy [University Hospitals Gasthuisberg, Department of Radiology, Leuven (Belgium); Nevens, Frederik; Verslype, Chris [University Hospitals Gasthuisberg, Department of Hepatology, Leuven (Belgium); Wilmer, Alexander [University Hospitals Gasthuisberg, Department of Medical Intensive Care Unit, Leuven (Belgium)

    2004-10-01

    of TIPS can be obtained long-term after implantation of an e-PTFE-covered stent-graft, leading to a definitive resolution of portal hypertension-related complications. The incidence of TIPS-induced hepatic encephalopathy is acceptable. (orig.)

  7. Elective implantation of covered stents for coarctation and recoarctation in adolescents and adults.

    Science.gov (United States)

    Alcibar, Juan; Blanco, Roberto; Fernandez, Luis; Arriola, Josune; Garcia, Koldobika; Peña, Natividad; Inguanzo, Ramón; Voces, Roberto; Castellanos, Enrique; Montes, Pedro M

    2013-06-01

    Stent implantation is an effective therapy for aortic coarctation and recoarctation. However, in adolescents and adults, aortic wall rupture and dissection can occur, as well as aneurysms during follow-up. In order to reduce these complications, we electively implant covered stents. Since 2005, we have performed the procedure using femoral access in 17 patients (2 adolescents and 15 adults), 16 electively and 1 as a rescue procedure. We used the Mullins technique in all cases, implanting a NuMED(®) covered stent. Good stent apposition was achieved in all 17 procedures; 8 patients required a distal flare. Gradient was reduced from 40 (16) mmHg to 2 (2) mmHg (P<.001) and lumen diameter increased from 4 (2) mm to 19 (3) mm (P<.001). Two exceptional cases are discussed: one patient with aortic wall rupture who underwent a rescue procedure using a stent within a covered stent and another patient with total obstruction and intercostal aneurysm in whom the outcome was fatal at 48 h postprocedure (autopsy is shown). Four-year clinical follow-up included Doppler echocardiography; an additional imaging technique was required in 13 patients. All patients recovered well and there were no complications. Covered stents are effective in treating coarctation and recoarctation in adolescents and adults, are the treatment of choice in patients with complex anatomy, and must be available in the operating room as a rescue device when implanting a conventional stent. Copyright © 2012 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  8. The role of superficial femoral artery endoluminal bypass in long de novo lesions and in-stent restenosis.

    NARCIS (Netherlands)

    Doomernik, D.E.; Golchehr, B.; Lensvelt, M.M.A.; Reijnen, M.M.P.J.

    2012-01-01

    AIM: Results of endovascular treatment for long de novo lesions of the superficial femoral artery (SFA) are limited by in-stent restenosis (ISR). Polytetrafluoroethylene (PTFE) covered stents are developed to reduce the incidence of ISR. This study was conducted to summarize available data on the us

  9. Partially uncovered Cheatham platinum-covered stent to treat complex aortic coarctation associated with aortic wall aneurysm.

    Science.gov (United States)

    Butera, Gianfranco; Piazza, Luciane

    2015-04-01

    Percutaneous treatment of aortic coarctation is a widely used option. Covered stents have increased the profile of efficacy and safety of this procedure. Here we report on a 32-year-old woman with significant aortic recoarctation associated with aortic wall aneurysm and close proximity of both lesions to the origin of both the subclavian arteries. It was decided to manually and partially uncover the proximal part of the stent to have a hybrid stent that could act as a bare stent at the level of the origin of the subclavian arteries and as a covered stent at the level of the aneurysm.

  10. Sealing of Airway Fistulas for Metallic Covered Z-type Stents

    Directory of Open Access Journals (Sweden)

    Hongwu WANG

    2011-08-01

    Full Text Available Background and objective Treating airway fistulas, including esophagorespiratory fistulas (ERFs, bronchopleural fistulas (BPFs, and tracheomediastinal fistulas (TMFs, is difficult. The aim of this study is to evaluate the safety and clinical efficacy of metallic covered Z-type stents (CZTS for the treatment of airway fistulas through bronchoscopy or fluroscopy. Methods Thirty-eight patients with fistulas between the esophagus, mediastina, and airways (32 ERFs, 5 BPFs, and 1 TMF were retrospectively reviewed after treatment with covered metallic esophageal and airway stents. The fistulas were caused by esophageal (n=26, bronchogenic (n=11, and thyroid (n=1 carcinomas. Results Forty-six fistulas were found in 38 patients. The fistula size ranged from 0.5 cm to 7.0 cm. Forty airway covered metal stents (24 Y-type, 8 L-type, and 8 I-type and 24 esophageal metal stents were placed. Complete responses to the sealing effects of fistulas were noted in 4.3% of all the fistulas, 60.9% showed complete clinical responses, 23.9% showed partial responses, and 10.9% showed no response. An effectivity rate of 89.1% was observed, and the median survival duration of all patients was 5 months. Conclusion The use of CZTS appears to be safe and feasible for the palliative treatment of ERFs, BPFs, and TMFs. Airway stent placement is recommended for patients with ERF. In the event that airway stents fail, esophageal stents should be given. Airway bifurcation stents were observed to be especially suitable for the sealing of fistulas near the trachea carina.

  11. Fabrication of a silver particle-integrated silicone polymer-covered metal stent against sludge and biofilm formation and stent-induced tissue inflammation

    Science.gov (United States)

    Lee, Tae Hoon; Jang, Bong Seok; Jung, Min Kyo; Pack, Chan Gi; Choi, Jun-Ho; Park, Do Hyun

    2016-01-01

    To reduce tissue or tumor ingrowth, covered self-expandable metal stents (SEMSs) have been developed. The effectiveness of covered SEMSs may be attenuated by sludge or stone formation or by stent clogging due to the formation of biofilm on the covering membrane. In this study, we tested the hypothesis that a silicone membrane containing silver particles (Ag-P) would prevent sludge and biofilm formation on the covered SEMS. In vitro, the Ag-P-integrated silicone polymer-covered membrane exhibited sustained antibacterial activity, and there was no definite release of silver ions from the Ag-P-integrated silicone polymer membrane at any time point. Using a porcine stent model, in vivo analysis demonstrated that the Ag-P-integrated silicone polymer-covered SEMS reduced the thickness of the biofilm and the quantity of sludge formed, compared with a conventional silicone-covered SEMS. In vivo, the release of silver ions from an Ag-P-integrated silicone polymer-covered SEMS was not detected in porcine serum. The Ag-P-integrated silicone polymer-covered SEMS also resulted in significantly less stent-related bile duct and subepithelium tissue inflammation than a conventional silicone polymer-covered SEMS. Therefore, the Ag-P-integrated silicone polymer-covered SEMS reduced sludge and biofilm formation and stent-induced pathological changes in tissue. This novel SEMS may prolong the stent patency in clinical application. PMID:27739486

  12. Indications and immediate and long-term results of a novel pericardium covered stent graft: Consecutive 5 year single center experience.

    Science.gov (United States)

    Secco, Gioel Gabrio; Serdoz, Roberta; Kilic, Ismail Dogu; Caiazzo, Gianluca; Mattesini, Alessio; Parisi, Rosario; De Luca, Giuseppe; Pistis, Gianfranco; Marino, Paolo Nicola; Di Mario, Carlo

    2016-03-01

    The use of covered stent grafts during percutaneous coronary intervention (PCI) is a life saving solution to seal acute iatrogenic vessel rupture. However, the presence of an impenetrable mechanical barrier is also appealing during treatment of friable coronary plaques but the synthetic PTFE-membrane that might trigger excessive neointimal proliferation has limited its elective-use. Pericardium tissue may offer an appealing "natural" alternative. Aim of our study is to report the consecutive 5-year single center experience with the use of pericardium-covered stents (PCS) (ITGI-Medical, Israel) in a variety of emergency and elective applications. Nineteen consecutive patients undergoing implantation of PCS at the Royal Brompton in the last 5-years. Reasons for PCS implantation included treatment of degenerated vein grafts, large coronary aneurysms, and acute iatrogenic vessel rupture. Angiographic success, defined as the ability of the device to be deployed in the indexed lesion with no contrast extravasation with residual angiographic stenosis <30% and a final thrombolysis in myocardial infarction (TIMI)-3 flow was achieved in all cases. Procedural success, defined as the achievement of angiographic success without any major adverse cardiovascular event (MACE) was achieved in 94.7% of patients. In-stent restenosis (ISR) was observed in 26.3% and all patients underwent successful target vessel revascularization with DES (mean time to restenosis 9.0 ± 4.0 months). At a mean follow-up of 32.5 ± 23.3 months no acute or late stent thrombosis was observed. PCSs were effective in the treatment of friable embolization-prone coronary plaques, sealing of acute iatrogenic vessel rupture and exclusion of large aneurysms with no thrombosis but high target lesion revascularization. © 2015 Wiley Periodicals, Inc.

  13. Magnesium alloy covered stent for treatment of a lateral aneurysm model in rabbit common carotid artery: An in vivo study

    Science.gov (United States)

    Wang, Wu; Wang, Yong-Li; Chen, Mo; Chen, Liang; Zhang, Jian; Li, Yong-Dong; Li, Ming-Hua; Yuan, Guang-Yin

    2016-11-01

    Magnesium alloy covered stents have rarely been used in the common carotid artery (CCA). We evaluated the long-term efficacy of magnesium alloy covered stents in a lateral aneurysm model in rabbit CCA. Magnesium alloy covered stents (group A, n = 7) or Willis covered stents (group B, n = 5) were inserted in 12 New Zealand White rabbits and they were followed up for 12 months. The long-term feasibility for aneurysm occlusion was studied through angiograms; the changes in vessel area and lumen area were assessed with IVUS. Complete aneurysmal occlusion was achieved in all aneurysms. Angiography showed that the diameter of the stented CCA in group A at 6 and 12 months was significantly greater than the diameter immediately after stent placement. On intravascular ultrasound (IVUS) examination, the mean lumen area of the stented CCA in group A was significantly greater at 6 and 12 months than that immediately after stent placement; the mean lumen area was also significantly greater in group A than in group B at the same time points. The magnesium alloy covered stents proved to be an effective approach for occlusion of lateral aneurysm in the rabbit CCA; it provides distinct advantages that are comparable to that obtained with the Willis covered stent.

  14. Microvascular Coronary Flow Comparison in Acute Myocardial Infarction Angioplasty treated with a mesh covered stent (MGUARD Stent) versus Bare Metal Stent

    Energy Technology Data Exchange (ETDEWEB)

    Lindefjeld, Dante S., E-mail: dslindef@puc.cl [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Guarda, Eduardo [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Méndez, Manuel [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Martínez, Alejandro [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Pérez, Osvaldo [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Hospital Dr. Sótero del Río, Santiago-Chile (Chile); Fajuri, Alejandro; Marchant, Eugenio [Hospital Clínico, Pontificia Universidad Católica de Chile (Chile); Aninat, Mauricio; Torres, Humberto [Hospital Dr. Gustavo Fricke, Viña del Mar-Chile (Chile); Dussaillant, Gastón [Hospital Clínico Universidad de Chile, Santiago-Chile (Chile)

    2013-01-15

    Background: Distal embolization of thrombus/platelet aggregates decreases myocardial reperfusion during primary percutaneous coronary intervention (PCI), and is associated with worse immediate and long-term prognosis of patients with ST-elevation myocardial infarction (STEMI). Objective: Assess the efficacy of a mesh covered stent (MGuard™ stent, MGS) in preventing distal embolization and microvascular reperfusion impairment during primary PCI, compared with a bare metal stent (BMS). Methods: Forty patients with STEMI referred for primary PCI were randomized for stenting the culprit lesion with the MGS (n = 20) or a BMS (n = 20). Blinded experts performed off-line measurements of angiographic epicardial and microvascular reperfusion criteria: TIMI flow grade, myocardial blush, corrected TIMI frame count (cTFC). Results: At baseline clinical, angiographic and procedural variables were not different between groups. Post PCI TIMI flow grade was similar in both groups. We observed better myocardial Blush grade in group MGS compared to BMS (median value 3.0 vs 2.5, 2p = 0.006) and cTFC (mean cTFC: MGS 19.65 ± 4.07 vs BMS 27.35 ± 7.15, 2p < 0.001, cTFC mean difference MGS-BMS: 7.7, CI 95%: 3.94 to 11.46). MGS stent group had a higher percentage of successful angioplasty (cTFC ≤ 23: MGS 85% vs BMS 30%, 2p < 0.001). We had two cases of acute stent thrombosis (one for each group) at 30 days follow up, but no clinical events at 6 months follow up. Conclusions: In this exploratory study, MGS significantly improved microvascular reperfusion criteria compared with a BMS in primary PCI. However its safety and impact on clinical outcomes should be verified in larger randomized clinical trials.

  15. Bayesian network meta-analysis of nitinol stents, covered stents, drug-eluting stents, and drug-coated balloons in the femoropopliteal artery.

    Science.gov (United States)

    Katsanos, Konstantinos; Spiliopoulos, Stavros; Karunanithy, Narayan; Krokidis, Miltiadis; Sabharwal, Tarun; Taylor, Peter

    2014-04-01

    Several randomized controlled trials (RCTs) have shown the superiority of some of these technologies over balloon angioplasty, but direct comparisons between these treatment options are lacking. The authors conducted a network meta-analysis of RCTs comparing bare nitinol stents, covered nitinol stents, paclitaxel- or sirolimus-eluting stents (PES or SES), and paclitaxel-coated balloons (PCB) with plain balloon angioplasty or with each other in the femoropopliteal artery (PROSPERO registry: CRD42013004845). Sixteen RCTs comprising 2532 patients with 4227 person-years of follow-up were analyzed on an intention-to-treat basis. Bayesian random effects Poisson and binomial models were used for mixed treatment comparisons (WinBUGS). Clinical heterogeneity was accounted for by incorporating a meta-regression model on trial-specific baseline risk. End points included technical success, vascular restenosis, target lesion revascularization, and major amputations. Pairwise odds ratios and rate ratios (ORs and RRs) of absolute treatment effects were calculated, and the probabilities of each treatment being best are reported. Summary estimates are reported as the posterior median and associated credible intervals (CrIs) that serve the same purpose as confidence intervals in the context of the Bayesian framework. Extensive sensitivity, meta-regression, and network consistency analyses were performed to evaluate heterogeneity. Technical success was highest with covered stents (pooled OR, 13.6; 95% CrI, 3.3-31.1, probability best 82%) followed by uncovered stents (pooled OR, 7.0; 95% CrI, 2.6-129, probability best 18%) when compared with balloon angioplasty (reference treatment). Vascular restenosis was lowest with PES (RR, 0.43; 95% CrI, 0.16-1.18, probability best 45%) followed by PCB (RR, 0.43; 95% CrI, 0.26-0.67, probability best 42%). Target lesion revascularization was lowest with PCB (RR, 0.36; 95% CrI, 0.23-0.55, probability best 56%) followed by PES (RR, 0.42; 95% CrI, 0

  16. Efeitos a curto prazo de "stents" não recobertos e recobertos com politetrafluoroetileno em aorta de suínos: um modelo experimental Short-term effects of polytetrafluoroethylene covered and uncovered metallic "stents" in pig aorta: an experimental model

    Directory of Open Access Journals (Sweden)

    Marco Aurélio Grüdtner

    2004-04-01

    Full Text Available OBJETIVO: Descrever um estudo experimental avaliando através da morfometria digital o espessamento intimal na parede arterial após o implante de "stents" metálicos auto-expansíveis recobertos ou não com politetrafluoroetileno (PTFE na aorta de suínos. MÉTODOS: Em três grupos de suínos jovens uma bainha introdutora de 12 F foi inserida na aorta abdominal distal. Os animais do grupo I (n=5 foram considerados controle. Os animais do grupo II (n=10 receberam o implante de um stent metálico auto-expansível não recoberto. No grupo III (n=10 um stent auto-expansível recoberto com PTFE foi inserido. Após quatro semanas os animais foram sacrificados e os espécimes arteriais foram retirados, sendo o espessamento intimal quantificado pela análise morfométrica. RESULTADOS: Na comparação entre os grupos I, II e III quanto às áreas da íntima, média e índice intimal, não foi observada variação estatisticamente significativa. Diferenças foram observadas entre os grupos em relação às áreas luminais proximais (p=0,0036 e distais (p=0,044. Através dos testes de comparação múltipla para Kruskal-Wallis foi identificada uma diferença entre os grupos I e II. Entretanto, quando essas variáveis foram controladas pelo fator peso (relação área luminal/peso, a diferença não foi mais observada. CONCLUSÕES: Nesse estudo a curto prazo, o revestimento de PTFE não esteve associado a adicional espessamento intimal além daquele promovido pelo dispositivo metálico em artérias de grande calibre e condições de alto fluxo.PURPOSE: To report an experimental study evaluating, through digital morphometry, the intimal thickening of the arterial wall after the implant of auto-expandable stainless steel stents covered or not with polytetrafluoroethylene (PTFE in the pig aorta. METHODS: In three groups of pigs a 12 F sheath was inserted in distal abdominal aorta. Group I animals (n=5 served as control. Group II animals (n=10 received an auto

  17. Fully-covered metallic stenting in an infant with tracheoesophageal fistula due to button battery ingestion.

    Science.gov (United States)

    Zhang, Zhongxiao; Ma, Jing; Liu, Shuaishuai; Liu, Xia; Yan, Xiuli; Niu, Tiehuan; Li, Changxiao; Li, Qian; Wang, Chao; Meng, Chen

    2017-04-01

    Previously, the main treatment options for tracheoesophageal fistula included surgery and conservative treatment. Herein, we report a child suffering from severe tracheoesophageal fistula due to button battery ingestion. The child relapsed soon after a repair surgery. Then, he was endotracheally implanted with a fully-covered metallic stent combined with a jejunal tube feeding. He recovered soon and the stent was removed five months later. The fistula was healed with no relapse during a 25-month follow-up. Therefore, endotracheal implantation of fully-covered metallic stent is an alternative treatment for tracheoesophageal fistula due to button battery ingestion, especially in cases with severe respiratory disorders. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. A fully-covered stent (Alimaxx-E) for the palliation of malignant dysphagia: a prospective follow-up study

    NARCIS (Netherlands)

    M.J. Uitdehaag; J.E. van Hooft; E.M.L. Verschuur; A. Repici; E.W. Steyerberg; P. Fockens; E.J. Kuipers; P.D. Siersema

    2009-01-01

    Background: The majority of the Currently available metal stents are partially covered to reduce migration risk. However, one of the remaining issues is tissue ingrowth through the uncovered stent parts. Objective: To determine efficacy, recurrent dysphagia, and complications of a fully covered sten

  19. Telescoping dual covered stent graft construct for endovascular treatment of a giant extracranial carotid artery pseudoaneurysm

    Directory of Open Access Journals (Sweden)

    Dale Ding

    2016-01-01

    Full Text Available Large pseudoaneurysms which compress the parent vessel are challenging lesions to successfully treat with endovascular therapy. We describe the endovascular treatment of a giant extracranial carotid artery (ECCA pseudoaneurysm resulting in substantial mass effect on the common carotid artery (CCA bifurcation using a telescoping dual covered stent graft construct. A 56-year-old male was diagnosed with an 8.5 cm × 13 cm pseudoaneurysm arising from the left CCA bifurcation, which was causing luminal narrowing of the CCA and proximal internal carotid artery (ICA. The patient underwent endovascular intervention, during which a balloon-expandable covered stent was deployed within a heparin-bonded covered stent, such that the overall construct spanned from the CCA to the lower cervical ICA. The employment of a telescoping dual covered stent technique can successfully treat appropriately selected patients with large or giant ECCA pseudoaneurysms, with the concomitant goals of excluding the pseudoaneurysm and restoring the luminal caliber of the parent artery.

  20. Removal of retrievable self-expandable urethral stents: experience in 58 stents

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon; Song, Ho-Young; Kim, Jin Hyoung; Ko, Heung-Kyu; Kim, Yong Jae; Woo, Chul-Woong; Kim, Tae-Hyung; Ko, Gi-Young; Yoon, Hyun-Ki; Sung, Kyu-Bo [Asan Medical Center, Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Seoul (Korea); Park, Hyungkeun [Asan Medical Center, Department of Urology, University of Ulsan College of Medicine, Seoul (Korea)

    2006-09-15

    The purpose of this study was to retrospectively evaluate the safety and efficacy of removing retrievable self-expandable urethral stents using a retrieval hook wire. Under fluoroscopic guidance, the removal of 58 polyurethane or PTFE (polytetrafluoroethylene)-covered stents was attempted in 33 patients using a retrieval hook wire. Indications for removal were elective removal (n=21), stent migration (n=19), formation of tissue hyperplasia around or inside of the stent (n=14), stent deformity (n=3), and severe pain (n=1). The mean time the stents remained in place was 64.8{+-}42.9 days (range, 1-177 days). Fifty-six (97%) of the 58 stents were successfully removed using the retrieval hook wire despite the following difficulties; hook wire disconnection (n=2), untied drawstrings (n=3), and polyurethane membrane disruption/separation (n=4). The removal procedure using a retrieval hook wire failed in two stents (3%) which had migrated into the urinary bladder. One of the two stents with migration into the urinary bladder was removed using a snare through the cystostomy route. The overall complication rate was 14% (seven hematuria cases and one urethral tear case), and all were minor and spontaneously resolved without further treatment. In conclusion, removal of retrievable urethral stents using a retrieval hook wire was safe and effective despite some technical difficulties. It is a useful method for allowing temporary stent placement and solving various complications of stent use. (orig.)

  1. A newly designed Y-shaped covered stent in the palliative treatment of hepatic hilar malignant obstruction: Case report

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Byung Chul; Lee, So Won [Dept. of Radiology, Mokdong Hospital, Ewha Womans University College of Medicine, Seoul (Korea, Republic of); Chung, Hwan Hoon [Dept. of Radiology, Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of)

    2013-01-15

    We report a case in an inoperable patient with the hilar malignant biliary obstruction treated palliatively by the use of a newly designed Y-shaped covered stent without interfering contra-lateral bile duct. We percutaneously inserted a newly designed Y-shaped covered stent into a biliary tree in an inoperable patient with Bismuth Type II cholangiocarcinoma. We checked tubograms, enhanced CT studies, and blood bilirubin levels before, one week after, and at every three month after the stenting, by observing closely the signs of clinical infection as well. The follow-up period was about 12 months. The placement of the Y-shaped covered stent was successful and resulted in adequate biliary drainage in the immediate post-procedural tubogram and in the follow-up abdominal CT. The serum bilirubin levels did not show elevation after the insertion of the Y-shaped covered stent.

  2. Covered self-expandable metallic stent placement for a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Woon Ha; Jung, Gyoo Sik; Kim, Kyu Jong; Lee, Sang Ho [Gospel Hospital, College of Medicine, Kosin University, Busan (Korea, Republic of); Ko, Ji Ho [Masan Samsung Medical Center, Sungkyunkwan University School of University, Masan (Korea, Republic of); Jeong, Kyung Soon [University of Ulsan Colleg of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-09-15

    To evaluate the technical feasibility and clinical effectiveness of stent placement for the treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer. Under fluoroscopic guidance, one or two covered stents were placed in 20 consecutive patients (age range, 44-75 years) with an anastomotic stricture due to a recurrent gastric malignancy. Before stent placement, all patients had severe nausea and recurrent vomiting after ingestion. Stent placement was technically successful for all patients, and no procedural complications occurred. After stent placement, 18 of 20 (90.0%) patients were able to ingest at least a liquid diet and had a markedly decreased incidence of vomiting. During the follow-up of 2-116 weeks (mean, 25.5 weeks), stent migration occurred in two patients (10.0%) on one day after the procedure. All patients with stent migration were treated successfully by means of placing a second stent. Three patients showed a recurrence of the stricture due to tumor overgrowth; two of the patients were treated with coaxial placement of a second stent. Another patient refused additional management. Covered self-expandable metallic stent placement seems to be technically feasible and effective for palliative treatment of a post-operative malignant anastomotic stricture secondary to recurrent gastric cancer.

  3. Role of Fully Covered Self-Expandable Metal Stent for Treatment of Benign Biliary Strictures and Bile Leaks

    Energy Technology Data Exchange (ETDEWEB)

    Pausawasadi, Nonthalee [Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok (Thailand); Soontornmanokul, Tanassanee; Rerknimitr, Rungsun [Department of Medicine, Chulalongkorn University, Bangkok (Thailand)

    2012-02-15

    Endoscopic therapy by balloon dilation and placement of multiple large-bore plastic stents is the treatment of choice for benign biliary stricture. This approach is effective but it typically requires multiple endoscopic sessions given the short duration of stent patency. The endoscopic approach for treatment of bile leak involves the placement of a stent with or without biliary sphincterotomy. The self-expandable metal stent (SEMS) has traditionally been used for palliation of malignant biliary strictures given the long duration of stent patency owing to their larger stent diameter. Recently, SEMS has been used in a variety of benign biliary strictures and leaks, especially with the design of the covered self-expandable metal stent (CSEMS), which permits endoscopic-mediated stent removal. The use of CSEMS in benign biliary stricture could potentially result in a decrease in endoscopic sessions and it is technically easier when compared to placement of multiple plastic stents. However, complications such as cholecystitis due to blockage of cystic duct, stent migration, infection and pancreatitis have been reported. The potential subsegmental occlusion of contralateral intrahepatic ducts also limits the use of CSEMS in hilar stricture. Certain techniques and improvement of stent design may overcome these challenges in the future. Thus, CSEMS may be appropriate in only highly selected conditions, such as refractory benign biliary stricture, despite multiple plastic stent placement or difficult to treat bile duct stricture from chronic pancreatitis, and should not be used routinely. This review focuses on the use of fully covered self-expandable metal stent for benign biliary strictures and bile leaks.

  4. Combined Placement of Covered Self-Expanding Metallic Stents and Nasojejunal Tube for Managing Large Lower Esophageal Perforations.

    Science.gov (United States)

    Rana, Surinder S; Gupta, Rajesh; Dahiya, Divya; Behera, Arunanshu; Bhasin, Deepak K

    2014-02-01

    Covered self-expanding metallic stents (cSEMSs) have emerged as effective treatment option for esophageal perforations. However, the large lower esophageal perforations where the cSEMS is placed across gastroesophageal junction have lower healing rates because refluxed gastric contents constantly irritate perforation and also there is increased risk of stent migration. Moreover, gastric mucosa tends to prolapse into lumen of lower end of stent causing its obstruction, leading to seepage of saliva and fluids from upper end of stent even in the patients who are on parenteral nutrition. We present our experience of a novel technique of combined cSEMS and nasojejunal tube (NJT) placement in four patients (two males) with benign large lower esophageal perforations. The NJT was placed through the stent into the jejunum through which patients were given enteral feeding. The stents were placed 5 - 21 days after esophageal perforation with the size of perforation ranging from 4 to 6 cm. As the NJT formed a loop in stomach, it prevented migration of stent. And also its presence in lumen of stent prevented its obstruction by prolapsing gastric mucosa, thereby preventing seepage of saliva and fluids from side of stent. Both stents and NJT were removed after 6 weeks and leak closed in all patients. Combined cSEMS and NJT placement seems to be safe and effective for treating large lower esophageal perforations. NJT placement seems to decrease risk of migration, prevents seepage of fluids and permits early enteral nutrition, thereby improving the healing rates.

  5. Influence of a dexamethasone-eluting covered stent on tissue reaction: an experimental study in a canine bronchial model

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Ji Hoon; Song, Ho-Young; Choi, Gi Bok; Kim, Tae-Hyung; Suh, Ji-Yeon [University of Ulsan College of Medicine, Department of Radiology, Asan Medical Center, Seoul (Korea); Seo, Tae-Seok [Gachon Medical School, Department of Radiology, Gil Medical Center, Inchon (Korea); Yuk, Soon Hong [Hannam University, Department of Polymer Science and Engineering, College of Engineering, Daejeon (Korea); Kim, Young-Hwa [Soonchunhyang University Chonan Hospital, Department of Radiology, Chonan (Korea); Cho, Yong-Mee [University of Ulsan College of Medicine, Department of Pathology, Asan Medical Center, Seoul (Korea)

    2005-06-01

    This study was designed to evaluate the feasibility and efficacy of a dexamethasone (DXM)-eluting, covered, self-expanding metallic stent to reduce tissue reaction following stent placement in a canine bronchial model. We placed a DXM-eluting, polyurethane-covered, self-expanding metallic stent (drug stent, DS) and a polyurethane-covered, self-expanding metallic stent (control stent, CS) alternately in each left main bronchus and left lower lobe bronchus in 12 dogs. The stents were 20 mm in diameter and length when fully expanded. The dose of DXM was approximately 36.7 mg in each DS, but was absent in the CS. The dogs were euthanased 1 week (n=4), 2 weeks (n=4) or 4 weeks (n=4) after stent placement. Histologic findings, such as epithelial erosion/ulcer or granulation tissue thickness, were obtained from the mid-portion of the bronchus, where the stent had been placed, and evaluated between DS and CS. There were no procedure-related complications or malpositioning of any of the bronchial stents. Stent migration was detected in one dog just before euthanasia 1 week following stent placement. Stent patency was maintained until euthanasia in all dogs. Epithelial erosion/ulcer (%) was significantly less in the DS (mean{+-}standard deviation, 46.88{+-}23.75) than in the CS (73.75{+-}14.08) (P=0.026) for all time-points. There was a decrease in epithelial erosion/ulcer as the follow-up period increased in both DS and CS. The granulation tissue thickness (mm) was less in DS (2.63{+-}2.05) than in CS (3.49{+-}2.95), although the difference was not significant (P=0.751) for all time-points. There was a tendency toward an increase in granulation tissue thickness and chronic lymphocytic infiltration as the follow-up period increased in both DS and CS. In conclusion, DXM-eluting, covered, self-expanding metallic stent seems to be effective in reducing tissue reaction secondary to stent placement in a canine bronchial model. (orig.)

  6. Endovascular Treatment of Internal Carotid and Vertebral Artery Aneurysms Using a Novel Pericardium Covered Stent

    Science.gov (United States)

    Vulev, I.; Klepanec, A.; Bazik, R.; Balazs, T.; Illes, R.; Steno, J.

    2012-01-01

    Summary Intracranial aneurysm is a fairly common (often asymptomatic) condition. Subarachnoid hemorrhage associated with aneurysmal rupture is a potentially lethal event with a mortality rate as high as 50 percent and a high rate of disability among those who survive the initial hemorrhage, such that recently published guidelines support treatment of intracerebral aneurysms. The current treatment options include surgical clipping and endovascular treatment, but these are not without significant problems. Despite the trend toward endovascular treatment the rate of recurrence and complications is high. Current published evidence of the use of covered stent is limited to stents covered with polytetrafluoroethylene. It is now recognized that mammalian extracellular matrix represents an excellent scaffold material suitable for many therapeutic applications and glutaraldehyde treated pericardium has been widely used for many years due to its desirable features such as low immunogenicity and durability. This report describes the first published experience with the Aneugraft Pericardium Covered Stent (ITGI Medical, OR Akiva, Israel) in the treatment of internal carotid and vertebral artery aneurysms in three patients. In all three cases, the implantation of this novel device has resulted in successful closure of aneurysms. PMID:22681731

  7. Optical coherence tomography for the assessment of pericardium covered stents for the treatment of degenerated saphenous vein grafts

    NARCIS (Netherlands)

    P. Tyczynski (Pawel); N. Kukreja (Neville); R.J.M. van Geuns (Robert Jan); J.J. Wykrzykowska (Joanna); M.N. Sheppard (Mary); C. di Mario (Carlo)

    2010-01-01

    textabstractAims: Pre- and post-interventional optical coherence tomography (OCT) assessment of degenerated saphenous vein grafts (SVG) treated with implantation of pericardium covered stents. Percutaneous treatment of SVG represents one of the major challenges of current percutaneous coronary

  8. Novel Remanufacturing Process of Recycled Polytetrafluoroethylene(PTFE)/GF Laminate

    Science.gov (United States)

    Xi, Z.; Ghita, O. R.; Johnston, P.; Evans, K. E.

    2011-01-01

    Currently, the PTFE/GF laminate and PTFE PCB manufacturers are under considerable pressure to address the recycling issues due to Waste Electrical and Electronic Equipment (WEEE) Directive, shortage of landfill capacity and cost of disposal. This study is proposing a novel manufacture method for reuse of the mechanical ground PTFE/Glass fibre (GF) laminate and production of the first reconstitute PTFE/GF laminate. The reconstitute PTFE/GF laminate proposed here consists of a layer of recycled sub-sheet, additional layers of PTFE and PTFE coated glass cloth, also covered by copper foils. The reconstitute PTFE/GF laminate showed good dielectric properties. Therefore, there is potential to use the mechanical ground PTFE/GF laminate powder to produce reconstitute PTFE/GF laminate, for use in high frequencies PCB applications.

  9. Fluoroscopic-guided covered metallic stent placement for gastric outlet obstruction and post-operative gastroenterostomy anastomotic stricture

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jeong Min; Han, Young Min; Kim, Chong Soo; Lee, Sang Young; Lee, Soo Teik; Yang, Doo Hyun

    2001-07-01

    AIM: To evaluate the feasibility and safety of fluoroscopic-guided covered metallic stent placements in providing palliative care for patients with inoperable malignant gastric outlet obstruction. MATERIALS AND METHODS: Under fluoroscopic guidance, placement of self-expandable, covered stents was attempted in 20 patients with inoperable or recurrent gastric cancer (age range 36-79 years). All patients had inoperable gastric outlet obstruction, 13 with native anatomy and seven with post-operative anatomy (gastrointestinal anastomotic sites). All patients had intolerance to oral alimentation and/or vomiting after ingestion. Success was defined both technically and clinically. RESULTS: The placement of the stent was technically successful in 18 patients and failed in two patients (technical success: 90%). The cause of the technical failures was an inability to negotiate the guide wire through the obstruction sites in spite of the use of both fluoroscopic and endoscopic guidance. After stent placement, 15 patients were able to ingest at least liquids and had a markedly decreased incidence of vomiting (clinical success: 75%). During the mean follow-up of 6 weeks, there have been no stent reocclusion and no life-threatening complications except migration of two stents in one patient. CONCLUSION: Fluoroscopically guided covered metallic stent placement appears to be valuable for the palliative treatment of malignant obstruction of gastric outlet and post-operative gastrointestinal anastomoses. Lee, J.M. et al. (2001)

  10. A Double-Layered Covered Biliary Metal Stent for the Management of Unresectable Malignant Biliary Obstruction: A Multicenter Feasibility Study

    Science.gov (United States)

    Park, Jin-Seok; Jeong, Seok; Lee, Don Haeng; Moon, Jong Ho; Lee, Kyu Taek; Dong, Seok Ho

    2016-01-01

    Background/Aims The covered self-expandable metal stent (CMS) was developed to prevent tumor ingrowth-induced stent occlusion during the treatment of malignant biliary obstruction. However, complications such as cholecystitis, pancreatitis, and stent migration can occur after the endoscopic insertion of CMSs. The aim of the present study was to assess the efficacy and safety of a double-layered CMS (DCMS) for the management of malignant bile duct obstruction. Methods DCMSs were endoscopically introduced into 59 patients with unresectable malignant extrahepatic biliary obstruction at four tertiary referral centers, and the patient medical records were retrospectively reviewed. Results Both the technical and functional success rates were 100%. Procedure-related complications including pancreatitis, cholangitis, stent migration, and liver abscess occurred in five patients (8.5%). The median follow-up period was 265 days (range, 31 to 752 days). Cumulative stent patency rates were 68.2% and 40.8% at 6 and 12 months, respectively. At the final follow-up, the rate of stent occlusion was 33.9% (20/59), and the median stent patency period was 276 days (range, 2 to 706 days). Conclusions The clinical outcomes of DCMSs were comparable to the outcomes previously reported for CMSs with respect to stent patency period and complication rates. PMID:27172927

  11. A Covered Nitinol Stent Fracture in a Patient with a Malignant Esophageal Stricture: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Hee Jin; Cho, Yun Ku; Kim, Wan Tae [Seoul Veterans Hospital, Seoul (Korea, Republic of)

    2008-11-15

    Self-expanding metallic stent insertion has been widely applied for the palliative treatment of malignant esophageal strictures. Although it is known as an easy, safe, and effective procedure, complications are well known and include things such as stent migration and esophageal stent occlusion caused by tumor in growth. However, metallic stent fractures have been rarely reported in the esophagus, especially for nitinol stents. We report a case of a stent fracture associated with migration in a patient with a malignant esophageal stricture near the gastroesophageal junction. It is highly probable that the stent fracture was due to chemical erosion of the stent caused by gastric juice

  12. Endovascular covered stent treatment for descending aorta pseudoaneurysm following coarctation of the aorta repair in an infant.

    Science.gov (United States)

    Takawira, Farirai F; Sinyangwe, Greenwood; Mooloo, Rene

    2010-12-01

    The development of a pseudoaneurysm is a rare complication following repair of a coarctation of the aorta. Surgical management of pseudoaneurysms is associated with high morbidity and mortality. We describe the successful endovascular deployment of a covered stent in a sick infant with a descending aorta pseudoaneurysm, following the repair of an aortic coarctation. We highlight the challenges we encountered. Endovascular repair is a safe palliative alternative to re-do open surgery in unstable infants with large pseudoaneurysms following aortic coarctation repair. The role of endovascular stents as the final definitive therapy will remain limited by the deployable, small-size stents in small, growing children.

  13. Covered stents for endovascular repair of iatrogenic injuries of iliac and femoral arteries

    Energy Technology Data Exchange (ETDEWEB)

    Kufner, Sebastian, E-mail: kufners@dhm.mhn.de [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Cassese, Salvatore; Groha, Philipp; Byrne, Robert A. [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); Schunkert, Heribert; Kastrati, Adnan [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany); DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich (Germany); Ott, Ilka; Fusaro, Massimiliano [Deutsches Herzzentrum München, Technische Universität München, Munich (Germany)

    2015-04-15

    Background: The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. A strategy of percutaneous transluminal angioplasty (PTA) with covered stent (CS) may represent a valuable alternative to open surgery. However, systematic evaluations of CS in this setting represent a scientific gap. In the present study, we investigate the procedural and clinical outcomes associated with PTA and CS implantation to repair iatrogenic injuries of peripheral arteries. Methods: All patients undergoing PTA with CS for endovascular repair of iatrogenic injuries of peripheral arteries between August 2010 and July 2013 at our Institution were retrospectively analyzed. The primary endpoint was the technical success. Secondary endpoints were in-hospital mortality and cumulative death, target lesion revascularization (TLR), amputation and major stroke at 12-month follow-up. Results: During the period of observation, a total of 30 patients underwent PTA with either self-expandable (43.3%) or balloon-expandable CS (56.7%) for iatrogenic injuries of peripheral arteries. Injuries consisted of perforation/rupture (76.7%), arteriovenous fistula (16.7%) and pseudoaneurysm (6.7%) of iliac–femoral arteries. Technical success was achieved in all cases. Median follow-up was 409 days [210–907]. The incidence of in-hospital mortality was 10.0%. At 12-month follow-up, the incidence of death, TLR, amputation and major stroke was 20.0%, 17.0%, 3.3% and 6.7%, respectively. Conclusion: The use of covered stents for endovascular repair of iatrogenic injuries of peripheral arteries shows a high technical success and may be alternative to surgery. Further studies with larger populations are needed to confirm these preliminary findings. - Highlights: • The growing number of complex endovascular procedures is expected to increase the risk of iatrogenic injuries of peripheral arteries. • Percutaneous transluminal angioplasty with

  14. Endoscopic ultrasound-guided biliary drainage with placement of a fully covered metal stent for malignant biliary obstruction

    Institute of Scientific and Technical Information of China (English)

    Tae Hyeon Kim; Seong Hun Kim; Hyo Jeong Oh; Young Woo Sohn; Seung Ok Lee

    2012-01-01

    AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage (EUS-BD) with a fully covered self-expandable metal stent for managing malignant biliary stricture.METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography (ERCP) fails.EUS-guided choledochoduodenostomy (EUS-CD) and EUS-guided hepaticogastrostomy (EUS-HG) was performed in 9 patients and 4 patients,respectively.RESULTS:The technical and functional success rate was 92.3% (12/13) and 91.7% (11/12),respectively.Using an intrahepatic approach (EUS-HG,n =4),there was mild peritonitis (n =1) and migration of the metal stent to the stomach (n =1).With an extrahepatic approach (EUS-CD,n =10),there was pneumoperitoneum (n =2),migration (n =2),and mild peritonitis (n =1).All patients were managed conservatively with antibiotics.During follow-up (range,1-12 mo),there was re-intervention (4/13 cases,30.7%) necessitated by stent migration (n =2) and stent occlusion (n =2).CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.

  15. Double-layered covered stent for the treatment of malignant oesophageal obstructions: Systematic review and meta-analysis

    Science.gov (United States)

    Hussain, Zeiad; Diamantopoulos, Athanasios; Krokidis, Miltiadis; Katsanos, Konstantinos

    2016-01-01

    AIM To investigate the efficacy of double-layered covered stent in the treatment of malignant oesophageal obstructions. METHODS A systematic review and meta-analysis was performed following the PRISMA process. PubMed (Medline), EMBASE (Excerpta Medical Database), AMED (Allied and Complementary medicine Database), Scopus and online content, were searched for studies reporting on the NiTi-S polyurethane-covered double oesophageal stent for the treatment of malignant dysphagia. Weighted pooled outcomes were synthesized with a random effects model to account for clinical heterogeneity. All studies reporting the outcome of palliative management of dysphagia due to histologically confirmed malignant oesophageal obstruction using double-layered covered nitinol stent were included. The level of statistical significance was set at α = 0.05. RESULTS Six clinical studies comprising 250 patients in total were identified. Pooled technical success of stent insertion was 97.2% (95%CI: 94.8%-98.9%; I2 = 5.8%). Pooled complication rate was 27.6% (95%CI: 20.7%-35.2%; I2 = 41.9%). Weighted improvement of dysphagia on a scale of 0-5 scoring system was -2.00 [95%CI: -2.29%-(-1.72%); I2 = 87%]. Distal stent migration was documented in 10 out of the 250 cases examined. Pooled stent migration rate was 4.7% (95%CI: 2.5%-7.7%; I2 = 0%). Finally, tumour overgrowth was reported in 34 out of the 250 cases with pooled rate of tumour overgrowth of 11.2% (95%CI: 3.7%-22.1%; I2 = 82.2%). No funnel plot asymmetry to suggest publication bias (bias = 0.39, P = 0.78). In the sensitivity analysis all results were largely similar between the fixed and random effects models. CONCLUSION The double-layered nitinol stent provides immediate relief of malignant dysphagia with low rates of stent migration and tumour overgrowth PMID:27678367

  16. Heparinized poly(vinyl alcohol)-small intestinal submucosa composite membrane for coronary covered stents

    Energy Technology Data Exchange (ETDEWEB)

    Jiang Tao; Wang Guixue; Qiu Juhui; Luo Lailong [Bioengineering College and ' 111 Project' Laboratory of Biomechanics and Tissue Repair, Chongqing University, Chongqing (China); Zhang Guoquan, E-mail: wjjt72@live.c [Histology and Embryology Department, Medical College of China People Armed Police Forces, Tianjin (China)

    2009-04-15

    To develop a novel coating material for coronary covered stents, we prepared a kind of composite membrane which contains polyvinyl alcohol (PVA) and porcine small intestinal submucosa (SIS) powders crosslinked and heparinized by N-(3-dimethylaminopropyl)-N'-ethylcarbodiimide hydrochloride (EDC) and N-hydroxysuccinimide (NHS). The amount of immobilized heparin increased with increasing ratios of EDC:heparin, and the maximum amount was approximately 60 {mu}g heparin per milligram SIS powder at a weight ratio of EDC:heparin of 2. Uniaxial tensile and balloon inflation testing suggested that the composite membrane crosslinked by lower EDC concentration is more flexible and elastic. The clotting time (APTT and PT) of the heparinized PVA-SIS membrane was longer than that of the unheparinized membrane. The number of adherent platelets on the heparinized PVA-SIS composite membrane was about 25% of the unheparininzed, and there was no sign of accumulation and almost no pseudopodium was observed. The endothelial cells were amicable with the heparinized and unheparinized PVA-SIS composite membranes. In in vivo implantation tests, we observed a thin capsule formed by several layers of fibroblasts surrounding the implants. These results showed that the heparinized PVA-SIS composite membrane has potential biomechanical and biological properties as a coating material for coronary covered stent.

  17. Use of covered Cheatham-Platinum stent as the primary modality in the treatment for native coarctation of the aorta

    Institute of Scientific and Technical Information of China (English)

    CHANG Zong-ping; WU Wen-hui; HU Hai-bo; LI Shi-guo; YU Ji-hong; YAN Chao-wu; JIANG Shi-liang; XU Zhong-ying; ZHANG Ge-jun; HUANG Lian-jun; ZHAO Shi-hua; LING Jian; ZHENG Hong; JIN Jing-lin

    2012-01-01

    Background Bare stent implantation in the treatment for native and recurrent coarctation of the aorta (CoA) has become established as an alternative to surgery and balloon angioplasty.However,this modality still encounters significant complications during the procedure and/or follow-up.The covered Cheatham-Platinum (CP) stent commonly used to be chosen as a rescue treatment in these patients.The purpose of this study was to evaluate the use of covered CP stent as the primary modality in the treatment for native CoA.Methods Twenty-five covered CP stents and 2 bare CP stents were implanted in 25 patients with native CoA.All patients after the intervention were invited for follow-up examinations.Results The peak systolic gradient across the lesion decreased significantly from a median value of 67.5 mmHg (quartile range,19.3 mmHg) to 2 mmHg (quartile range,4.0 mmHg) (P <0.0001).Stenotic segment diameter increased from a median value of 5.0 mm (quartile range,1.5 mm) to 17.9 mm (quartile range,2.5 mm) (P <0.0001).The median ratio of diameter of the coarctation postprocedure to preprocedure was 4.2 (quartile range,1.6).All of the CP stents were placed in the suitable position without any acute complications.During a follow-up period of up to 72 months,no complications were encountered.Most of the patients (21/25) were normotensive,apart from four patients requiring antihypertensive medication during the follow-up.Conclusion The implantation of covered CP stent as the primary modality is safe and effective in the treatment for native CoA in adolescents and adults.

  18. Effectiveness and Safety of Endoscopic Treatment of Benign Biliary Strictures Using a New Fully Covered Self Expandable Metal Stent

    Directory of Open Access Journals (Sweden)

    Mihir S. Wagh

    2013-01-01

    Full Text Available Background. In patients with benign biliary strictures, the use of fully covered self-expandable metal stents (SEMS has been proposed as an alternative to plastic stenting, but high quality prospective data are sparse. This study was performed to evaluate the long-term effectiveness and safety of a new fully covered SEMS for benign biliary strictures. Methods. All consecutive patients with benign biliary strictures were treated with placement of a fully covered SEMS (WallFlex for 6 months. Short- and long-term stricture resolution, adverse events, and ease of stent removal were recorded. Results. 23 patients were enrolled. Stricture etiology was chronic pancreatitis (14, postorthotopic liver transplant (4, idiopathic (4, and biliary stones (1. All ERCPs were technically successful. All stents were successfully removed. Short-term stricture resolution was seen in 22/23 (96% patients. Long-term success was 15/18 (83.3%. All 3 failures were patients with biliary strictures in the setting of chronic calcific pancreatitis. Conclusions. The use of the new SEMS for the treatment of benign biliary strictures led to short-term stricture resolution in the vast majority of patients. Over a long-term followup the success rate appears favorable compared to historical results achieved with multiple plastic stenting, particularly in patients with chronic pancreatitis. The study was registered with ClinicalTrials.gov (NCT01238900.

  19. Endoscopic suture fixation is associated with reduced migration of esophageal fully covered self-expandable metal stents (FCSEMS).

    Science.gov (United States)

    Wright, Andrew; Chang, Andrew; Bedi, Aarti Oza; Wamsteker, Erik-Jan; Elta, Grace; Kwon, Richard S; Carrott, Phillip; Elmunzer, B Joseph; Law, Ryan

    2016-12-07

    Esophageal fully covered self-expandable metal stents (FCSEMS) are indicated for the management of benign and malignant conditions of the esophagus including perforations, leaks, and strictures. FCSEMS are resistant to tissue ingrowth and are removable; however, stent migration occurs in 30-55% of cases. Endoscopic suture fixation of FCSEMS has been utilized to decrease the risk of stent migration though data supporting this practice remain limited. The primary aim of this study was to compare clinical outcomes and migration rate of patients who underwent placement of esophageal FCSEMS with and without endoscopic suture fixation. Our single-center, retrospective, cohort study includes patients who underwent esophageal FCSEMS placement with and without endoscopic suture fixation between January 1, 2012, and November 11, 2015. Baseline patient characteristics, procedural details, and clinical outcomes were abstracted. Logistic regression was performed to identify clinical and technical factors associated with outcomes and stent migration. A total of 51 patients underwent 62 FCSEMS placements, including 21 procedures with endoscopic suture fixation and 41 without. Suture fixation was associated with reduced risk of stent migration (OR 0.13, 95% CI 0.03-0.47). Prior stent migration was associated with significantly higher risk of subsequent migration (OR 6.4, 95% CI 1.6-26.0). Stent migration was associated with lower likelihood of clinical success (OR 0.21, 95% CI 0.06-0.69). There was a trend toward higher clinical success among patients undergoing suture fixation (85.7 vs. 60.9%, p = 0.07). Endoscopic suture fixation of FCSEMS was associated with a reduced stent migration rate. Appropriate patient selection for suture fixation of FCSEMS may lead to reduced migration in high-risk patients.

  20. Endovascular treatment of peripheral arterial injury with covered stents: an experimental study in pigs

    Directory of Open Access Journals (Sweden)

    Sergio Belczak

    2011-01-01

    Full Text Available OBJECTIVE: To evaluate the feasibility of using endovascular repair to treat penetrating arterial injuries with covered stents. Feasibility was examined according to the circumferential extent of the injury. INTRODUCTION: Surgical trauma often increases the risk of major morbidity and mortality associated with vascular injury, and endovascular repair has many advantages in such situations. METHODS: Twenty white male domestic pigs weighing 28-38 kg with controlled vascular injuries were divided into four equal groups according to the circumferential extent of their vascular lesion (i.e., no lesion, lesion 50%, and complete lesion. The left common carotid artery was dissected with proximal and distal control, and this procedure was followed by controlled sectioning of the arterial wall. Local manual compression was applied for 10 min and was followed by endovascular repair with the placement of a 5x50 mm VIABHAN TM covered stent using the femoral approach. We also monitored additional variables, such as the duration of the procedures (the mean was 56.3 ± 19.1 min, ultrasound parameters (e.g., maximum arterial diameter, peak systolic and diastolic velocity, and resistance index, arteriography findings, and fluctuations in vital signs (e.g., cardiac output, arterial pressure, and central venous pressure. RESULTS: The experimental procedure was found to be feasible and reproducible. Repairs were successful in all animals in the control (no lesion and 50% group and in one pig in the complete lesion group. DISCUSSION: The endovascular repair of an arterial injury is possible, but success depends on the circumferential extent of the arterial lesion. The present experimental model, which involved endovascular techniques, highlighted important factors that must be considered in future studies involving similar animals and materials.

  1. In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease

    NARCIS (Netherlands)

    Groot Jebbink, Erik; Ter Mors, Thijs G; Slump, Cornelis H; Geelkerken, Robert H; Holewijn, Suzanne; Reijnen, Michel MPJ

    2017-01-01

    Objectives Various configurations of kissing stent (KS) configurations exist and patency rates vary. In response the covered endovascular reconstruction of the aortic bifurcation configuration was designed to minimize mismatch and improve outcome. The aim of the current study is to compare

  2. Recanalization of an Occluded Intrahepatic Portosystemic Covered Stent via the Percutaneous Transhepatic Approach

    Energy Technology Data Exchange (ETDEWEB)

    Chan, Chih Yang; Liang, Po Chin [National Taiwan University Hospital, Taipei (China)

    2010-08-15

    A 41-year-old woman with liver cirrhosis had recurrent portal hypertension and bleeding from esophageal varices due to complete occlusion of a previously inserted transjugular intrahepatic portosystemic shunt stent. Because recanalization of the stent by the transjugular approach was unsuccessful, ultrasound-guided entry to the splenic vein and portal vein was used. After catheter-directed intrathrombus thrombolysis, successful opening of the stent was achieved and a stent was placed. We herein report a rare case in which thrombolysis and recanalization of a TIPS stent were performed via a percutaneous transhepatic approach

  3. Impending rupture of saphenous vein graft aneurysm with floating fractured bare metal stent treated by coil embolization and covered stent implantation.

    Science.gov (United States)

    Kodama, Atsuko; Kurita, Tairo; Kato, Osamu; Suzuki, Takahiko

    2016-11-01

    Aneurysmal degeneration of a saphenous vein graft (SVG) is a rare, but potentially fatal complication of coronary artery bypass graft (CABG) surgery. In this case report, a patient that had undergone prior CABG surgery and bare metal stent (BMS) implantation at the site of a stenotic SVG lesion presented at our hospital with chest pain, and an SVG aneurysm was detected at the previous BMS implantation site. In addition, the implanted BMS was fractured and floating in the SVG aneurysm. The SVG aneurysm was successfully occluded by percutaneous intervention, using a combination of distal covered stent deployment at the site of the anastomosis between the native coronary artery and the SVG and proximal coil embolization of the aneurysm.

  4. [The application of Y-shaped self-expandable covered metal stents in the thoracostomach-airway fistula: a single center, 11 years experience].

    Science.gov (United States)

    Fang, Yi; Li, Tengfei; Han, Xinwei; Wu, Gang; Ren, Jianzhuang; Ren, Kewei; Lu, Huibin; Zhang, Quanhui; Li, Zongming

    2015-08-01

    To investigate the clinical feasibility and efficacy of Y-shaped self-expandable covered metal stents (Y-stents) in the management of thoracostomach-airway fistula. Retrospective analysis was performed for 108 patients treated for thoracostomach-airway fistula with Y-shaped self-expandable coated metal stents between April 2003 and October 2014. Y-stents were designed based on the dimensions of trachea and bronchus and sites of the fistula and then were inserted under DSA monitoring. There were 65 cases with single big Y-stent placement, 26 cases with single small Y-stent placement, 23 cases with double Y-stents placement, and 1 case with 3 Y-stents placement. Stent implantation was successfully accomplished with single manipulation in all patients. Complete occlusion of the fistula was obtained in 104 patients after the primary manipulation, and 4 patients required a secondary manipulation where a double Y-stents was inserted because of failure of primary manipulate. Ninety-two patients completed the follow-up , while 16 were lost. Fifty-nine patients died while 33 were alive with marked improvement in their quality of life. The placement of Y-stents can effectively occlude the thoracostomach-airway fistula in patients who had had the esophageal tumors resected. The technique is not only feasible but reliable to improve the quality of life of the patients.

  5. The use of covered stents for the endovascular treatment of extracranial internal carotid artery stenosis: a prospective study with a 5-year follow-up

    Energy Technology Data Exchange (ETDEWEB)

    Szolics, Alex; Szikra, Peter; Palko, Andras; Voeroes, Erika [University of Szeged, Department of Radiology, Szeged (Hungary); Sztriha, Laszlo K. [University of Szeged, Department of Neurology, Szeged (Hungary); Szolics, Miklos [Tawam Hospital in affiliation with Johns Hopkins Medicine, Division of Neurology, Al Ain, P.O. Box 15258, Abu Dhabi Emirate (United Arab Emirates)

    2010-07-15

    To evaluate the safety and feasibility of the use of covered stents for the treatment of extracranial carotid artery stenosis caused by highly embologenic plaques, and to study the long-term outcome of patients receiving such covered stents. Between 2002 and 2007, 46 patients (63% symptomatic, 78.3% male, 67 {+-} 8.6 years old) with internal carotid artery stenosis caused by embologenic plaques or restenosis were treated with self-expanding covered stents (Symbiot, Boston Scientific). Pre-dilatation or protecting devices were not used. Post-dilatation was applied in every patient. Each patient was followed long-term. The outcome measures were the occurrence of neurological events, and the development of in-stent restenosis, as detected by clinical examination and duplex ultrasound. The technical success rate of stenting was 100%. There were no neurological complications in the peri-procedural period. The mean follow-up period was 34.3 {+-} 27.7 months (the rate of patients lost to follow-up was 15.2%) during which no stroke or stroke-related deaths occurred. Restenosis was detected in 3 patients (6.5%). Covered stents provide efficient peri- and post-procedural protection against neurological complications due to embolisation from high-risk plaques during carotid artery stenting. Restenosis of covered stents appears to be infrequent during long-term follow-up. (orig.)

  6. Geometrical consequences of kissing stents and the Covered Endovascular Reconstruction of the Aortic Bifurcation configuration in an in vitro model for endovascular reconstruction of aortic bifurcation

    NARCIS (Netherlands)

    Groot Jebbink, E.; Grimme, F.A.; Goverde, P.C.; Oostayen, J.A.; Slump, C.H.; Reijnen, M.M.P.J.

    2015-01-01

    OBJECTIVE: Kissing stents (KS) are commonly used to treat aortoiliac occlusive disease, but patency results are often lower than those of isolated stents. The Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) technique was recently introduced to reconstruct the aortic bifurcation

  7. Geometrical consequences of kissing stents and the covered endovascular reconstruction of the aortic bifurcation configuration in an in vitro model for endovascular reconstruction of aortic bifurcation

    NARCIS (Netherlands)

    Groot Jebbink, Erik; Grimme, Frederike A.B.; Goverde, Peter C.J.M.; Oostayen, van Jacques A.; Slump, Cornelis H.; Reijnen, Michel M.P.J.

    2015-01-01

    Objective: Kissing stents (KS) are commonly used to treat aortoiliac occlusive disease, but patency results are often lower than those of isolated stents. The Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) technique was recently introduced to reconstruct the aortic bifurcation

  8. Comparison of the utility of covered metal stents versus uncovered metal stents in the management of malignant biliary strictures in 749 patients.

    Science.gov (United States)

    Lee, Jeffrey H; Krishna, Somashekar G; Singh, Amanpal; Ladha, Harshad S; Slack, Rebecca S; Ramireddy, Srinivas; Raju, Gottumukkala S; Davila, Marta; Ross, William A

    2013-08-01

    Self-expandable metal stents (SEMSs) are used to relieve malignant biliary obstruction. To compare outcomes between covered self-expandable metal stents (CSEMSs) and uncovered self-expandable metal stents (USEMSs) in malignant biliary obstruction. Retrospective cohort study. Tertiary cancer center. Patients with malignant biliary obstruction. Placement of CSEMS or USEMS. Time to recurrent biliary obstruction (TRO), overall survival (OS), and adverse events. From January 2000 to June 2011, 749 patients received SEMSs: 171 CSEMSs and 578 USEMSs. At 1 year, there was no significant difference in the percentage of patients with recurrent obstruction (CSEMSs, 35% vs USEMSs, 38%) and survival (CSEMSs, 45% vs USEMSs, 49%). There was no significant difference in the median OS (CSEMSs, 10.4 months vs USEMSs, 11.8 months; P = .84) and the median TRO (CSEMSs, 15.4 months vs USEMSs, 26.3 months; P = .61). The adverse event rate was 27.5% for the CSEMS group and 27.7% for the USEMS group. Although tumor ingrowth with recurrent obstruction was more common in the USEMS group (76% vs 9%, P < .001), stent migration (36% vs 2%, P < .001) and acute pancreatitis (6% vs 1%, P < .001) were more common in the CSEMS group. Retrospective study. There was no significant difference in the patency rate or overall survival between CSEMSs and USEMSs for malignant distal biliary strictures. The CSEMS group had a significantly higher rate of migration and pancreatitis than the USEMS group. No significant SEMS-related adverse events were observed in patients undergoing neoadjuvant chemoradiation or surgical resection. Copyright © 2013 American Society for Gastrointestinal Endoscopy. Published by Mosby, Inc. All rights reserved.

  9. Percutaneous unilateral biliary metallic stent placement in patients with malignant obstruction of the biliary hila and contralateral portal vein steno-occlusion

    Energy Technology Data Exchange (ETDEWEB)

    Son, Rak Chae; Gwon, Dong Il; Ko, Heung Kyu; Kim, Jong Woo; Ko, Gi Young [Dept. of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2015-06-15

    To investigate the outcomes of percutaneous unilateral metallic stent placement in patients with a malignant obstruction of the biliary hila and a contralateral portal vein steno-occlusion. Sixty patients with a malignant hilar obstruction and unilobar portal vein steno-occlusion caused by tumor invasion or preoperative portal vein embolization were enrolled in this retrospective study from October 2010 to October 2013. All patients were treated with percutaneous placement of a biliary metallic stent, including expanded polytetrafluoroethylene (ePTFE)-covered stents in 27 patients and uncovered stents in 33 patients. A total of 70 stents were successfully placed in 60 patients. Procedural-related minor complications, including self-limiting hemobilia (n = 2) and cholangitis (n = 4) occurred in six (10%) patients. Acute cholecystitis occurred in two patients. Successful internal drainage was achieved in 54 (90%) of the 60 patients. According to a Kaplan-Meier analysis, median survival time was 210 days (95% confidence interval [CI], 135-284 days), and median stent patency time was 133 days (95% CI, 94-171 days). No significant difference in stent patency was observed between covered and uncovered stents (p = 0.646). Stent dysfunction occurred in 16 (29.6%) of 54 patients after a mean of 159 days (range, 65-321 days). Unilateral placement of ePTFE-covered and uncovered stents in the hepatic lobe with a patent portal vein is a safe and effective method for palliative treatment of patients with a contralateral portal vein steno-occlusion caused by an advanced hilar malignancy or portal vein embolization. No significant difference in stent patency was detected between covered and uncovered metallic stents.

  10. Covered Bronchial Stent Insertion to Manage Airway Obstruction with Hemoptysis Caused by Lung Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sae Ah; Kim, Do Hyeong [Dankook University College of Medicine, Dankook University Hospital, Cheonan (Korea, Republic of); Jen, Gyeong Sik [Bundang CHA General Hospital, CHA University, Seongnam (Korea, Republic of)

    2012-07-15

    Malignant airway obstruction and hemoptysis are common in lung cancer patients. Recently, airway stent is commonly used to preserve airway in malignant airway obstruction. Hemoptysis can be managed through various methods including conservative treatment, endobronchial tamponade, bronchoscopic intervention, embolization and surgery. In our case studies, we sought to investigate the effectiveness of airway stents for re-opening the airway as well as tamponade effects in four patients with malignant airway obstruction and bleeding caused by tumors or lymph node invasions.

  11. A Multicenter, Prospective Study of a New Fully Covered Expandable Metal Biliary Stent for the Palliative Treatment of Malignant Bile Duct Obstruction

    Directory of Open Access Journals (Sweden)

    Bret T. Petersen

    2013-01-01

    Full Text Available Background and Study Aims. Endoscopic placement of self-expanding metal stents (SEMSs is indicated for palliation of inoperable malignant biliary obstruction. A fully covered biliary SEMS (WallFlex Biliary RX Boston Scientific, Natick, USA was assessed for palliation of extrahepatic malignant biliary obstruction. Patients and Methods. 58 patients were included in this prospective, multicenter series conducted under an FDA-approved IDE. Main outcome measurements included (1 absence of stent occlusion within six months or until death, whichever occurred first and (2 technical success, need for reintervention, bilirubin levels, stent patency, time to stent occlusion, and adverse events. Results. Technical success was achieved in 98% (57/58, with demonstrated acute removability in two patients. Adequate clinical palliation until completion of followup was achievedin 98% (54/55 of evaluable patients, with 1 reintervention due to stent obstruction after 142 days. Mean total bilirubin decreased from 8.9 mg/dL to 1.2 mg/dL at 1 month. Device-related adverse events were limited and included 2 cases of cholecystitis. One stent migrated following radiation therapy. Conclusions. The WallFlex Biliary fully covered stent yielded technically successful placement with uncomplicated acute removal where required, appropriate reduction in bilirubin levels, and low rates of stent migration and occlusion. This SEMS allows successful palliation of malignant extrahepatic biliary obstruction.

  12. Sustained Benefit at 2 Years for Covered Stents Versus Bare-Metal Stents in Long SFA Lesions: The VIASTAR Trial

    Energy Technology Data Exchange (ETDEWEB)

    Lammer, Johannes, E-mail: jlammer@gmx.at, E-mail: johannes.lammer@meduniwien.ac.at [Medical University Vienna, The Department of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy (Austria); Zeller, Thomas, E-mail: thomas.zeller@universitaets-herzzentrum.de [Universitaets-Herzzentrum Freiburg-Bad Krozingen, Department of Angiology (Germany); Hausegger, Klaus A., E-mail: klaus.hausegger@lkh-klu.at [Klinikum Klagenfurt, The Department of Diagnostic and Interventional Radiology (Austria); Schaefer, Philipp J., E-mail: jp.schaefer@rad.uni-kiel.de [University Clinics Schleswig-Holstein, The Department of Radiology (Germany); Gschwendtner, Manfred, E-mail: manfred.gschwendtner@elisabethinen.or.at [Elisabethinen Hospital, The Department of Diagnostic and Interventional Radiology (Austria); Mueller-Huelsbeck, Stefan, E-mail: muehue@diako.de [Diakonissen Hospital, The Department of Diagnostic and Interventional Radiology (Germany); Rand, Thomas, E-mail: thomas.rand@wienkav.at [Hietzing Hospital, The Department of Radiology (Austria); Funovics, Martin, E-mail: martin.funovics@meduniwien.ac.at; Wolf, Florian, E-mail: florian.wolf@meduniwien.ac.at [Medical University Vienna, The Department of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy (Austria); Rastan, Aljoscha, E-mail: aljoscha.rastan@universitaets-herzzentrum.de [Universitaets-Herzzentrum Freiburg-Bad Krozingen, Department of Angiology (Germany); Gschwandtner, Michael, E-mail: michael.gschwandtner@meduniwien.ac.at [Medical University Vienna, The Department of Angiology (Austria); Puchner, Stefan, E-mail: stefan.puchner@meduniwien.ac.at [Medical University Vienna, The Department of Cardiovascular and Interventional Radiology, Department of Biomedical Imaging and Image-guided Therapy (Austria); and others

    2015-02-15

    PurposeThe hypothesis that covered stents are superior to bare-metal stents (BMS) in long femoropopliteal artery disease was tested. The one-year results of the VIASTAR trial revealed a patency benefit of covered stents in the treatment-per-protocol (TPP) analysis only.MethodsA prospective, randomized, single-blind, multicenter study evaluated 141 patients with symptomatic peripheral arterial disease (PAD) after treatment with heparin-bonded covered stents (VIABAHN{sup ®} Endoprosthesis) or BMS. Clinical outcomes and patency rates were assessed at 1, 6, 12, and 24 months. Mean lesion length was 19.0 ± 6.3 cm in the VIABAHN{sup ®} versus 17.3 ± 6.6 cm in the BMS group.ResultsThe 24-month primary patency rates in the VIABAHN{sup ®} and BMS group were: intention-to-treat 63.1 (95 % CI 0.52–0.76) versus 41.2 % (95 % CI 0.29–0.57; log rank p = 0.04) and TPP 69.4 (95 % CI 0.58–0.83) versus 40.0 % (95 % CI 0.28–0.56; log rank p = 0.004). Freedom from target-lesion-revascularization (TLR) was 79.4 (95 % CI 0.70–0.90) versus 73.0 % (95 % CI 0.63–0.85) for VIABAHN{sup ®} versus BMS (log rank p = 0.37). For the TPP group in lesions ≥20 cm, the 24-month patency rates were 65.2 (95 % CI 0.50–0.85) versus 26.7 % (95 % CI 0.12–0.59; log rank p = 0.004) for VIABAHN{sup ®} versus BMS, and freedom from TLR was 80.0 (95 % CI 0.68–0.94) versus 61.9 % (95 % CI 0.44–0.87; log rank p = 0.13). The ankle brachial index was 0.89 ± 0.18 versus 0.91 ± 0.17 (p = 0.76) at 24-month in the VIABAHN{sup ®} versus the BMS group, respectively.ConclusionAt 24-month, this trial in PAD patients with long femoropopliteal lesions demonstrated a significantly improved primary patency rate for heparin-bonded covered stents compared to BMS, however, without a significant impact on clinical outcomes and TLR rate (Reg. Nr. ISRCTN48164244)

  13. Prophylactic placement of a covered nitinol stent to prevent carotid blowout in a patient with supraclavicular lymph node metastasis from esophageal cancer.

    Science.gov (United States)

    Fujita, Takeshi; Ito, Katsuyoshi; Tanabe, Masahiro; Matsunaga, Naofumi

    2015-01-01

    Enlargement of primary tumor and metastatic lymph nodes in patients with head and neck cancer can be progressive and invade the surrounding vessels despite intensive treatment. Carotid blowout (CBS) tends to occur in these patients, and prompt treatment is required. Surgical management of carotid blowout is technically troublesome because exploration and repair of the previously irradiated or tumor-invaded field are difficult. Endovascular therapy with stent deployment is a good alternative to surgery. Even with such interventional procedures as stent grafting, it is sometimes difficult to obtain favorable outcomes in end-stage patients with poor general conditions. The prophylactic placement of a covered nitinol stent was performed to prevent carotid blowout in a patient with supraclavicular lymph node metastasis from esophageal cancer, and fatal bleeding due to carotid blowout was avoided. The usefulness of the prophylactic placement of a covered nitinol stent for preventing carotid blowout in an end-stage patient is presented.

  14. Covered Stent Implantation for the Treatment of Direct Carotid-Cavernous Fistula and Its Mid-Term Follow-up

    Science.gov (United States)

    Briganti, F.; Tortora, F.; Marseglia, M.; Napoli, M.; Cirillo, L.

    2009-01-01

    Summary Carotid-cavernous fistulas are abnormal arteriovenous communications either directly between the internal carotid artery and the cavernous sinus or between the dural branches of the internal and external carotid arteries. These fistulas predominantly present with ocular manifestations and they are treated mainly by endovascular techniques in most cases. A detailed review of the literature allowed us to make a complete analysis of the information available on the topic. We describe a case of a direct carotid-cavernous fistula occluded by endovascular implantation of a covered stent, showing the persistence of results after three years. PMID:20465897

  15. Novel deployment of a covered duodenal stent in open surgery to facilitate closure of a malignant duodenal perforation

    Directory of Open Access Journals (Sweden)

    Psaila Josephine

    2009-10-01

    Full Text Available Abstract Background Its a dilemma to attempt a palliative procedure to debulk the tumour and/or prevent future obstructive complications in a locally advanced intra abdominal malignancy. Case presentation A 38 year old Vietnamese man presented with a carcinoma of the colon which had invaded the gallbladder and duodenum with a sealed perforation of the second part of the duodenum. Following surgical exploration, it was evident that primary closure of the perforated duodenum was not possible due to the presence of unresectable residual tumour. Conclusion We describe a novel technique using a covered duodenal stent deployed at open surgery to aid closure of a malignant duodenal perforation.

  16. In vivo geometry of the kissing stent and covered endovascular reconstruction of the aortic bifurcation configurations in aortoiliac occlusive disease.

    Science.gov (United States)

    Groot Jebbink, Erik; Ter Mors, Thijs G; Slump, Cornelis H; Geelkerken, Robert H; Holewijn, Suzanne; Reijnen, Michel Mpj

    2017-01-01

    Objectives Various configurations of kissing stent (KS) configurations exist and patency rates vary. In response the covered endovascular reconstruction of the aortic bifurcation configuration was designed to minimize mismatch and improve outcome. The aim of the current study is to compare geometrical mismatch of kissing stent with the covered endovascular reconstruction of the aortic bifurcation configuration in vivo. Methods Post-operative computed tomographic data and patient demographics from 11 covered endovascular reconstruction of the aortic bifurcation and 11 matched kissing stent patients were included. A free hand region of interest and ellipse fitting method were applied to determine mismatch areas and volumes. Conformation of the stents to the vessel wall was expressed using the D-ratio. Results Patients were mostly treated for Rutherford category 2 and 3 (64%) with a lesion classification of TASC C and D in 82%. Radial mismatch area and volume for the covered endovascular reconstruction of the aortic bifurcation group was significantly lower compared to the kissing stent configuration ( P < 0.05). The D-ratio did not significantly differ between groups. Measurements were performed with good intra-class correlation. There were no significant differences in the post-procedural aortoiliac anatomy. Conclusions The present study shows that radial mismatch exists in vivo and that large differences in mismatch exist, in favour of the covered endovascular reconstruction of the aortic bifurcation configuration. Future research should determine if the decreased radial mismatch results in improved local flow profiles and subsequent clinical outcome.

  17. Successful endovascular treatment of a hemodialysis graft pseudoaneurysm by covered stent and direct percutaneous thrombin injection.

    LENUS (Irish Health Repository)

    Keeling, Aoife N

    2011-07-25

    Vascular access for hemodialysis remains a challenge for nephrologists, vascular surgeons, and interventional radiologists alike. Arteriovenous fistula and synthetic grafts remain the access of choice for long-term hemodialysis; however, they are subject to complications from infection and repeated needle cannulation. Pseudoaneurysms are an increasingly recognized adverse event. At present, there are many minimally invasive methods to repair these wall defects. We present a graft pseudoaneurysm, which required a combination of endovascular stent graft placement and percutaneous thrombin injection for successful occlusion.

  18. A case of rectovagino-vesical fistula due to radiation therapy for uterine cancer treated with covered expandable metallic stent

    Energy Technology Data Exchange (ETDEWEB)

    Ohtsukasa, Shunroh; Okabe, Satoshi; Tanami, Hideaki [Tokyo Medical and Dental Univ. (Japan). School of Medicine] (and others)

    2002-04-01

    A 65-year-old woman had received a panhysterectomy and radiation therapy for a uterine cancer in 1974 and underwent a drainage operation for a peritonitis due to rupture of the bladder associated with radiation cystitis in 1983. A rectovesical fistula was revealed and partial resection of the bladder and rectum was performed in 1996. In 1998, rectovesical fistula recurred and symptom of fecaluria and contact-type dermatitis at perineal region subsequently worsened. In February, 2000, colonoscopy and gastrograffin-enema revealed a giant recto-vagino-vesical fistula. Although we recommended ileostomy, the patient refused our offer. She gave informed consent to our proposal about the insertion of a covered expandable metallic stent (EMS) into the rectum to treat for fecaluria. After insertion of a covered EMS, fecaluria and contact-type dermatitis at perineal region subsequently improved. Three months later, fecaluria appeared again. Finally, seven months later, severe inflammation occurred at perineal and pubic region because of migration of the covered EMS into the bladder, then we removed the covered EMS and performed ileostomy. It is difficult to use the covered EMS treatment for benign rectovesical or rectovaginal fistula for a long term. (author)

  19. 带膜支架在神经介入治疗中的应用现状%Covered stents in neural interventional therapy

    Institute of Scientific and Technical Information of China (English)

    张昌伟; 王朝华; 谢晓东; 闫庆; 李江涛

    2008-01-01

    BACKGROUND: With the development of neural interventional therapy, the application of covered stents in neural intervention is becoming a topic of general interest.OBJECTIVE: To introduce the structure of stent-graft, and to summary the application of covered stents in clinical treatment of the neural interventional therapy and the shortage of covered stents.RETRIEVAL STRATEGY: The relevant articled were searched for in Pubmed database by researcher of this article with the key words of "stent graft, covered stents, cerebrovascular disease" in English, and with the key words of "covered stent, cerebrovascular disease" in Chinese in VIP database. 223 English and 196 Chinese articles were selected and reviewed primarily. Inclusive criteria: Articles having a close relation with the application of covered stents in neural intervention, especially in cerebrovascular disease, and the latest articles or articles published in authority journals in the same field were chosen. Exclusive criteria: articles with repetitive studies were excluded.LITERATURE EVALUATION: 223 English and 196 Chinese articles were primarily checked by reading titles and abstracts. Among the 31 collected articles, 4 are reviews, 3 are experimental studies and others are clinical studies.DATA SYNTHESIS: Covered stents show special advantages in neural interventional therapy and become a hot spot in present study. There are individual case reports or small group case reports on the application of covered stents in hemorrhagic cerebrovascular disease. It is reported that the covered stent effectively occludes aneurysm, dissecting aneurysm and arteriovenous fistula, keeps patency of the parent artery. The covered stent isolates ulcerated plaque via physical barriers, avoids the abscission of embolus, which can further reduce the development of embolism in percutaneous carotid artery stenting. After releasing covered stents, polytetrafluoroethylene makes the disepiment smooth. Its good biocompatibility

  20. A Nano-Inspired Multifunctional POSS-PCU Covered Stent: Endothelial Progenitor Cell Capture with Stealth Liposomal Drug Release

    OpenAIRE

    Tan, A. J. K.

    2014-01-01

    The 2 main unresolved issues inherent in coronary stents are in-stent restenosis (ISR) and late stent thrombosis (ST). ISR is largely due to vascular smooth muscle cell (VSMC) proliferation, and ST is attributed to a lack of re-endothelialization. This thesis describes the conceptualization and development of a biofunctionalized polyhedral oligomeric silsesquioxane poly(carbonate-urea) urethane (POSS-PCU) platform, for the express purpose of circumventing ISR and ST. A bare-metal stent is emb...

  1. Subclavian artery pseudoaneurysm complicating central venous catheterization: endovascular treatment with Amplatzer Vascular Plug 4 and covered stent.

    Science.gov (United States)

    Rossi, Umberto G; Petrocelli, Francesco; Ferro, Carlo

    2013-12-01

    Central venous catheterization is a routine vascular access procedure; however, it may be associated with life-threatening complications such as arterial puncture, leading to pseudoaneurysm formation. We report a case of a 41-year-old female that developed an iatrogenic left subclavian pseudoaneurysm complicating the attempt of left internal jugular vein cannulation for temporary hemodialysis therapy. The patient underwent urgent endovascular treatment with deployment of covered stent into the left subclavian artery (SCA) after embolization of the origin of the left internal mammary artery with Amplatzer Vascular Plug 4. The patient's recovery was unremarkable. Follow-up till 24 months reveals total exclusion of the pseudoaneurysm of the left SCA with patency of the distal branches.

  2. Experiment of new compliance covered endovascular stent in sheep model%新型高柔顺主动脉覆膜支架实验研究

    Institute of Scientific and Technical Information of China (English)

    王韧; 韩晓峰; 杨帆; 孙立忠; 黄连军; 徐志伟; 杜月河; 贾莲; 郑斯宏

    2014-01-01

    目的 探讨新型高柔顺主动脉覆膜支架在动物模型中使用的安全性和可靠性.方法 12只绵羊分为2组,每组6只,分别进行胸主动脉覆膜支架实验和腹主动脉覆膜支架实验.10 mm人工血管与绵羊腹主动脉吻合,然后经人工血管植入输送器和支架,在胸主动脉释放支架.存活30d后行胸主动脉造影,观察支架位置、形态;然后处死绵羊,进行大体解剖和病理检查.结果 所有支架均释放在所需位置,术中造影无支架移位及内漏.胸主动脉支架组有1只羊术后无法站立,术后5d死亡,尸体解剖可见支架部位血管腔内血栓形成,堵塞管腔.腹主动脉支架组有1只羊术后无法站立,术后30 d后处死,尸体解剖同样发现支架部位血管腔内血栓形成,堵塞管腔.其余羊均术后即可站立,正常活动,饮食无异常.1个月后造影,支架部位管腔通畅,支架固定在释放位置,无移位、内漏及造影剂外漏.病理检查结果证实:植入的支架与血管结合紧密,支架内壁组织光滑.结论 新型高柔顺主动脉覆膜支架在动物实验中表现了良好性能,具有安全性和可靠性.%Objective In order to test feasibility and security of new compliance covered endovascular stent in sheep model.Methods 12 sheeps were divided into 2 groups:thoracic aortic stent group and abdominal aortic stent group.10 mm diameters of vascular prosthesis was end-to-side anastomosed with abdominal aorta of the sheep.Stents were transported through vascular prosthesis into thoracic aorta of the sheep.The stents were deployed in desired position of thoracic aorta.30 days later,aortogram were performed to observe position and shape of the stents.Then,the sheep were euthanized,gross and histopathologic study were executed.Results All stent were successfully deployed,no stent shifting and endoleak were observed during aortagram 30 days after operation.1 sheep died of thrombosis of the thoracic aortic stent at 5 day

  3. Radiological image-guided placement of covered Niti-S stent for palliation of dysphagia in patients with cervical esophageal cancer.

    Science.gov (United States)

    Fujita, Takeshi; Tanabe, Masahiro; Shimizu, Kensaku; Iida, Etsushi; Matsunaga, Naofumi

    2013-06-01

    The aim of this study was to evaluate the clinical effectiveness of covered Niti-S stent placement under multidetector CT and fluoroscopy guidance for the palliation of dysphagia in patients with cervical esophageal cancer. Under radiological imaging guidance using axial and sagittal CT scans, and fluoroscopy, Niti-S esophageal stents were placed in ten consecutive patients with complete obstruction caused by cervical esophageal cancer (9 men and 1 woman; age range = 54-79 years; mean age = 68.1 years) between February 2010 and December 2011. The procedure time and technical success rate were evaluated. Swallowing improvement was assessed by the following items: ability to eat and/or swallow (graded as follows: 3 = ability to eat normal diet, 2 = ability to eat semisolids, 1 = ability to swallow liquids, 0 = complete obstruction). Procedural and post-procedural complications were also evaluated. Survival (mean ± SD) was examined. The mean (±SD) procedure time was 40 ± 19 min (range = 21-69 min). Stent placement was technically successful in all patients; inadequate stent deployment did not occur in any case. Ability to eat and/or swallow was improved and scored 2.4 (score 3 in 5 cases, score 2 in 4 cases, score 1 in 1 case, and score 0 in no case) after stent placement. No major or post-procedural complications were encountered. The mean survival time was 131 ± 77 days (range = 31-259 days). Niti-S stents appeared to be a safe and effective device for the palliation of dysphagia caused by advanced cervical esophageal cancer. Multidetector CT and fluoroscopy image guidance helped the operators accurately place the stents in the cervical esophagus.

  4. Reação histopatológica da parede da aorta abdominal ao stent não recoberto Histopathological reaction of the abdominal aorta wall to non-covered stents

    Directory of Open Access Journals (Sweden)

    Rubio Bombonato

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a reação histopatológica da parede aorta abdominal, em suínos, no nível das artérias renais, na presença de stent metálico não recoberto. MÉTODO: Foi estudada histopatologicamente a aorta abdominal de 10 suínos, com peso médio de 86,6 quilos e idade média de 6 meses, submetidos a implante de stent metálico posicionado na aorta, no nível das artérias renais, após 100 dias do implante. Os stents foram liberados por auto-expansão com laparotomia. Os cortes histológicos foram realizados nos seguintes locais: 1 transição entre a aorta normal e aorta contendo stent; 2 aorta contendo o stent; 3 porção contendo os óstios das artérias renais, 4 linfonodos periaórticos e, 5 parênquima renal. As lâminas foram coradas pela técnica da hematoxilina e eosina. RESULTADOS: Os achados macroscópicos revelaram: linfonodomegalia periaórtica; espessamento da parede aórtica; artérias lombares e renais pérvias; estrutura anatômica renal normal. Análises microscópicas, próximas aos stents, evidenciaram espessamento da parede vascular, secundário à fibrose intimal e camada média comprometida com fibrose intersticial. Medidas micrométricas da parede aórtica com o stent, comparada à aorta sem o stent, apresentaram aumento da espessura da parede (75,9% por hiperplasia da camada íntima secundária à proliferação de fibroblastos; depósitos de colágeno com infiltrado inflamatório e granulomas do tipo corpo estranho. CONCLUSÃO: O stent de aço inoxidável descoberto, implantado na aorta de suínos, produziu importante reação inflamatória, com fibrose nas camadas média e íntima, evidenciada pelas análises histopatológicas e a sua presença não comprometeu o estado pérvio da aorta e dos ramos lombares e renais.OBJECTIVE: To evaluate the histopathological reaction of the abdominal aorta wall in pigs' renal arteries to the presence of non-covered stainless steel stents. METHODS: The abdominal aorta of

  5. Fenestration of a Papyrus PK covered stent to recover the occluded left main bifurcation after sealing a left main perforation during a CTO procedure.

    Science.gov (United States)

    Werner, Gerald S; Ahmed, Waqar H

    2017-03-06

    Covered stents are indicated for coronary perforations, but they may seal off major side branches in that process. We report the successful sealing of an ostial left main perforation, induced by a guide catheter in the course of a retrograde approach to treat a chronic total occlusion (CTO) of the right coronary artery (RCA) in a 76year old woman with prior CABG. The implanted Papyrus covered stent, however, overlapped the left main bifurcation and occluded the non-grafted circumflex artery (CX) resulting in acute ischemia. Through a double lumen catheter advanced over the wire located in the left anterior descending coronary artery (LAD) territory, a stiff recanalization wire could be advanced from the side-port to penetrate the stent membrane towards the CX. This was successfully achieved, and after subsequent dilatation, a drug-eluting stent was implanted in Culotte-fashion from the CX to the left main with subsequent kissing-balloon dilatation. The clinical symptoms subsided immediately, and the RCA was finally recanalized in antegrade parallel wire technique. No periprocedural infarct was observed during 48h of follow-up before discharge. At clinical follow-up of 6months the patient is symptom-free. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Lethal post-endoscopic retrograde cholangiopancreatography pancreatitis following fully covered metal stent placement in distal biliary obstruction due to unresectable cholangiocarcinoma.

    Science.gov (United States)

    Itoi, Takao; Tsuchiya, Takayoshi; Tanaka, Reina; Ikeuchi, Nobuhito; Sofuni, Atsushi

    2013-05-01

    Biliary self-expandable metallic stent (SEMS) is the preferred and first-line therapy for unresectable malignant biliary obstruction. To date, several reports have revealed the relatively high incidence of acute complications such as pancreatitis and cholecystitis due to mechanical stent compression. In the present case, we encountered fatal pancreatitis following fully covered metal stent placement. An 85-year-old man had middle bile duct strictures due to cholangiocarcinoma. A 10-mm diameter fully covered SEMS was placed across the papilla for biliary decompression. Laboratory data and physical evidence the following day revealed acute pancreatitis. Therefore, antibiotics and protein degeneration enzyme inhibitors were given. However, his condition did not improve. Two days after the procedure, we removed the stent and returned him to his original hospital. Serum amylase level decreased below 400 mg/dL 6 h after the procedure. However, the acute pancreatitis worsened. Although we treated the patient in the intensive care unit, he died 32 days after the second admission.

  7. Malignant tracheal-mediastinal-parenchymal-pleural fistula after chemoradiation plus bevacizumab: management with a Y-silicone stent inside a metallic covered stent.

    Science.gov (United States)

    Machuzak, Michael S; Santacruz, Jose F; Jaber, Wissam; Gildea, Thomas R

    2015-01-01

    Tracheal or bronchial-mediastinal fistulas are a rare entity associated to high mortality. We report a case of a 58-year-old man with an unresectable non-small cell carcinoma of the lung, treated with chemoradiation followed by bevacizumab. Approximately, 6 weeks after starting bevacizumab he developed a severe cough with copious secretions He could not lie supine due to the feeling of drowning. Investigations revealed a large tracheo-mediastinal-parenchymal-pleural fistula. Palliative management was offered with interventional bronchoscopic techniques. He was found to have a large central airway defect that obliterated almost 40% of the trachea. Under general anesthesia and positive pressure ventilation, a unique approach was used to rebuild an eroded tracheal and right main stem bronchial wall. A self-expanding metallic stent (SEMS) was placed to provide a scaffold of support, whereas a Dumon Y-stent was placed inside the SEMS. This combination allowed for a patent, stable airway; recreating the normal anatomy in a minimally invasive manner walling off the fistula. The patient was discharged 2 days after the bronchoscopic intervention, with significant palliation of his symptomatology. Eighteen months later, the upper lobe cavity persists with a stable airway and stents perfectly positioned with clinically insignificant evidence of stent related granulation in the upper trachea.

  8. Heparin and Vascular Endothelial Growth Factor Loaded Poly(L-lactide-co-caprolactone) Nanofiber Covered Stent-Graft for Aneurysm Treatment.

    Science.gov (United States)

    Wang, Jing; An, Qingzhu; Li, Dawei; Wu, Tong; Chen, Weiming; Sun, Binbin; El-Hamshary, Hany; Al-Deyab, Salem S; Zhu, Wei; Mo, Xiumei

    2015-11-01

    Restenosis caused by thrombopoiesis is one of the biggest hinders of endovascular stent-graft used in small-diameter vessels. Rapid endothelialization of the lumen of stent is a promising approach to prevent thrombosis. In this study, we aimed at loading heparin, a potent anticoagulants, and vascular endothelial growth factor (VEGF) into the core of poly(L-lactide-co-caprolactone) nanofiber via emulsion electrospinning. The nanofiber was covered on the stent and applied in the treatment of vascular diseases such as aneurysm. The morphologies of the emulsion electrospun nanofibers and core--shell structure were observed by scanning electron microscope and laser scanning confocal microscope. The release profiles of heparin and VEGF, degradation rate of nanofiber mats and cell proliferation in vitro were investigated. It was found that the release of both heparin and VEGF from the nanofiber lasted for more than 30 days without serious initial burst release. The degradation rate of nanofiber mats containing heparin and VEGF was faster than that of pure PLCL nanofiber mats. Moreover, the released VEGF could promote the proliferation of Pig iliac endothelial cells (PIECs) cultured on the nanofiber mat, which was of great benefit to stent endothelialization. The results of digital subtraction angiography (DSA) follow-up indicated the aneurysm was obliterated by separating the aneurysm dome from the blood circulation and the parent artery kept long-term patency. Results of the study demonstrated that the heparin and VEGF loaded nanofiber could provide an approach to fabricate covered stent-graft with properties of anticoagulation and induction of rapid endothelialization.

  9. MR evaluation ex vivo and in vivo of a covered stent-graft for abdominal aortic aneurysms: ferromagnetism, heating, artifacts, and velocity mapping.

    Science.gov (United States)

    Engellau, L; Olsrud, J; Brockstedt, S; Albrechtsson, U; Norgren, L; Ståhlberg, F; Larsson, E M

    2000-07-01

    Magnetic resonance imaging (MRI) safety was evaluated at 1.5 T in a covered nickel titanium stent-graft (Vanguard) used for endovascular treatment of abdominal aortic aneurysms (AAAs). Imaging artifacts were assessed on MRI with contrast-enhanced (CE) three-dimensional (3D) MR angiography (MRA) and spiral computed tomography (CT) in 10 patients as well as ex vivo. Velocity mapping was performed in the suprarenal aorta and femoral arteries in 14 patients before and after stent-graft placement. For comparison it was also performed in six healthy volunteers. No ferromagnetism or heating was detected. Metal artifacts caused minimal image distortion on MRI/MRA. The artifacts disturbed image evaluation on CT at the graft bifurcation and graft limb junction. No significant differences in mean flow were found in patients before and after stent-graft placement. Our study indicates that MRI at 1.5 T may be performed safely in patients with the (Vanguard) stent-graft. MRI/MRA provides diagnostic image information. Velocity mapping is not included in our routine protocol.

  10. USE OF COVERED SELF-EXPANDABLE NITINOL STENT FOR ANASTOMOTIC BILIARY STRUCTURE MANAGEMENT AFTER LIVER TRANSPLANTATION: THE FIRST EXPERIENCE

    Directory of Open Access Journals (Sweden)

    M. N. Kornilov

    2013-01-01

    Full Text Available Aim. The aim of this study focuses on the first experience with self-expandable stents, analysis of its efficacy and safety in the treatment of anastomotic strictures after liver transplantation. Materials and methods. There’re 136 liver transplantations performed from 2004 till 2012. To correct anastomotic strictures we’ve used only the self-expandable coated nitinol stent. We performed stenting in 7 recipient. Result. In 131 liver transplant recipients incidence of biliary strictures has been 5.3%. All of 5 patients have been managed by retrograde or antegrade way. Conclusion. Our first experience demonstrate efficacy and safety of the used tecniques up to 24 months. The analysis of more long-term results is required. 

  11. Comparison of transjugular intrahepatic portosystemic shunt with covered stent and ballon-occluded retrograde transvenous obliteration in managing isolated gastric varices

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seung Kwon; Lee, Kristen A.; Sauk, Steven; Korenblat, Kevin [Washington University St. Louis School of Medicine, St. Louis (United States)

    2017-04-15

    Although a transjugular intrahepatic portosystemic shunt (TIPS) is commonly placed to manage isolated gastric varices, balloon-occluded retrograde transvenous obliteration (BRTO) has also been used. We compare the long-term outcomes from these procedures based on our institutional experience. We conducted a retrospective review of patients with isolated gastric varices who underwent either TIPS with a covered stent or BRTO between January 2000 and July 2013. We identified 52 consecutive patients, 27 who had received TIPS with a covered stent and 25 who had received BRTO. We compared procedural complications, re-bleeding rates, and clinical outcomes between the two groups. There were no significant differences in procedural complications between patients who underwent TIPS (7%) and those who underwent BRTO (12%) (p = 0.57). There were also no statistically significant differences in re-bleeding rates from gastric varices between the two groups (TIPS, 7% [2/27]; BRTO, 8% [2/25]; p = 0.94) or in developing new ascites following either procedure (TIPS, 4%; BRTO, 4%; p = 0.96); significantly more patients who underwent TIPS developed hepatic encephalopathy (22%) than did those who underwent BRTO (0%, p = 0.01). There was no statistically significant difference in mean survival between the two groups (TIPS, 30 months; BRTO, 24 months; p = 0.16); median survival for the patients who received TIPS was 16.6 months, and for those who underwent BRTO, it was 26.6 months. BRTO is an effective method of treating isolated gastric varices with similar outcomes and complication rates to those of TIPS with a covered stent but with a lower rate of hepatic encephalopathy.

  12. Selection and fabrication of a non-woven polycarbonate urethane cover for a tissue engineered airway stent

    NARCIS (Netherlands)

    Chen, Weiluan; Clauser, Johanna; Thiebes, Anja Lena; McGrath, Donnacha J.; McHugh, Peter E.; Steinseifer, Ulrich; Jockenhoevel, Stefan; Hennink, Wim E.; Kok, Robbert Jan

    2016-01-01

    One of the major problems in end-stage bronchotracheal cancer is stenosis of the upper airways, either due to luminal ingrowth of the tumor or mucus plugging. Airway stents that suppress tumor ingrowth and sustain mucociliary transport can alleviate these problems in end-stage bronchial cancer. We

  13. Flexo-dielectro-optical spectroscopy of PDLC films modified by nano-rubbed PTFE layers

    Science.gov (United States)

    Popova, Lidia T.

    2016-02-01

    The electro-optical (EO) response of planar single layers of polymer-dispersed liquid crystal (PDLC) composites of relatively large nematic microdroplets modified by layers of teflon (PTFE), was studied. The PDLC films were prepared from liquid crystal E7 and photopolymer NOA-65 in cells assembled with parallel or orthogonal PTFE-covered glass plates. The influence of nanostructured PTFE polymer nanolayers on both the polarized and depolarized component of laser light transmitted through PDLC cells of both geometry of layer rubbing directions was determined. Flexo-dielectro-optical spectroscopy in the range of 10 Hz - 1 kHz was applied to examine the amplitude-frequency EO modulation by PTFE-modified PDLCs in dependence on the applied alternating-current electric field. Specific fall-downs in the frequency spectra of the first and second harmonic EO modulation by PTFE-modified PDLCs were observed, that could be tuned by the driving electric field.

  14. Effect of Early Use of Covered Self-Expandable Endoscopic Stent on the Treatment of Postoperative Stapler Line Leaks.

    Science.gov (United States)

    Quezada, Nicolás; Maiz, Cristóbal; Daroch, David; Funke, Ricardo; Sharp, Allan; Boza, Camilo; Pimentel, Fernando

    2015-10-01

    Postoperative leaks are a dreaded complication after bariatric surgery (BS). Its treatment is based on nutritional support and sepsis control by antibiotics, collections drainage and/or prosthesis, and/or surgery. The aim of this study is to report our experience with coated self-expandable endoscopic stents (SEES) for leaks treatment. This study was performed in a University Hospital, (censored). We performed a retrospective analysis of our BS database from January 2007 to December 2013. All patients with leak after BS treated with SEES were included. We identified 29 patients; 17 (59%) were women, with median age of 37 (19-65) years, and preoperative body mass index of 40 (28.7-56-6) kg/m(2). Nineteen (65.5%) patients had a sleeve gastrectomy and 10 (34.5%) a Roux-en-Y gastric bypass. All patients had a leak in the stapler line. Median time from surgery to leak diagnosis was 7 (1-51) days, and SEES were installed 8 (0-104) days after diagnosis. Twenty-one (72%) patients also had abdominal exploration. Median length of SEES use was 60 (1-299) days. Patients who had SEES as primary treatment (with or without simultaneous reoperation) had a shorter leak closure time (50 [6-112] vs 109 [60-352] days; p = 0.008). Twenty-eight (96.5%) patients successfully achieved leak closure with SEES. There were 16 migrations in 10 (34%) patients, 1 (3%) stent fracture, 1 opening of the blind end of alimentary limb (3%), and 5 patients (17%) required a second stent due to leak persistence. SEES is a feasible, safe, and effective management of post BS leaks, although patients may also require prosthesis revision and abdominal exploration. Primary SEES placement is associated with a shorter leak resolution time.

  15. An in vivo pilot study of a microporous thin film nitinol-covered stent to assess the effect of porosity and pore geometry on device interaction with the vessel wall.

    Science.gov (United States)

    Chun, Youngjae; Kealey, Colin P; Levi, Daniel S; Rigberg, David A; Chen, Yanfei; Tillman, Bryan W; Mohanchandra, K P; Shayan, Mahdis; Carman, Gregory P

    2017-03-01

    Sputter-deposited thin film nitinol constructs with various micropatterns were fabricated to evaluate their effect on the vessel wall in vivo when used as a covering for commercially available stents. Thin film nitinol constructs were used to cover stents and deployed in non-diseased swine arteries. Swine were sacrificed after approximately four weeks and the thin film nitinol-covered stents were removed for histopathologic evaluation. Histopathology revealed differences in neointimal thickness that correlated with the thin film nitinol micropattern. Devices covered with thin film nitinol with a lateral × vertical length = 20 × 40 µm diamond pattern had minimal neointimal growth with well-organized cell architecture and little evidence of ongoing inflammation. Devices covered with thin film nitinol with smaller fenestrations exhibited a relatively thick neointimal layer with inflammation and larger fenestrations showed migration of inflammatory and smooth muscle cells through the micro fenestrations. This "proof-of-concept" study suggests that there may be an ideal thin film nitinol porosity and pore geometry to encourage endothelialization and incorporation of the device into the vessel wall. Future work will be needed to determine the optimal pore size and geometry to minimize neointimal proliferation and in-stent stenosis.

  16. A Case of Successful Placement of a Fully Covered Metallic Stent for Hemobilia Secondary to Hepatocellular Carcinoma with Bile Duct Invasion

    Directory of Open Access Journals (Sweden)

    Yoshiaki Kawaguchi

    2012-12-01

    Full Text Available Hemobilia represents gastrointestinal bleeding that develops as a result of communication between blood vessels and the biliary tract, which causes the blood to reach the duodenal papilla. It is characterized by biliary colic as the initial symptom, and the complications of cholangitis, obstructive jaundice and/or anemia. In general, definitive diagnosis is made by esophagogastroduodenoscopy which confirms bleeding from the duodenal papilla. Abdominal US and abdominal enhanced CT are performed to identify the source of the bleeding, as well as ERCP for biliary drainage to control the comorbid cholangitis. If active hemorrhage accompanied by worsening of the anemia is suspected, abdominal angiography is performed to selectively image the hepatic artery. Then, embolization of the culprit vessel is recommended. In our patients with difficult hemostasis, because of the direct compression hemostasis to the tumor site achieved with the fully covered metallic stent and secondary compression hemostasis due to blood clots, the bleeding could be controlled.

  17. Placement of a covered self-expandable nitinol stent for bile duct stricture that caused by ischemic injury after transcatheter arterial chemoembolization in a patient with hepatocellular carcinoma: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Yoo, Kweon; Seo, Tae Seok; Cha, In Ho; Huh, Sik; Byun, Kwan Soo [Guro Hospital, Korea University College of Medicine, Seoul (Korea, Republic of)

    2008-10-15

    The authors report here on a case of focal stricture in the common hepatic duct that was caused by ischemic bile duct injury after repeat TACE procedures for hepatocellular carcinoma, and the patient was successfully treated with a covered self-expandable nitinol stent.

  18. Superhydrophobic laser ablated PTFE substrates

    Energy Technology Data Exchange (ETDEWEB)

    Falah Toosi, Salma; Moradi, Sona [Department of Chemical and Biological Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z3 (Canada); Kamal, Saeid [Laboratory for Advanced Spectroscopy and Imaging research (LASIR) Chemistry Department, The University of British Columbia, Vancouver, BC, V6T 1Z3 (Canada); Hatzikiriakos, Savvas G., E-mail: savvas.hatzi@ubc.ca [Department of Chemical and Biological Engineering, The University of British Columbia, Vancouver, BC, V6T 1Z3 (Canada)

    2015-09-15

    Highlights: • Uniaxial and biaxial patterns fabricated on PTFE surface are responsible for superhydrophobic behavior of the surface. • Biaxial scan artificially creates high level of dual scale roughness on the PTFE surface with high contact angles (CAs) and low contact angle hysteresis (CAH) similar in all directions. • Contact angle of biaxially scanned surfaces can be as high as 170° and their contact angle hysteresis can reach as low as 3°. - Abstract: The effect of femtosecond laser irradiation process parameters (fluence, scanning speed and beam overlap) on the wettability of the resulted micro/nano-patterned morphologies on polytetrafluoroethylene is studied in detail. Several distinctly different micro/nano-patterns were fabricated including uniaxial and biaxial patterns. In particular, using biaxial scanning well defined pillared morphology was fabricated. The wettability analysis of the biaxially scanned samples revealed enhanced superhydrophobicity exhibiting high contact angles and low contact angle hysteresis.

  19. Future developments in biliary stenting

    Directory of Open Access Journals (Sweden)

    Hair CD

    2013-06-01

    Full Text Available Clark D Hair,1 Divyesh V Sejpal21Department of Medicine, Section of Gastroenterology and Hepatology, Baylor College of Medicine, Houston, TX, USA; 2Department of Medicine, Section of Gastroenterology, Hofstra North Shore-LIJ School of Medicine, North Shore University Hospital, Manhasset, NY, USAAbstract: Biliary stenting has evolved dramatically over the past 30 years. Advancements in stent design have led to prolonged patency and improved efficacy. However, biliary stenting is still affected by occlusion, migration, anatomical difficulties, and the need for repeat procedures. Multiple novel plastic biliary stent designs have recently been introduced with the primary goals of reduced migration and improved ease of placement. Self-expandable bioabsorbable stents are currently being investigated in animal models. Although not US Food and Drug Administration approved for benign disease, fully covered self-expandable metal stents are increasingly being used in a variety of benign biliary conditions. In malignant disease, developments are being made to improve ease of placement and stent patency for both hilar and distal biliary strictures. The purpose of this review is to describe recent developments and future directions of biliary stenting.Keywords: plastic stents, self-expandable metal stents, drug eluting stents, bioabsorbable stents, malignant biliary strictures, benign biliary strictures

  20. Use of self-expanding covered stent and negative pressure wound therapy to manage late rectal perforation after injury from an improvised explosive device: a case report.

    Science.gov (United States)

    Ozer, M Tahir; Coskun, Ali K; Sinan, Huseyin; Saydam, Mehmet; Akay, Emin O; Peker, Subutay; Ogunc, Gokhan; Demirbas, Sezai; Peker, Yusuf

    2014-06-01

    Blast injuries, caused by explosions accompanied by high-pressure waves, produce tissue damage in the acute period, followed in the later period by circulatory disorders due to vascular endothelial damage and related tissue necrosis. Blunt rectal perforation is rare and difficult to diagnose. In the acute period following blast pelvic injuries, the main objectives are to stop bleeding, minimise contamination and preserve the patient's life. The patient in this report had major vascular injuries, severe pelvic injury and, in the later period, rectal perforation because of vascular endothelial damage caused by the blast effect. Our aim was to treat the patient conservatively because of his poor general condition. We placed a self-expanding covered stent (SECS) into the rectum and then applied negative pressure wound therapy (NPWT; V.A.C.® Therapy, KCI) to the pelvic region and perirectal area. At the end of the treatment, the rectal perforation was closed, and the patient was discharged with healing. In this article, we discuss the novel use of an SECS with NPWT and review related literature.

  1. Jet blown PTFE for control of biocompatibility

    Science.gov (United States)

    Leibner, Evan Scott

    The development of fully hemocompatible cardiovascular biomaterials will have a major impact on the practice of modern medicine. Current artificial surfaces, unlike native vascular surfaces, are not able to control clot and thrombus formation. Protein interactions are an important component in hemocompatibility and can result in decreased patency due to thrombus formation or surface passivation which can improve endothelization. It is believed that controlling these properties, specifically the nanometer sizes of the fibers on the material's surface, will allow for better control of biological responses. The biocompatibility of Teflon, a widely used polymer for vascular grafts, would be improved with nanostructured control of surface features. Due to the difficultly in processing polytetrafluoroethylene (PTFE), it has not been possible to create nanofibrous PTFE surfaces. The novel technique of Jet Blowing allows for the formation of nanostructured PTFE (nPTFE). A systematic investigation into controlling polymer properties by varying the processing conditions of temperature, pressure, and gas used in the Jet Blowing allows for an increased understanding of the effects of plasticization on the material's properties. This fundamental understanding of the material science behind the Jet Blowing process has enabled control of the micro and nanoscale structure of nPTFE. While protein adsorption, a key component of biocompatibility, has been widely studied, it is not fully understood. Major problems in the field of biomaterials include a lack of standard protocols to measure biocompatibility, and inconstant literature on protein adsorption. A reproducible protocol for measuring protein adsorption onto superhydrophobic surfaces (ePTFE and nPTFE) has been developed. Both degassing of PBS buffer solutions and evacuation of the air around the expanded PTFE (ePTFE) prior to contact with protein solutions are essential. Protein adsorption experiments show a four

  2. PTFE PCB的加工%Processing PTFE PCB

    Institute of Scientific and Technical Information of China (English)

    李海

    2003-01-01

    聚四氟乙烯PTFE或Teflon印制板在无线天线、基站和无线通讯设施中应用日趋广泛。PTFE在双面PCB和单面FR4 PCB的应用也非常普及。作为专业的PTFE PCB生产厂家,形成了一个特殊的市场范围。随着无线通讯的发展,PTFE和混合介质层的PCB会越来越多的进入PCB市场。PTFE也给常规FR4厂家带来挑战。

  3. Simulations of Self-Expanding Braided Stent Using Macroscopic Model of NiTi Shape Memory Alloys Covering R-Phase

    Science.gov (United States)

    Frost, M.; Sedlák, P.; Kruisová, A.; Landa, M.

    2014-07-01

    Self-expanding stents or stentgrafts made from Nitinol superelastic alloy are widely used for a less invasive treatment of disease-induced localized flow constriction in the cardiovascular system. The therapy is based on insertion of a stent into a blood vessel to maintain the inner diameter of the vessel; it provides highly effective results at minimal cost and with reduced hospital stays. However, since stent is an external mechanical healing tool implemented into human body for quite a long time, information on the mechanical performance of it is of fundamental importance with respect to patient's safety and comfort. Advantageously, computational structural analysis can provide valuable information on the response of the product in an environment where in vivo experimentation is extremely expensive or impossible. With this motivation, a numerical model of a particular braided self-expanding stent was developed. As a reasonable approximation substantially reducing computational demands, the stent was considered to be composed of a set of helical springs with specific constrains reflecting geometry of the structure. An advanced constitutive model for NiTi-based shape memory alloys including R-phase transition was employed in analysis. Comparison to measurements shows a very good match between the numerical solution and experimental results. Relation between diameter of the stent and uniform radial pressure on its surface is estimated. Information about internal phase and stress state of the material during compression loading provided by the model is used to estimate fatigue properties of the stent during cyclic loading.

  4. Endothelialization of over- and undersized flow-diverter stents at covered vessel side branches: An in vivo and in silico study.

    Science.gov (United States)

    Berg, Philipp; Iosif, Christina; Ponsonnard, Sebastien; Yardin, Catherine; Janiga, Gábor; Mounayer, Charbel

    2016-01-01

    Although flow-diverting devices are promising treatment options for intracranial aneurysms, jailed side branches might occlude leading to insufficient blood supply. Especially differences in the local stent strut compression may have a drastic influence on subsequent endothelialization. To investigate the outcome of different treatment scenarios, over- and undersized stent deployments were realized experimentally and computationally. Two Pipeline Embolization Devices were placed in the right common carotid artery of large white swine, crossing the right ascending pharyngeal artery. DSA and PC-MRI measurements were acquired pre- and post-stenting and after three months. To evaluate the stent strut endothelialization and the corresponding ostium patency, the swine were sacrificed and scanning electron microscopy measurements were carried out. A more detailed analysis of the near-stent hemodynamics was enabled by a realistic virtual stenting in combination with highly resolved Computational Fluid Dynamics simulations using case-specific boundary conditions. The oversizing resulted in an elongated stent deployment with more open stent pores, while for the undersized case a shorter deployment with more condensed pores was present. In consequence, the side branch of the first case remained patent after three months and the latter almost fully occluded. The virtual investigation confirmed the experimental findings by identifying differences between the individual velocities as well as stent shear stresses at the distal part of the ostia. The choice of flow-diverting device and the subsequent deployment strategy strongly influences the patency of jailed side branches. Therefore, careful treatment planning is required, to guarantee sufficient blood supply in the brain territories supplied those branches.

  5. Bronchial stents

    Directory of Open Access Journals (Sweden)

    Ibrahim Emad

    2006-01-01

    Full Text Available Bronchial stents are mostly used as a Palliative relief of symptoms often caused by airway obstruction, It is also used for sealing of stump fistulas after pneumonectomy and dehiscence after bronchoplastic operations. Advances in airway prosthetics have provided a variety of silicone stents, expandable metal stents, and pneumatic dilators, enabling the correction of increasingly complex anatomical problems. Several series have been published describing the application and results of these techniques. This manuscript reviews the historical development of stents, types, indication, outcome, and complications. Alternative therapies for tracheobronchial stenting were also reviewed

  6. Use of a novel covered self-expandable metal stent with an anti-migration system for endoscopic ultrasound-guided drainage of a pseudocyst.

    Science.gov (United States)

    Téllez-Ávila, Félix Ignacio; Villalobos-Garita, Alvaro; Ramírez-Luna, Miguel Ángel

    2013-06-16

    The development of pseudocysts in patients with chronic pancreatitis has been reported in 23%-60% of cases and drainage is indicated when they become symptomatic. Endoscopic ultrasound-guided drainage with the placement of plastic or metallic stents to create a cystogastric anastomosis has been shown to be a reliable and efficacious maneuver. Metallic stent use appears to be a safe and effective alternative that shortens the length of time of the procedure and maintains a greater diameter in the cystogastric communication. However, important migration rates have been reported. The use of new metallic stents that are specially designed to prevent migration represents a promising development in the treatment of these group of patients that appears to be safe and effective for pseudocyst drainage and could importantly reduce migration rates, while at the same time having the advantage of a single step procedure and a larger fistula diameter in the endoscopic cystogastric anastomosis.

  7. 可回收食管覆膜支架治疗良性食管瘘的疗效分析%The effectiveness of retrievable covered-stent for the treatment of benign esophageal fistulas: a clinical analysis

    Institute of Scientific and Technical Information of China (English)

    韩世龙; 朱晓黎; 孙鸽

    2012-01-01

    目的 分析总结置入可回收食管覆膜支架治疗由于多种原因引起的良性食管瘘的疗效及堵漏失败后的治疗策略.方法 收集苏州大学附属第一医院自2006年1月至2011年6月经食管碘水造影确诊的21例良性食管瘘患者,在DSA监视下置入可回收食管覆膜支架,支架在体内放置28~250 d后取出并行食管造影检查评估瘘口封闭情况,对堵漏失败的病例,尝试胃镜下钛夹夹闭、DSA下生物胶堵漏及永久食管覆膜支架堵漏后进行成功补救治疗.结果 入组所有病例中,可回收食管覆膜支架均一次性置入,技术成功率100%,术中无严重并发症.14例支架取出术后复查食管造影显示瘘口完全封闭,首次支架治愈率66.7%,未成功患者中5例取出支架复查食管造影见对比剂外溢,提示瘘口未完全封闭,其中2例各放置永久性覆膜食管支架l枚,6个月后食管造影复查成功堵漏.2例在用钛夹夹闭瘘口;1例用生物胶堵漏后未成功.2次支架治疗成功率为76.2%,通过其他微创方式补救治疗后成功率85.7%.所有堵漏成功的患者支架取出后或微创补救堵漏成功后行上消化道造影证实无对比剂外溢.支架相关并发症包括不同程度胸骨后疼痛不适或异物感21例(100%),支架移位3例(14.3%);严重并发症为迟发性支架所致大出血、休克、死亡2例(9.5%).结论 应用可回收食管覆膜支架封堵由多种病变引起的良性食管瘘技术成功率及回收率高,封堵瘘口疗效确切,严重并发症少,对堵漏失败者可尝试永久支架或钛夹夹闭方法治疗.%Objective To analyze the effectiveness of retrievable covered stent in treating esophageal fistulas and to discuss the management of complications occurred after stenting. Methods Twenty-one patients with esophogography-proved esophageal fistulas, who were encountered in authors' hospital during the period from Jan. 2006 to June 2011, were enrolled

  8. Carotid artery stenting: which stent for which lesion?

    Science.gov (United States)

    Bosiers, Marc; Deloose, Koen; Verbist, Jürgen; Peeters, Patrick

    2005-01-01

    The different geometries and working principles of carotid stents (nitinol or cobalt chromium, open- or closed-cell configuration) provide each product with unique functional properties. The individual characteristics of each device may make it an attractive choice in one circumstance but render it less desirable in other situations. In approximately 75% of all procedures, all types of stents will achieve similar outcomes, making adequate device selection unnecessary. For the remaining quarter, careful preoperative screening is mandatory. In addition to eventual access issues, the choice of the optimal carotid stent depends mainly on arterial anatomy and lesion morphology. When treating a tortuous anatomy, stents with a flexible and comformable open-cell configuration are preferred. In arteries with a significant mismatch between common carotid artery and internal carotid artery diameter, cobalt chromium (Elgiloy) or tapered nitinol stents are selected. Lesions with suspected high emboligenicity are best covered with stents with a closed-cell configuration, whereas highly calcified lesions need treatment with nitinol stents. Thorough knowledge of the characteristics, advantages and disadvantages, and working principles of the different available stents is mandatory to optimally select the materials to be used for patients eligible for carotid revascularization.

  9. Experimental study of the compression properties of Al/W/PTFE granular composites under elevated strain rates

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, X.F., E-mail: lynx@mail.njust.edu.cn [School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094 (China); Zhang, J.; Qiao, L.; Shi, A.S.; Zhang, Y.G.; He, Y. [School of Mechanical Engineering, Nanjing University of Science and Technology, Nanjing 210094 (China); Guan, Z.W. [School of Engineering, University of Liverpool, Brownlow Street, Liverpool L69 3GQ (United Kingdom)

    2013-10-01

    Granular composites consisting of aluminium (Al), tungsten (W) and polytetraflouroethylene (PTFE) are typical energetic materials, which possess high density and strength along with other advantageous properties. To investigate the mechanical behaviour of Al/W/PTFE granular composites, compression tests of three Al/W/PTFE mixtures under quasi-static loading and high strain rate conditions were conducted on a CSS-44100 Materials Testing System and a Split-Hopkinson Pressure Bar (SHPB), respectively. By employing Al bars, the amplitude of the transmitted signal was significantly enhanced and a high signal-to-noise ratio was obtained. This enhancement was due to the decreased Young's modulus of the bars, which led to increased signal amplitude from the strain gauges. The Al/W/PTFE granular composites were processed using a cold isostatic pressing and vacuum sintering approach. In this work, the fracture modes and stress-strain relationships of Al/W/PTFE composites with mass ratios of Al:W:PTFE of 24:0:76, 12:50:38 and 5.5:77:17.5 were studied. A detailed discussion is provided to cover the effect that tungsten addition, strain rate and mass ratio have on the deformation behaviour of the composites. The results show that the mass ratio plays a significant role in determining the dynamic behaviour and failure modes of the composites. Both the Al/W/PTFE (24:0:76) and the Al/W/PTFE (12:50:38) composites are strain rate dependent, elasto-plastic materials characterised by increased yield stress with increased strain rate. However, the Al/W/PTFE (5.5:77:17.5) composite is a brittle material, which shows brittle fracture at a relatively low strain.

  10. Estudo da resposta tissular à endoprótese recoberta de jugular bovina em veia cava inferior de suínos Bovine jugular covered stent-graft implanted in swine inferior vena cava - a study of tissue response

    Directory of Open Access Journals (Sweden)

    Cristina Ribeiro Riguetti Pinto

    2006-06-01

    Full Text Available OBJETIVO: Avaliar a resposta tissular a uma endoprótese, com cobertura biológica heteróloga, implantada em veia cava inferior de suínos. MÉTODO: Desenvolvemos uma endoprótese auto-expansível, revestida com um segmento de jugular bovina, conservada por processo L-hydro e suturada em um stent de aço inoxidável 316L. O dispositivo introdutor utilizado foi a bainha de liberação da endoprótese aórtica Taheri-Leonhardt (Flórida, EUA. Foram implantadas endopróteses em 10 suínos, todas na veia cava infra-renal. Os animais foram submetidos à flebografia peroperatória. À necropsia, após 2 meses, cada endoprótese foi retirada em bloco e analisada macroscopicamente, visando a avaliação da perviedade, aderência aos tecidos vizinhos e incorporação à parede venosa; e, histopatologicamente, visando a resposta histológica ao enxerto. RESULTADOS: Na análise macroscópica, todas as endopróteses encontravam-se pérvias e totalmente incorporadas à parede venosa, porém seis apresentavam trabeculações grosseiras no seu interior e quatro algum grau de fibrose perivascular. Três animais desenvolveram linfocele, uma retroperitoneal e as outras na parede abdominal. No estudo histopatológico, observamos reação inflamatória granulomatosa tipo corpo estranho em todos os casos, sendo predominante na camada média (80%. CONCLUSÃO: O modelo estudado apresentou baixa trombogenicidade, corroborando com a eficácia do meio de conservação e material escolhidos; porém, baixa biocompatibilidade, provavelmente pelo obstáculo imunológico dos xenoenxertos e resposta tissular exagerada do território venoso.OBJECTIVE: To evaluate tissue response to a bovine jugular vein covered stent when implanted in the swine inferior vena cava. METHOD: We developed a self-expanding stent, using a segment of L-hydro conserved bovine jugular vein, which was trimmed and sutured to a 316L stainless steel stent. We used the Taheri-Leonhardt delivery system for

  11. Polymer-Free Drug-Eluting Stents : An Overview of Coating Strategies and Comparison with Polymer-Coated Drug-Eluting Stents

    NARCIS (Netherlands)

    Chen, Weiluan|info:eu-repo/dai/nl/371747198; Habraken, Tom C J; Hennink, Wim E.|info:eu-repo/dai/nl/070880409; Kok, Robbert J.|info:eu-repo/dai/nl/170678326

    2015-01-01

    Clinical evaluations have proven the efficacy of drug-elution stents (DES) in reduction of in-stent restenosis rates as compared to drug-free bare metal stents (BMS). Typically, DES are metal stents that are covered with a polymer film loaded with anti-inflammatory or antiproliferative drugs that

  12. Polymeric Biodegradable Stent Insertion in the Esophagus

    Directory of Open Access Journals (Sweden)

    Kai Yang

    2016-04-01

    Full Text Available Esophageal stent insertion has been used as a well-accepted and effective alternative to manage and improve the quality of life for patients diagnosed with esophageal diseases and disorders. Current stents are either permanent or temporary and are fabricated from either metal or plastic. The partially covered self-expanding metal stent (SEMS has a firm anchoring effect and prevent stent migration, however, the hyperplastic tissue reaction cause stent restenosis and make it difficult to remove. A fully covered SEMS and self-expanding plastic stent (SEPS reduced reactive hyperplasia but has a high migration rate. The main advantage that polymeric biodegradable stents (BDSs have over metal or plastic stents is that removal is not require and reduce the need for repeated stent insertion. But the slightly lower radial force of BDS may be its main shortcoming and a post-implant problem. Thus, strengthening support of BDS is a content of the research in the future. BDSs are often temporarily effective in esophageal stricture to relieve dysphagia. In the future, it can be expect that biodegradable drug-eluting stents (DES will be available to treat benign esophageal stricture, perforations or leaks with additional use as palliative modalities for treating malignant esophageal stricture, as the bridge to surgery or to maintain luminal patency during neoadjuvant chemoradiation.

  13. Therapeutic ultrasound to stimulate osteoconduction - A placebo controlled single blind study using e-PTFE membranes in rats

    NARCIS (Netherlands)

    Schortinghuis, J; Ruben, JL; Raghoebar, GM; Stegenga, B

    2004-01-01

    To decrease heating time of bone defects covered with osteoconductive membranes, an attempt was made to stimulate the osteoconductive process with therapeutic ultrasound. In 72 rats, a circular mandibular defect was created and covered on both sides with an e-PTFE membrane. A control group, an ultra

  14. Hot embossing of PTFE: Towards superhydrophobic surfaces

    Science.gov (United States)

    Jucius, D.; Grigaliūnas, V.; Mikolajūnas, M.; Guobienė, A.; Kopustinskas, V.; Gudonytė, A.; Narmontas, P.

    2011-01-01

    Three types of reusable stamps with features in the form of 2D arrays of pits having lateral dimensions in the range of 2-80 μm and heights of 1.5-15 μm were successfully employed for the hot embossing of PTFE at temperatures up to 50 °C above the glass transition temperature of PTFE amorphous phase. Due to the softening of PTFE at the temperatures used in this study, we were able to decrease imprint pressure significantly when comparing with the imprint conditions reported by other authors. Impact of the imprint temperature, pressure and time on the fidelity of pattern transfer as well as on water repellency was tested. The best results of embossing were achieved by applying pressure of 10 kg/cm 2 for 2 min at 170 °C. In this case, flattening of a natural PTFE roughness and pretty accurate deep replicas of the stamp patterns were observable on the whole imprinted area. Improvement in water repellency was largest for the samples imprinted by Ni stamp patterned with a 2D array of 2 μm square pits spaced by the same dimension and having a depth of 1.5 μm. Cassie-Baxter wetting regime was observed for the deepest imprints with water contact angles up to the superhydrophobic limit.

  15. Emerging Stent and Balloon Technologies in the Femoropopliteal Arteries

    Directory of Open Access Journals (Sweden)

    Georgios Pastromas

    2014-01-01

    Full Text Available Endovascular procedures for the management of the superficial femoral (SFA and popliteal artery disease are increasingly common. Over the past decade, several stent technologies have been established which may offer new options for improved clinical outcomes. This paper reviews the current evidence for SFA and popliteal artery angioplasty and stenting, with a focus on randomized trials and registries of nitinol self-expanding stents, drug-eluting stents, dug-coated balloons, and covered stent-grafts. We also highlight the limitations of the currently available data and the future routes in peripheral arterial disease (PAD stent and balloon technology.

  16. Development and assessment of 316LVM cardiovascular stents

    Energy Technology Data Exchange (ETDEWEB)

    Raval, Ankur [Research and Development Division, Sahajanand Medical Technologies, Surat 395003 (India)]. E-mail: ankur.med@sahmed.com; Choubey, Animesh [Research and Development Division, Sahajanand Medical Technologies, Surat 395003 (India); Engineer, Chhaya [Research and Development Division, Sahajanand Medical Technologies, Surat 395003 (India); Kothwala, Devesh [Research and Development Division, Sahajanand Medical Technologies, Surat 395003 (India)

    2004-11-25

    One of the most common causes for heart failure is vasoconstriction. The medical procedure for alleviating vasoconstriction, angioplasty, calls for intracoronary stents. And the manufacture of intracoronary stents demands absolutely unmatched precision. Current study investigates CNC controlled pulsed Nd:YAG (neodymium:yttrium aluminium garnet) laser for cutting complex geometry of a stent on 316LVM tubings. It has been shown that surface quality of cardiovascular stents has a significant influence on biocompatibility. Therefore, optimal method and parameters for acid pickling of these slotted tube laser cut stents were explored, as a pretreatment for electropolishing. Pickling was necessary prior to electropolishing for removing the oxide films covering the stent surface. An optimal condition for electrochemical polishing could also be established and it caused a smooth stent surface. Passivation of these electropolished stents was done. Furthermore, materials characterization of stents was performed by means of composition and microstructural analysis.

  17. 30-day results from prospective multi-specialty evaluation of carotid artery stenting using the CGuard micronet-covered embolic prevention stent system in real world multicenter clinical practice: the IRON-GUARD study.

    Science.gov (United States)

    Speziale, Francesco; Capoccia, Laura; Sirignano, Pasqualino; Mansour, Wassim; Pranteda, Chiara; Casana, Renato; Setacci, Carlo; Accrocca, Federico; Alberti, Domenico; de Donato, Gianmarco; Ferri, Michelangelo; Gaggiano, Andrea; Galzerano, Giuseppe; Ippoliti, Arnaldo; Mangialardi, Nicola; Pratesi, Giovanni; Ronchey, Sonia; Ruffino, Maria Antonella; Siani, Andrea; Spinazzola, Angelo; Sponza, Massimo

    2017-05-09

    The aim of the present study was to evaluate peri-procedural and 30-day outcomes in a prospective series of patients treated with the CGuard embolic prevention stent system (EPS). From April 2015 to June 2016 a physician-initiated prospective multicenter study was performed in 200 consecutive patients admitted to protected carotid artery stenting (CAS) and treated using CGuard EPS in twelve Vascular Centers. Outcome measures were: technical success, periprocedural (0-24 hours) and post- procedural (24hours-30 days) major and minor strokes, death, acute myocardial infarction (AMI), transient ischemic attack (TIA), and external carotid occlusion. In 3 centres consecutive diffusion-weighted magnetic- resonance-cerebral imaging (DW-MRI) were performed ≤72 hours prior and within 72 hours after the intervention. Distal embolic protection device was employed in 182 patients (91%). Technical success was 100%. No death, AMI or major stroke occurred periprocedurally. There were 2 TIAs and 5 peri-procedural minor strokes (2.5%), including one thrombosis solved by surgery. In the remaining patients (199/200; 99.5%) one-month follow-up duplex ultrasound revealed optimal technical results. Post-procedural clinical follow- up was uneventful. No external carotid artery occlusion occurred. New postprocedural DW-MRI lesions were detected in 12 patients out of 61 (19.6%) including bilateral in 5 (8.2%) and isolated ipsilateral in 6 (9.8%) whereas 1 patient (1.6%) had contralateral-only lesions. Multi-center multi-specialty use of the CGuard EPS in routine clinical practice was associated with no major peri-procedural neurologic complications and a total elimination of post-procedural neurologic complications by 30 days.

  18. A simple technique to remove migrated esophageal stents.

    Science.gov (United States)

    Noyer, C M; Forohar, F

    1998-09-01

    A 51-yr-old man with a tracheoesophageal fistula from an esophageal carcinoma had two expandable covered stents placed, which migrated distally. After several unsuccessful attempts to remove the stents, we fashioned a homemade snare to entrap and remove the stents under endoscopic and fluoroscopic guidance.

  19. Endoscopic extra-cavitary drainage of pancreatic necrosis with fully covered self-expanding metal stents (fcSEMS) and staged lavage with a high-flow water jet system.

    Science.gov (United States)

    Smith, Ioana B; Gutierrez, Juan P; Ramesh, Jayapal; Wilcox, C Mel; Mönkemüller, Klaus E

    2015-04-01

    To present a novel, less-invasive method of endoscopic drainage (ED) for walled-off pancreatic necrosis (WON).We describe the feasibility, success rate, and complications of combined ED extra-cavitary lavage and debridement of WON using a biliary catheter and high-flow water jet system (water pump). Endoscopic ultrasound (EUS)-guided drainage was performed with insertion of two 7-Fr, 4-cm double pigtail stents. Subsequently a fully covered self-expanding metal stent (fcSEMS) was placed. The key aspect of the debridement was the insertion of a 5-Fr biliary catheter through or along the fcSEMS into the cavity, with ensuing saline lavage using a high-flow water jet system. The patients were then brought back for repeated, planned endoscopic lavages of the WON. No endoscopic intra-cavitary exploration was performed. A total of 17 patients (15 men, 2 women; mean age 52.6, range 24 - 69; mean American Society of Anesthesiologists [ASA] score of 3) underwent ED of WON with this new method. The mean initial WON diameter was 9.5 cm, range 8 to 26 cm. The total number of ED was 84, range 2 to 13. The mean stenting period was 42.5 days. The mean follow-up was 51 days, range 3 to 370. A resolution of the WON was achieved in 14 patients (82.3 %). There were no major complications associated with this method. ED of complex WON with fcSEMS followed by repeated endoscopic extra-cavitary lavage and debridement using a biliary catheter and high-flow water jet system is a minimally invasive, feasible method with high technical and clinical success and minimal complications.

  20. 覆膜CP支架治疗主动脉缩窄的临床应用研究%Application of covered cheatham-platinum stent implantation with coarctation of aorta

    Institute of Scientific and Technical Information of China (English)

    韩晓峰; 黄小勇; 郭曦; 薛玉国; 董继伟; 李杰; 黄连军

    2013-01-01

    目的:探讨覆膜(cheatham-platinum,CP)支架治疗青少年及成人先天性主动脉缩窄的临床应用价值.方法:回顾性分析2005年4月至2012年6月期间,接受CP支架介入治疗的23例主动脉缩窄患者,男性17例、女性6例,年龄12 ~29岁,平均(19.79±5.16)岁,体质量36~ 65 kg,平均(52.74±8.33)kg.患者术前经主动脉CTA检查,主动脉缩窄段平均直径4.2~11.7 mm,平均(6.53±1.89)mm,缩窄段长度5~23 mm,平均(14.63±4.64) mm.由股动脉穿刺入路置入装有支架的球囊导管,确切定位后扩张(balloon in balloon,BIB)球囊释放CP支架.结果:23例主动脉缩窄患者CP支架均成功置入,2例患者合并动脉导管未闭.术前缩窄段平均收缩压力阶差(63.8±17.6)mmHg(1 mmHg =0.133 kPa),术后缩窄段平均收缩压力阶差降至(6.47±2.12) mmHg;术后主动脉缩窄段直径增至(21.78±3.19)mm.随访3~12个月,除2例患者术后需继续控制血压外,余患者无上下肢压力阶差及高血压表现.复查CT示缩窄段管腔未发生再狭窄及其它并发症.结论:CP支架对治疗青少年及成人主动脉缩窄的近期疗效满意,远期效果有待进一步观察.%Objective:To evaluate the outcome of covered Cheatham-Platinum (CP)stent implantation for the treatment of native coarctation of Aorta(COA).Methods:From August 2005 to June 2012,23 patients (17 male and 6 female) with native COA who were diagnosed by computed tomography angiography accepted the treatment of covered CP stent implantation.The mean age was (19.79 ±5.16) years,the mean weight was 36-65 kg,(52.74 ±8.33) kg,the mean coarctation diameter was 4.2-11.7 mm,(6.53 ± 1.89)mm,and the mean coarctation length was 5-23 mm,aveiage was (14.63± 4.64) mm,measured by aortic computed tomography angiography.The size of stent and balloon were chosen according to digital subtraction angiography (DSA) examinations.The covered CP stent was delivered to the lesion by the balloon and catheter delivery system

  1. Mechanical and Microstructural Properties of PTFE/Al/W System

    Science.gov (United States)

    Cai, Jing; Jiang, Fengchun; Vecchio, Kenneth S.; Meyers, Marc A.; Nesterenko, Vitali F.

    2007-12-01

    Mechanical and microstructural properties of high density PTFE/Al/W composites consisting of PTFE matrix, aluminum and tungsten particles were investigated. Three types of samples having different porosities and particle sizes of W with an identical weight ratio between PTFE, Al and W were fabricated by Cold Isostatic Pressing. The quasi-static and Hopkinson Bar compression tests were employed to investigate the mechanical properties of these materials. The results demonstrated that the porous PTFE/Al/W composite samples containing fine W particles have higher quasi-static and dynamic fracture stresses than higher density PTFE/Al/W samples containing coarse W particles. ESEM micrographs revealed that deformation occurred mainly in the PTFE matrix while metal particles remain undeformed. We observed nano-fibers of PTFE caused by high strain rate deformation.

  2. Migrated esophageal stent posing a challenge for ventilation

    Directory of Open Access Journals (Sweden)

    Nita D'souza

    2017-01-01

    Full Text Available Self-expandable esophageal stents are being commonly used for palliative treatment in advanced esophageal cancer patients to relieve dysphagia, prevent tracheoesophageal fistula, and facilitate symptomatic betterment. The modern covered stents reduce the ingrowth of the tumor but have seen an increase in the incidence of stent migrations. We report a rather complicated presentation of an esophageal stent for esophageal dilatation and a challenging management of a difficult tracheostomy.

  3. Water-absorptivity and mechanical behaviors of PTFE/PA6 and PTFE/PA66 blends

    Institute of Scientific and Technical Information of China (English)

    ZHAO Rong-guo; LUO Wen-bo; XIAO Hua-ming; WU Guo-zhong

    2006-01-01

    The effects of polytetrafluoroethylene (PTFE) content on water-absorptivity,tensile strength,flexural strength,and notched impact strength of polytetrafluoroethylene/polyamide 6 (PTFE/PA6) and polytetrafluoroethylene/polyamide 66 (PTFE/PA66) blends were investigated by water immersion test,uniaxial tensile test,three-point test,and Charpy impact fracture test. The water-absorptivity in the blend decreases with increasing PTFE content,which indicates that the PTFE phase restrains the polyamide phase from water absorption. For water-free blends,the addition of PTFE causes a reduction in tensile strength,while for water-absorbed PTFE/PA6 blends,the tensile strength increases with increasing PTFE. Simultaneously,the absorbed water improves the elongation,but results in a notable reduction in flexural strength of the blends. Although the addition of PTFE causes a reduction in notched impact strength of the blends,as compared to pure polyamide,the absorbed water has little effects on the notched impact strength of the blends. Finally,the effects of temperature and loading frequency on complex viscosity parameters of PTFE/PA6 and PTFE/PA66 melts were tested. It is found that the complex viscosity of PTFE/PA6 melt is reversed with increasing temperature and shear velocity,but that of PTFE/PA66 melt increases approximately in exponential form with increasing temperature. To fill polyamide with suitable mass percentage of PTFE can effectively reduce the viscosity of blend,and as a result,the molding and processing properties are improved.

  4. Gastrointestinal stenting

    Energy Technology Data Exchange (ETDEWEB)

    Zollikofer, C.L.; Schoch, E. [Dept. of Radiology, Kantonsspital Winterthur (Switzerland); Jost, R. [Dept. of Gastroenterology Internal Medicine, Kantonsspital Winterthur (Switzerland); Decurtins, M. [Dept. of Surgery, Kantonsspital Winterthur (Switzerland)

    2000-02-01

    Acute obstructions of the gastric outlet, the duodenum, or the large bowel require rapid treatment to relieve symptoms of retention or ileus. Large-caliber stents of 16 to 22 mm offer a new non-surgical alternative for treating these patients with minimal risks and high success rates. For gastroduodenal outlet obstructions palliated by self-expanded metal stents, clinical success rates are in the range of 80-100 %. Preoperative treatment of colorectal obstructions successfully relieves acute symptoms of ileus in 87-100 % allowing primary anastomosis and thereby reducing the costs caused by multiple operations and the need of intensive care by approximately 25 %. It is the purpose of this review to familiarize the reader with the indications, possibilities, and limits of intestinal stenting. (orig.)

  5. [Changes of content of regulatory lymphocytes and concentration of soluble interleukine-2 receptor in blood of patients with ischemic heart disease after coronary artery angioplasty with implantation of stents with rapamycin covering].

    Science.gov (United States)

    Potekhina, A V; Sokolov, V O; Pylaeva, E A; Provatorov, S I; Masenko, V P; Bosykh, E G; Noeva, E A; Krasnikova, T L; Aref'eva, T I

    2011-01-01

    We studied dynamics of content of subpopulation of lymphocytes including regulatory and effector T-lymphocytes as well as concentration of soluble form of interleukine-2 receptor (sCD25) in peripheral blood of patients after coronary stenting (CS) with implantation of stents with rapamycin covering (SRC). We included into the study 62 patients with stable effort II-III functional class angina. Coronary angiography (CA) was carried out in all, CS with implantation of 1 - 2 SRC - in 42 patients. Blood samples were taken before CA/CS, in 24, 48 hours, 7 days, 1 and 3 months after intervention. Content of T-, helper and cytotoxic T-cells, -, NK-, NKT-cells, activated effector T-lymphocytes (CD4+CD251owCD127high) and regulatory T-lymphocytes (CD4+CD25highCD1271ow) were measured by direct immunofluorescence and flow cytometry. CD4+ lymphocytes were isolated from mononuclear cell fraction of donor blood by magnetic separation. Content of regulatory T-lymphocytes in culture were determined by expression of a specific marker FOXP3+. Concentration of sCD25 was measured by chemiluminescent method. It was shown that content of main subpopulations of lymphocytes in blood changed after CS or CF. Blood content of regulatory T-lymphocytes and sCD25 significantly increased after 7 days and 1 month after CS but not after CA. Plasma sCD25 concentration correlated with content of regulatory T-lymphocytes in 1 month after SRC implantation. During cultivation of CD4+ lymphocytes in the presence of rapamycin we noted antiproliferative effect relative to FOXP3-cells and accumulation of regulatory +-lymphocytes. Thus implantation of SRC in coronary arteries leads to increase of number of circulating regulatory T-lymphocytes and blood concentration of sCD25. Changes of these parameters after CS can reflect peculiarities of local and systemic reaction arising in response to introduction of stent with drug covering and be significant for assessment of prognosis of the disease.

  6. The Reshock and Release Waves in PTFE

    Science.gov (United States)

    Karakhanov, S. M.; Bordzilovsky, S. A.

    1999-06-01

    To study the deformation and destruction of PTFE polymer the specimens were loaded by the complex wave structure: shock, reshock and release wave. The transmitted stress-time profiles were recorded with the manganin gages. The Lagrange analysis of stress histories gave the stress-volume paths during reshock loading and unloading of PTFE in the stress range of 10 to 35 GPa. The data revealed the viscoelastic behavior typical for polymers. For a single shock loading the relaxation zone with the duration of about 0.3 μs was noticeable behind the first stress jump. The reshock-release stress pulse that started from the state behind the first shock attenuated with the rate greater than in hydrodynamic approximation. The correlation was noticed between the stress-time and electrical resistivity-time profiles in the relaxation zone. The reloading-unloading stress hysteresis gave the possibility to measure the critical shear stress (τ) in a shocked state. The data showed the decrease in τ at higher stresses. The authors suggested that the most probable mechanism of destruction of PTFE in the studied region of pressures and temperatures is thermodestruction of a polymer chain by the thermal fluctuations under load.

  7. Nasal packing and stenting

    Directory of Open Access Journals (Sweden)

    Weber, Rainer K.

    2009-01-01

    Full Text Available Nasal packs are indispensable in ENT practice. This study reviews current indications, effectiveness and risks of nasal packs and stents. In endoscopic surgery, nasal packs should always have smooth surfaces to minimize mucosal damage, improve wound healing and increase patient comfort. Functional endoscopic endonasal sinus surgery allows the use of modern nasal packs, since pressure is no longer required. So called hemostatic/resorbable materials are a first step in this direction. However, they may lead to adhesions and foreign body reactions in mucosal membranes. Simple occlusion is an effective method for creating a moist milieu for improved wound healing and avoiding dryness. Stenting of the frontal sinus is recommended if surgery fails to produce a wide, physiologically shaped drainage path that is sufficiently covered by intact tissue.

  8. Mechanical and Microstructural Properties of PTFE/Al/W Composite

    Science.gov (United States)

    Cai, Jing; Jiang, Fengchun; Vecchio, Kenneth; Meyers, Marc; Nesterenko, Vitali

    2007-06-01

    Mechanical and microstructural properties of PTFE/Al/W composites with a density up to 7.1 g/cc fabricated by cold isostatic pressing with identical weight ratios of constituents (PTFE serving as the matrix) were investigated using quasi-static and Hopkinson Bar compression tests. The ultimate compressive strengths of the PTFE/Al/W composite (7.1 g/cc) with coarse W particles was ˜18 MPa (quasistatic loading) and ˜24 MPa (dynamic loading), while more porous PTFE/Al/W composite with fine W particles (5.9 g/cc) had flow stress 24 MPa (quasistatic) and 44 MPa (dynamic). Critical strains to failure for both composites are 4-5%. We attribute this unusual behavior to force chains created by small tungsten particles. Environmental scanning electron microscope revealed that the PTFE matrix was populated by a homogeneous distribution of nano-cracks and nanofibers of PTFE were observed after dropweight tests.

  9. Fully covered self-expanding metal stents in the management of difficult common bile duct stones Prótesis metálicas autoexpandibles totalmente recubiertas en el tratamiento de coledocolitiasis difíciles

    Directory of Open Access Journals (Sweden)

    Jesús García-Cano

    2013-01-01

    Full Text Available Background and objectives: plastic biliary stents are often used after an ERCP session without complete common bile duct stones (CBDS extraction. Sometimes, the volume of biliary drainage with these stents may be insufficient. We present our experience with the use of fully covered self-expanding metal stents (FCSEMS in the setting of incomplete CBDS extraction. Patients and methods: after an ERCP session with difficult CBDS not completely removed, biliary FCSEMS (Wallflex were inserted in some patients when it was deemed that biliary sphincterotomy and a single plastic stent would not provide an adequate drainage. Results: a retrospective study was performed. Biliary FCSEMS were inserted in 29 patients, mean age 81 years. CBDS could not be extracted through a biliary sphincterotomy due to its large size (n = 18 or because of the presence of inflammatory distal strictures (n = 11. The greatest biliary drainage with shortest ERCP time was considered mandatory due to clinical instability of patients and/or poor tolerance to conscious sedation administered by the endoscopist. Successful biliary drainage was obtained in all cases. FCSEMS were removed after a median of 199.5 days in 16 patients with a complete CBDS extraction in 15 (93.7%. FCSEMS were not removed in the remaining 13 patients due to their clinical condition, and a wait-and-see strategy was undertaken. Conclusions: in selected cases, utilization of removable FCSEMS can be a good option for a quick and adequate biliary drainage in the setting of difficult CBDS. Because of the higher cost of these stents its use needs to be individualized.Introducción y objetivos: las prótesis biliares plásticas suelen emplearse tras una sesión de CPRE sin extracción completa de coledocolitiasis. En ocasiones, el calibre de drenaje con estas prótesis puede ser insuficiente. Presentamos nuestra experiencia en la utilización de prótesis metálicas autoexpandibles totalmente recubiertas (PMATR en

  10. [E-PTFE Membrane for the Management of Perforated Corneal Ulcer].

    Science.gov (United States)

    Pahor, D; Pahor, A

    2016-10-01

    Purpose: To present the surgical management of perforated corneal ulcer using PRECLUDE® Pericardial Membrane, composed of expanded polytetrafluoroethylene (e-PTFE; GORE-TEX®), as an alternative surgical procedure in patients at high risk of graft rejections and to evaluate side effects for a prolonged period. Patients and Methods: The study included all patients who were admitted to our department and underwent surgical repair of perforated corneal ulcer with the e-PTFE membrane between 2010 and 2015. In total, 8 patients (8 eyes) were enrolled. Medical records of all patients were retrospectively reviewed. The operation was performed under peribulbar anaesthesia. Non-absorbable, microporous, watertight 0.1 mm thick e-PTFE membrane was used to close the corneal ulcer. The membrane was cut to overlap the defect adequately and to achieve the desired tissue attachment without preparing the conjunctiva or superficial trephination of the cornea. The membrane was fixed to the healthy cornea with several non-absorbable sutures (Prolene® 10.0), in order to achieve the proper stress without wrinkling. Results: Five of 8 patients were treated for systemic immunological diseases. Sjögren's syndrome was diagnosed in 2 patients, granulomatosis with polyangiitis in one, vasculitis with a history of previous sclerokeratitis in one and systemic lupus erythematosus in one. In 2 patients, corneal perforation was observed as a complication of corneal infection and in one patient as a late complication of a severe chemical burn. Corneal perforations were successfully covered with e-PTFE membrane in all patients. E-PTFE membrane was well tolerated in all patients and the eye was always preserved. After 3 to 4 months, the membrane was removed in 7 patients. The underlying cornea was thin, firm, stable and vascularised. In one patient with Sjögren's syndrome, the e-PTFE membrane is still in place. Conclusion: Surgical management of perforated corneal ulcer using E-PTFE membrane

  11. Pseudoaneurisme på arteria carotis interna behandlet med stent

    DEFF Research Database (Denmark)

    Benian, Cemil; Wagner, Aase; Cortsen, Marie

    2013-01-01

    Extracranial internal carotid artery aneurysms (EACIAs) are rare. Untreated they have a high stroke rate. Traditionally the treatment has been surgery or endovascular intervention with coils. Both are associated with relatively high complication rates. Another treatment option is endovascular int...... intervention with covered stent, which provides one-step closure of the aneurysm. As in the case story it can be complicated with in-stent occlusion. Therefore we recommend balloon occlusion test before treatment of EACIAs with covered stent....

  12. Treatment Approaches to Urinary Stones Caused by Forgotten DJ Stents

    Directory of Open Access Journals (Sweden)

    Ergun Alma

    2015-03-01

    Full Text Available Ureteral DJ stents have been used widely for years in urology practice. With increased use, complications have been increased and forgotton stents have started to cause problems. The most common complications are early pain and irritative symptoms. Late complications are bacterial colonization and stone formation because of the biofilm covering the stents. Treatment for a forgotten stent varies on many factors, such as stent localization and stone formation. In this article, we aimed to discuss our clinic approach on two different cases in light to current literature. [Cukurova Med J 2015; 40(Suppl 1: 58-63

  13. Biological safety evaluation of 125I-filled carbon nanotubes covered with metallic esophageal stent%125I碳纳米管覆膜金属支架生物安全性的实验研究

    Institute of Scientific and Technical Information of China (English)

    董生; 袁正; 李文新; 吴胜伟

    2011-01-01

    Objective To evaluate the biological safety of 125I-filled carbon nanotubes covered with metallic esophageal stent with regard to the normal esophagus before clinical application.Methods 125I-filled carbon nanotubes covered with metallic esophageal stent was prepared.Eighteen of New Zealand rabbits were randomly divided into three groups with 6 rabbits in each group.Three groups of stents,non-radioactive,low radio-activity ( 3.7 - 5.6 MBq),and high activity ( 11.1 - 13.0 MBq ) were placed in the midpiece of esophagus of rabbits.Esophagus opacification and three-diamensions DSA were performed at 0.5 h,7,14 and 30 d after insertion of the stents,respectively.The rabbits were killed at 30d after insertion of the stents,and histologic examinations of the esophageal walls were performed.Results In non-radioactive and low activity groups,1 of 6 rabbits died of wound infection at 1 and 3 d after surgery due to pulmonary infection,respectively.All specimens were obtained from 16 rabbits.Microscopically,in all rabbits of low activity and high activity groups,there were membrana mucosa necrotic and swell and breakage of the muscle fiber in esophageal submucosa and muscularis,submucosal inflammation,which were more severe in high activity group.In low activity group,one esophagus ectal membrane was involved,however,esophageal perforation did not develop.In high activity group,3 of 6rabbits esophageal perforation had developed,in which one esophagus mediastinum fistula developed,without inflammation.In non-radioactive group,it was almost normal in mucosa layer,a small amount of inflammatory cells were found in submucosal layer,and part of muscle fibers was fractured and no pathological changes of necrosis was found.Conclusions Radioactive 125I carbon nanotubes covered metallic stent with low activity(3.7 -5.6 MBq) can be used as intraluminal palliative brachytherapy,which is safe and effective.%目的 探讨125I碳纳米管覆膜金属支架对兔正常

  14. Symptomatic stent cast.

    Science.gov (United States)

    Keohane, John; Moore, Michael; O'Mahony, Seamus; Crosbie, Orla

    2008-02-01

    Biliary stent occlusion is a major complication of endoscopic stent insertion and results in repeat procedures. Various theories as to the etiology have been proposed, the most frequently studied is the attachment of gram negative bacteria within the stent. Several studies have shown prolongation of stent patency with antibiotic prophylaxis. We report the case of stent occlusion from a cast of a previously inserted straight biliary stent; a "stent cast" in an 86-year-old woman with obstructive jaundice. This was retrieved with the lithotrypter and she made an uneventful recovery. This is the first reported case of a biliary stent cast.

  15. Symptomatic stent cast.

    LENUS (Irish Health Repository)

    Keohane, John

    2012-02-03

    Biliary stent occlusion is a major complication of endoscopic stent insertion and results in repeat procedures. Various theories as to the etiology have been proposed, the most frequently studied is the attachment of gram negative bacteria within the stent. Several studies have shown prolongation of stent patency with antibiotic prophylaxis. We report the case of stent occlusion from a cast of a previously inserted straight biliary stent; a "stent cast" in an 86-year-old woman with obstructive jaundice. This was retrieved with the lithotrypter and she made an uneventful recovery. This is the first reported case of a biliary stent cast.

  16. Dacron or PTFE for above-knee femoropopliteal bypass. a multicenter randomised study

    DEFF Research Database (Denmark)

    Jensen, L P; Lepäntalo, M; Fossdal, J E

    2007-01-01

    To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass.......To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass....

  17. Stent graft placement for dysfunctional arteriovenous grafts

    Energy Technology Data Exchange (ETDEWEB)

    Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, College of Medicine, CHA University, Seongnam (Korea, Republic of); Shin, Byung Seok; Ohm, Joon Young; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of)

    2015-07-15

    This study aimed to evaluate the usefulness and outcomes of stent graft use in dysfunctional arteriovenous grafts. Eleven patients who underwent stent graft placement for a dysfunctional hemodialysis graft were included in this retrospective study. Expanded polytetrafluoroethylene covered stent grafts were placed at the venous anastomosis site in case of pseudoaneurysm, venous laceration, elastic recoil or residual restenosis despite the repeated angioplasty. The patency of the arteriovenous graft was evaluated using Kaplan-Meier analysis. Primary and secondary mean patency was 363 days and 741 days. Primary patency at 3, 6, and 12 months was 82%, 73%, and 32%, respectively. Secondary patency at the 3, 6, 12, 24, and 36 months was improved to 91%, 82%, 82%, 50%, and 25%, respectively. Fractures of the stent graft were observed in 2 patients, but had no effect on the patency. Stent graft placement in dysfunctional arteriovenous graft is useful and effective in prolonging graft patency.

  18. 21 CFR 872.3680 - Polytetrafluoroethylene (PTFE) vitreous carbon materials.

    Science.gov (United States)

    2010-04-01

    ... materials. 872.3680 Section 872.3680 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES DENTAL DEVICES Prosthetic Devices § 872.3680 Polytetrafluoroethylene (PTFE) vitreous carbon materials. (a) Identification. Polytetrafluoroethylene (PTFE)...

  19. Use of fully covered self-expanding metal stents for the management of benign biliary conditions Utilización de prótesis metálicas autoexpandibles totalmente recubiertas en procesos biliares benignos

    Directory of Open Access Journals (Sweden)

    J. García-Cano

    2010-09-01

    Full Text Available Background and aim: biliary self-expanding metal stents (SEMS have the advantage of being inserted undeployed with very small sizes and provide, when fully opened, large diameters for biliary drainage. However, their use in benign conditions has been very limited, mainly because of difficulty in their extraction. We present our initial experience with a fully covered SEMS (Wallflex for the management of benign problems of the bile duct. Patients and methods: in a prospective study, stents of 8 mm in diameter and 4, 6 or 8 cm long were inserted by means of ERCP. These SEMS were chosen when according to medical judgement it was thought that diameters greater than 10 French (3.3 mm were needed for proper biliary drainage. Stents were extracted also endoscopically, several months later when deemed clinically appropriate. Results: twenty biliary SEMS were inserted. Reasons for insertion were: large intrahepatic biliary fistula after hydatid cyst surgery (1, perforation of the papillary area following endoscopic sphincterotomy (2, coaxial insertion to achieve patency in obstructed uncovered stents inserted in benign conditions (3, benign strictures (7, multiple and large common bile duct stones that could not be extracted because of tapering and stricturing of the distal common bile duct (7. In all cases, successful biliary drainage was achieved and there were no complications from insertion. Stents were easily extracted after a mean time of 132 days (36-270 in place. Complete resolution of biliary problems was obtained in 14 patients (70%. Conclusions: in our initial experience, the fully covered Wallflex biliary stent was removed without any complication after being in place in the common bile duct for a mean time of over four months. Therefore, it could be used in the management of benign biliary conditions.Introducción y objetivo: las prótesis metálicas autoexpandibles biliares (PMAB tienen la ventaja de introducirse plegadas con calibres muy

  20. Economic analysis of esophageal stenting for management of malignant dysphagia.

    Science.gov (United States)

    Rao, C; Haycock, A; Zacharakis, E; Krasopoulos, G; Yakoub, D; Protopapas, A; Darzi, A; Hanna, G B; Athanasiou, T

    2009-01-01

    Over half of patients diagnosed with esophageal cancer are unsuitable for curative resection. A significant proportion of these patients will subsequently require palliative stenting to alleviate dysphagia. There is growing consensus in the literature that the deployment of a Self-Expanding Metal Stent is the optimum stenting strategy; however, it remains unclear whether covered or uncovered metal stents are more cost-effective. In order to determine which type of prosthesis is more cost-effective, we compared the different stenting strategies in terms of 1-year stent-related mortality, health-related quality of life, and cost. A decision analytical model was constructed to compare the 1-year stent-related mortality, health-related quality of life, and cost between covered and uncovered stents. Probabilistic sensitivity analysis was performed to quantify the uncertainty associated with our results. Value of Information analysis was performed to assess the value of further research. In order to fully characterize the uncertainty associated with this decision, plastic stents were included in our analysis. Stent-related mortality was slightly lower following covered stent deployment compared with uncovered stent deployment (1.00% vs. 1.26%). Covered stents were more effective by 0.0013 Quality-Adjusted Life Years (Standard Deviation [SD] 0.0013 Quality-Adjusted Life Years). They were also less expensive by $729.58 (SD $390.63). Probabilistic sensitivity analysis suggested that these results were not sensitive to model parameter uncertainty. Plastic stents deployment was $2832.64 (SD $1182.72) more expensive than uncovered metal stent deployment. Value of Information analysis suggests that the maximum value of further research in the UK is $61,124.30. The results of this study represent strong evidence for the cost-effectiveness of covered compared with uncovered self-expanding metal stents for the palliation of patients with malignant dysphagia. The findings support

  1. Coated stents to prevent restenosis in coronary heart disease

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2005-11-01

    Full Text Available Background: In-stent-restenosis (ISR is considered to be an essential limiting factor of stenting in coronary heart disease (CHD. The development of coated stents has raised expectations on substantial lowering restenosis after stenting with decreasing the rate of restenosis and a reduction in the rate of clinical events. Objectives: The present analysis addresses the questions on medical effectiveness and cost-effectiveness of the use of various coated stent types in CHD. Methods: The literature was searched in December 2004 in the most relevant medical and economic databases. The medical evaluation was conducted on the basis of published RCT. The data from the studies regarding various angiographic, sonographic and clinical endpoints were checked for methodical quality and summarised in meta-analyses. Within the scope of economic evaluation the primary studies were analysed and modelling was performed, applying clinical effect estimates from the meta-analyses of the medical evaluation and current estimates of German costs. Results: Medical evaluation: Ten different stenttypes were used in the included 26 RCT. The results for heparin, silicon-carbide, carbon and PTFE coated stenttypes could not reveal any significant differences between the medical effectiveness of coated and uncoated stents. The application of sirolimus, paclitaxel, everolimus and 7-hexanoyltaxol eluting stents showed a significant lower restenosis at 6-9 months with decrease in the rate of restenosis for polymer-based sirolimus, paclitaxel and 7-hexanoyltaxol eluting stents. In contrast, the use of gold-coated and actinomycin-D eluting stents was associated with a significantly higher restenosis. The polymer-based sirolimus and paclitaxel eluting stents also showed a significant and considerable reduction in the rate of repeated percutaneous revascularisations at 6-12 months (3.5% vs. 19.7%; p<0.0001, RR=0.19 [95%CI: 0.11; 0.33] and 3.5% vs. 12.2%; p<0.0001, RR=0.30 [95%CI: 0

  2. Modification of PTFE nanopowder by controlled electron beam irradiation: A useful approach for the development of PTFE coupled EPDM compounds

    Directory of Open Access Journals (Sweden)

    2008-04-01

    Full Text Available Low-temperature reactive mixing of controlled electron beam modified Polytetrafluoroethylene (PTFE nanopowder with Ethylene-Propylene-Diene-Monomer (EPDM rubber produced PTFE coupled EPDM rubber compounds with desired physical properties. The radiation-induced chemical alterations in PTFE nanopowder, determined by electron spin resonance (ESR and Fourier transform infrared (FTIR spectroscopy, showed increasing concentration of radicals and carboxylic groups (–COOH with increasing irradiation dose. The morphological variations of the PTFE nanopowder including its decreasing mean agglomerate size with the absorbed dose was investigated by particle size and scanning electron microscopy (SEM analysis. With increasing absorbed dose the wettability of the modified PTFE nanopowder determined by contact angle method increased in accordance with the (–COOH concentration. Transmission electron microscopy (TEM showed that modified PTFE nanopowder is obviously enwrapped by EPDM. This leads to a characteristic compatible interphase around the modified PTFE. Crystallization studies by differential scanning calorimetry (DSC also revealed the existence of a compatible interphase in the modified PTFE coupled EPDM.

  3. Properties of PTFE tape as a semipermeable membrane in fluorous reactions

    Directory of Open Access Journals (Sweden)

    Brendon A. Parsons

    2015-06-01

    Full Text Available In a PTFE tape phase-vanishing reaction (PV-PTFE, a delivery tube sealed with PTFE tape is inserted into a vessel which contains the substrate. The reagent diffuses across the PTFE tape barrier into the reaction vessel. PTFE co-polymer films have been found to exhibit selective permeability towards organic compounds, which was affected by the presence of solvents. In this study, we attempted to establish general trends of permeability of PTFE tape to different compounds and to better describe the process of solvent transport in PV-PTFE bromination reactions. Though PTFE tape has been reported as impermeable to some compounds, such as dimethyl phthalate, solvent adsorption to the tape altered its permeability and allowed diffusion through channels of solvent within the PTFE tape. In this case, the solvent-filled pores of the PTFE tape are chemically more akin to the adsorbed solvent rather than to the PTFE fluorous structure. The solvent uptake effect, which was frequently observed in the course of PV-PTFE reactions, can be related to the surface tension of the solvent and the polarity of the solvent relative to the reagent. The lack of pores in bulk PTFE prevents solvents from altering its permeability and, therefore, bulk PTFE is impermeable to most solvents and reagents. However, bromine, which is soluble in liquid fluorous media, diffused through the bulk PTFE. A better understanding of the PTFE phase barrier will make it possible to further optimize the PV-PTFE reaction design.

  4. A Dual Expandable Nitinol Stent: The Long-term Results in Patients with Malignant Gastroduodenal Strictures

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hee; Jung, Gyoo Sik; Oh, Kyeung Seung [Kosin University College of Medicine, Busan (Korea, Republic of)

    2009-12-15

    We wanted to evaluate the long-term results of a dual expandable nitinol stent for the palliative treatment of malignant gastroduodenal strictures. The dual stent consists of two stents; an outer partially nylon covered stent and an inner bare nitinol stent. The outer stent was placed into the stricture and this was followed by coaxial placement of the inner bare stent. Using fluoroscopic guidance, dual expandable stents were placed in 86 patients with inoperable malignant gastroduodenal strictures. The technical and clinical success, the complication, survival and the stent patency were evaluated during the follow-up period. Stent placement was technically successful in 83 of the 86 patients. After stent placement, 74 of the 85 patients showed improvement of their symptoms. During the mean follow-up period of 133 days, 24 patients (28%) developed recurrent symptoms due to incomplete expansion (n=1), stent migration (n=4), food impaction (n=2), granulation tissue formation (n=2), tumor overgrowth (n=6), tumor ingrowth (n=1) and stent collapse (n=8). Eleven of them were successfully treated by means of placing a second stent. The median period of stent patency was 212 days (mean, 299 days). The 30-day, 60-day, 90-day and 180-day patency rates were 93%, 84%, 81% and 53%, respectively. The dual expandable nitinol stent seems to be effective for the palliation of malignant gastroduodenal strictures

  5. Complications and the management of fully covered retrievable metal stent placement in benign tracheal stenosis%可回收全覆膜金属支架治疗良性气管狭窄的并发症及处理

    Institute of Scientific and Technical Information of China (English)

    王征宇; 王永利; 陈光利; 梁熙虹; 王振常; 马建中; 吴广忠; 张效平

    2012-01-01

    Objective To study complications and the management of the use of covered retrievable expandable metallic stents in the treatment of benign tracheal stenosis.Methods Fully covered retrievable metal stents were placed in 21 patients with benign tracheal stenosis.Stent-related complications and the management were reviewed and analysised.Results Twenty-eight fully covered retrievable metallic stents were successfully placed fluoroscopically in 21 patients.Stents were removed 4-12 months [mean (5.5 ±2.2) mouths] after placement in all patients.Stent-related complications included granulation tissue (n =18),stent migration (n =4),stent expectoration (n =2),halitosis (n =8),mucous retention (n =21)and mucus plugging(n =1).Granulation tissue was removed with a carbon dioxide laser in 2 patients.Stents were replaced for 2 times and 3 times respectively in 2 patients after stent migration and stent expectoration.An additional stent was placed in 2 patients after stent migration.Symptom of halitosis was relieved after prolonged course of systemic antibiotics treatment in 8 patients.Symptom of mucous retention was relieved with nebulized saline and N-acetylcysteine saline inhalation.Mucous plug was expelled after severe coughing after suctioning using an aspirator in one patient.There were statistically significant differences in stricture diameter,rank of tachypnea and pulmonary function (FEV1) in all 21 patients before stent insertion and after stents removal.No patient has experienced recurrence during the follow-up period of 1-36 months [mean (23.2 ± 8.0) months].Conclusion Fully covered retrievable metallic stent may be a safe and effective in benign tracheal stenosis.Stent-related complications may be effectively managed.%目的 探讨可回收全覆膜金属支架治疗良性气管狭窄的并发症及处理方法.方法 可回收全覆膜金属支架治疗良性气管狭窄患者21例,其中男18例,女3例,年龄16~ 65岁,平均年龄(33±15)岁,回顾总结分

  6. Prevention of potential complications related to transjugular intrahepatic portosystemic shunt procedure: efficacy of polytetrafluoroethylene stent grfat

    Energy Technology Data Exchange (ETDEWEB)

    Koo, Jae Hong; Seong, Chang Kyu [School of Medicine, Kyungpook National Univ., Daegu (Korea, Republic of); Kim, Young Hwan; Choi, Jin Soo; Lee, Sang Kwon; Kim, Gab Chul [School of Medicine, Keimyung Univ., Daegu (Korea, Republic of); Kim, Yong Joo [Andong General Hospital, Andong (Korea, Republic of); Seong, Nak Kwan; Park, Young Chan [School of Medicine, Daegu Catholic Univ., Daegu (Korea, Republic of)

    2004-11-01

    The purpose of this study was to assess the efficacy of a polytetrafluoroethylene (PTFE) stent graft for preventing potential complications related to a transjugular intrahepatic portosystemic shunt (TIPS). Between January 2002 and March 2003, seven patients (males: 5, females: 2, mean age: 44) underwent TIPS stent placement using the PTFE stent graft (Nitis,Taewoong, Seoul, Korea) to prevent potential complications such as life threatening hemoperitoneum, hemobilia and early stent occlusion. Three patients were admitted for esophageal varix bleeding, three patients were admitted for gastric varix bleeding and one patient was admitted for umbilical bleeding. The extrahepatic portal vein was punctured inadvertently in four patients (main portal vein: 1 case, portal vein bifurcation: 3 cases), but contrast media extravasation into the peritoneal cavity on the tractogram was noted only in two patients. Two of four patients had chronic portal vein occlusion with intra- and extrahepatic cavernous transformation. The bile duct was inadvertently punctured and visualized on the tractogram in three patients. All the identified biliary trees or contrast media extravasations observed on the tractograms were successfully sealed off on the post-procedure portograms. The immediate post-procedure clinical recovery courses were uneventful in all patients (no hemobilia or hemoperitoneum was noted). Bleeding control was successful in all patients. The one patient who had Child-Pugh cIass C disease died of hepatic encephalopathy 3 days after TIPS placement. Five of the six living patients have not shown any complications or rebleeding during the follow up periods (9-23 months). The one patient who had biliary communication on the tractogram rebled due to TIPS stent stenosis 25 days after TIPS, and this patient was successfully treated by TIPS revision. Potential complications related to TIPS procedure can be successfully prevented with PTFE stent graft placement.

  7. Dacron or PTFE for above-knee femoropopliteal bypass

    DEFF Research Database (Denmark)

    Jensen, Leif P.; Lepäntalo, M.; Fossdal, J.E.

    2007-01-01

    OBJECTIVES: To compare polytetrafluorethylene (PTFE) and polyester grafts (Dacron) for above knee femoropopliteal bypass. DESIGN: Multicenter randomised clinical trial. MATERIAL AND METHODS: 427 patients were randomised between 6mm Dacron (Uni-Graft, B. Braun Melsungen AG, 34212 Melsungen, Germany......) and PTFE (Goretex, W. L. Gore & Ass. Inc., Newark DE 19711, USA) above-knee femoropopliteal bypass grafts within 13 centres in Denmark (n=261), Norway (n=113) & Finland (n=53) between 1993 and 1998. Fourteen (3%) patients were excluded, leaving 413 patients with 208 Dacron and 205 PTFE grafts for analysis......-brachial pressures or imaging in case of doubt. RESULTS: The two-year primary patency rates for Dacron and PTFE were 70% and 57% (p=0.02), whereas the secondary patency rates were 76% and 65% (p=0.04), respectively. Primary patency at two years was significantly influenced by the number of patent crural vessels (two...

  8. Membrana-covered Esophageal Self-expanding Metallic Stent for Malignant Esophageal Stricture and Tracheoesophageal Fistula%自膨式食管金属加膜支架治疗恶性食管狭窄和气管食管瘘

    Institute of Scientific and Technical Information of China (English)

    徐怀阳; 钟竑; 陆善伟; 赵华

    2011-01-01

    目的:探讨自膨式食管金属加膜支架治疗恶性食管狭窄和气管食管瘘的疗效和并发症.方法:2004年1月至2009年6月对63例恶性食管狭窄和气管食管瘘患者实施食管支架置入,男45例,女28例;年龄45~81岁,平均69.3岁.支架为MTN型形状记忆钛镍合金食管加膜支架(南京微创医学科技有限公司生产),支架植入均在DSA监视下操作完成.结果:63例均一次性放置成功,即刻口服造影通过顺利剂.结论:自膨式食管金属加膜支架是治疗恶性食管狭窄和气管食管瘘的有效方法.%Objective: To explore the effect and complication of membrana-covered esophageal self-expanding metallic stent in the treatment of malignant esophageal stricture and tracheoesophageal fistula.Methods: From January 2004 to June 2009, 63 patients(45 males and 28 females), aged from 45 to 81 years old with an average age of 69.3, suffering from malignant esophageal stricture or tracheoesophageal fistula were treated by esophageal stent deployment under DSA monitoring.The esophageal stent was a kind of MTN typed shape memory Titanium stent covered with membrane (Made in Nanjing minimally invasive medicial Technology Co.,Ltd).Results: Stent implantation was successful in all the 63 patients during their first deployment.Immediately, oral contrast material could be swallowed through the esophagus smoothly.Concultion: Membrana-covered esophageal self-expanding metallic stent implantation is an effective and safe method for the treatment of malignant esophageal stricture and tracheoesophageal fistula.

  9. Clinical application of covered endoscophageal stent in treatment of terminal esophageal carcinoma and malignant esophageal fistula in elderly patients%覆膜金属支架在老年晚期食管癌及食管瘘患者中的应用

    Institute of Scientific and Technical Information of China (English)

    李姝; 王邦茂; 刘文天; 杨玉龙; 方维丽; 郑忠青

    2011-01-01

    Objective To explore the effect of covered endoesophageal stent in treatment of terminal esophageal carcinoma complicated with malignant esophageal fistula in the elderly. Methods The covered endoesophageal stent was placed at the focus of lesion for each elderly patient in guidance by the iron wire and the stent-transporter under the endoscopy or X-ray. Results All of the stents were successfully implanted in 225 elderly patients without technical failure. The fistula was fully closed in all 19 patients. The symptoms of dysphagia and bucking were relieved obviously in 184cases (81.8%). The 176 cases (78.2%) of patients could have semi-fluid food in first week after stent implant, then have full meal. The inspiration pneumonia caused by fistula was brought under control. Conclusions For elderly patients with esophageal carcinoma, when they lose the operative opportunity or can not tolerate an operation, the treatment with covered endoesophageal stent is effective and safe.%目的 探讨应用覆膜金属支架对老年晚期食管癌并发食管瘘患者的治疗作用.方法 在胃镜直视或X线透视下,由导丝引导定位,经支架输送器将覆膜金属支架置于病变部位.结果 225例患者均一次放置成功,19例食管瘘患者瘘口均完全封堵,技术成功率为100.0%.其中184例(81.8%)吞咽困难及呛咳症状显著改善,176例(78.2%)患者在支架置入术后1周内进半流质食物,后改为普通食物,肺部感染得到控制.结论 对于失去手术机会或无法耐受手术的老年晚期食管癌并发食管瘘患者,放置覆膜金属支架治疗,疗效确切,安全可行.

  10. 全覆膜与非覆膜金属支架治疗胆道恶性梗阻随机对照研究%Covered versus uncovered self-expandable metal stents for malignant biliary obstruction: a randomized, controlled study

    Institute of Scientific and Technical Information of China (English)

    冀明; 王拥军; 李鹏; 吕富靖; 李巍; 张澍田

    2012-01-01

    目的 比较全覆膜金属支架与非覆膜金属支架治疗胆道恶性梗阻的有效性和安全性.方法 2010年10月至2012年8月无法手术根治性切除胆道恶性梗阻病例,随机分为两组,A组置入全覆膜金属支架,B组置入非覆膜金属支架,观察治疗效果及并发症情况.结果 共入组81例患者,其中A组41例,B组40例,两组均成功置入支架,达到有效引流目的.A组支架开放中位时间182.5 d,B组支架开放中位时间195.0 d,两组间支架开放时间差异无统计学意义(P=0.616).A组发生并发症3例(7.3%),B组发生4例(10%).结论 全覆膜金属支架与非覆膜金属支架治疗胆道恶性梗阻均安全有效,通畅时间相似.%Objective To compare therapeutic efficacy and safety of covered and uncovered self-expandable metal stents for malignant biliary obstruction.Methods From October 2010 to August 2012,patients with unresectable malignant biliary obstruction were recruited and divided into 2 groups to receive covered metal stents (group A) or uncovered metal stents (group B).Efficacy and complication of the procedure were compared.Results A total of 81 patients were recruited,with 41 in group A and 40 in group B.Stents were placed successfully in all patients.The median patency time of stent in group A was 182.5 d,which was not significantly different from that of group B (195.0 d,P =0.616).Complications occurred in 3 patients of group A (7.3%) and 4 of group B (10%).Conclusion Covered and uncovered metal stents are both safe and effective for treatment of malignant biliary obstruction with same patency time.

  11. Self-expanding metallic esophageal stents: A long way to go before a particular stent can be recommended

    Institute of Scientific and Technical Information of China (English)

    Pankaj Jain

    2011-01-01

    We agree that the covered self-expanding metal stents (SEMSs) fare better than the uncovered stents as recurrent dysphagia due to tumor ingrowth is common with uncovered stent. Recent American College of Gastroenterology Practice Guideline on the Role of Esophageal Stents in Benign and Malignant Diseases concludes that SEMSs cannot be routinely recommended in conjunction with chemo-radiation. The comparison of ultraflex and choostent in the Italian study found no difference in the palliation of dysphagia, rate of complications and survival rate.

  12. The Scandinavian Propaten(®) trial - 1-year patency of PTFE vascular prostheses with heparin-bonded luminal surfaces compared to ordinary pure PTFE vascular prostheses - a randomised clinical controlled multi-centre trial

    DEFF Research Database (Denmark)

    Lindholt, J S; Gottschalksen, B; Johannesen, N

    2011-01-01

    To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study.......To compare 1-year potencies' of heparin-bonded PTFE [(Hb-PTFE) (Propaten(®))] grafts with those of ordinary polytetraflouroethylene (PTFE) grafts in a blinded, randomised, clinically controlled, multi-centre study....

  13. Mode of deployment of coronary Palmaz-Schatz stents after implantation with the stent delivery system: an intravascular ultrasound study.

    Science.gov (United States)

    Kiemeneij, F; Laarman, G; Slagboom, T

    1995-04-01

    The stent delivery system (SDS) is a sheath-covered Palmaz-Schatz stent mounted on a 3.0, 3.5, or 4.0 mm compliant polyethylene balloon catheter; the balloon resists maximal inflation pressures of 5.7, 6.2, or 6.0 atm, respectively. It is postulated that these pressures are too low to obtain optimal stent deployment. Because optimal stent deployment is a prerequisite for optimal short- and long-term outcome, we performed an intravascular ultrasound study to the mode of stent deployment after delivery with the SDS and after high-pressure dilatations with low-compliant, oversized balloon catheters. In 23 patients an intravascular ultrasound study (30 MHz, 4.3F transducer) was performed to the geometry of 29 stents immediately after delivery with the SDS and after successive high-pressure inflations with low-compliant balloons. After delivery with the SDS (3.3 +/- 0.4 mm), stent diameter was 3.0 +/- 0.4 mm. After high-pressure dilatations (12.4 +/- 1.4 atm) with low-compliant balloons (3.9 +/- 0.5 mm), stent diameter increased to 3.4 +/- 0.4 mm (p < 0.001). Only 8 (28%) stents were completely and symmetrically expanded to the corresponding reference diameter with good apposition after delivery with the SDS. Diameter of incomplete deployed stents (n = 16) was 2.8 +/- 0.3 mm. After high-pressure dilatations with low-compliant balloons (3.9 +/- 0.5 mm), diameter increased to 3.4 +/- 0.4 mm (p < 0.001). Now 20 (69%) stents (p = 0.004) became completely and symmetrically expanded to a diameter corresponding to the reference diameter. In conclusion, most stents are suboptimally deployed after delivery with the stent delivery system.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Neoatherosclerosis in the stent

    Directory of Open Access Journals (Sweden)

    A. A. Komkov

    2015-01-01

    Full Text Available Achievements of interventional cardiology in the treatment of coronary artery disease are based on coronary balloon angioplasty with implanting bare metal stents and drug eluting stents. Questions of complications such as early stent thrombosis and restenosis of stent were solved in a considerable degree. However, with the lengthening of the followup period, the problem of late complications became obvious. Except endothelization and fibromuscular proliferation in stented coronary arteries the process of plaque formation has an important influence on later complications in follow-up period more than one year. This process was defined as neoatherosclerosis. This is verified by clinical manifestations of the disease, histological studies, angioscopy, intravascular ultrasound and optical-coherence tomography in stented patients. Dynamic observation of the condition in stentedcoronary arteries showed multistep proliferation with restenosis, its regression, and neoatherosclerosis development. Evidences of neoatherosclerosis formation in stented coronary arteries are considered in this review.

  15. Shortening of Wallstent RP during carotid artery stenting requires appropriate stent placement.

    Science.gov (United States)

    Aikawa, Hiroshi; Nagata, Shun-ichi; Onizuka, Masanari; Tsutsumi, Masanori; Iko, Minoru; Kodama, Tomonobu; Nii, Kouhei; Matsubara, Shuko; Etou, Hosei; Go, Yoshinori; Kazekawa, Kiyoshi

    2008-06-01

    Changes in the location and length of the Wallstent RP during carotid artery stenting (CAS) were evaluated using intraoperative videos of 28 patients with carotid artery stenosis who underwent CAS with a 10/20 mm Wallstent RP to determine the appropriate stent placement. The stent was deployed after its midpoint was positioned over a virtual center line, the perpendicular line which crossed the most stenotic point of the lesion on the road mapping image. The length of the stenotic lesion, the changes in the locations of the distal and proximal ends of the stent, and the changes in stent length were examined. The distal end of the stent moved a maximum of 6.1 mm toward the proximal side to a point 19.9 mm from the virtual center line. The proximal end moved a maximum of 11.3 mm toward the distal side to a point 14.7 mm from the virtual center line. The stent length ranged from 37.7 to 44.5 mm (mean 41.2 mm). The 10/20 mm Wallstent RP placed by our technique covers the entire lesion with no less than 5.7 mm of margin over the segment distal to the lesion in patients with stenotic segments shorter than 29.4 mm.

  16. E-PTFE (Gore-Tex) suspension cervical facial rhytidectomy.

    Science.gov (United States)

    Conrad, K; Chapnik, J S; Reifen, E

    1993-06-01

    Restoration of a well-defined, youthful-looking, cervicomental angle is not easily achieved. The classic rhytidectomy is now often supplemented by lipectomy and platysmamodifying procedures. Still, irregularities of neck contour are bothersome, and for the short, stocky neck, results at times fall short of a patient's and surgeon's expectation. Insertion of an E-PTFE (expanded polytetrafluorethylene [E-PTFE]; tradename, Gore-Tex, W. L. Gore Associates Inc, Flagstaff, Ariz) soft-tissue patch as a sling to support the floor of the mouth and redefine the cervicomental angle for a smoother neck contour is described. This method was used in seven patients presenting with problematic aging neck. The first three patients needed readjustment of the E-PTFE membrane. This evolving method seems to offer a superior, more lasting result for the correction of an obtuse cervicomental angle.

  17. New stent developments for peripheral arterial occlusive disease; Neue Stententwicklungen fuer die periphere arterielle Verschlusskrankheit

    Energy Technology Data Exchange (ETDEWEB)

    Tepe, G. [Romed Kliniken, Klinikum Rosenheim, Institut fuer Diagnostische und Interventionelle Radiologie, Rosenheim (Germany)

    2010-01-15

    Infrainguinal peripheral occlusive disease is increasingly being treated by endovascular techniques. Bare metal stainless steel, self-expanding nitinol stents, drug-eluting and covered stents (stent grafts) are becoming increasingly more important adjuncts to percutaneous translumninal angioplasty in the treatment of peripheral artery disease. In this article the available evidence supporting the use of stents in the femoropopliteal and tibial arteries will be described as well as their limitations. Future stent developments will also be discussed. (orig.) [German] Die endovaskulaere Therapie spielt bei der Therapie der peripheren arteriellen Verschlusskrankheit (PAVK) eine wichtige Rolle. Unbeschichtete ballonexpandierbare Stahlstents, selbstexpandierende Nitinolstents sowie medikamentenbeschichtete und ''covered stents'' (Stentgrafts) haben eine zunehmende Bedeutung als Zusatztherapie zusammen mit der primaeren Ballonangioplastie gewonnen. In diesem Artikel wird die klinische Evidenz beschrieben, die die Anwendung von Stents im Bereich der femoropoplitealen und tibialen Strombahn unterstuetzt. Limitationen sowie zukuenftige Stententwicklungen werden ebenfalls diskutiert. (orig.)

  18. Novel management strategy for coronary steal syndrome: case report of occlusion of a LIMA graft side branch with a combination of drug-eluting and covered-stent deployment.

    LENUS (Irish Health Repository)

    Hynes, Brian G

    2009-11-01

    We report a novel percutaneous therapeutic approach to the management of suspected coronary artery steal syndrome resulting from a large side branch of the left internal mammary artery bypass graft, using a combination of coated and drug-eluting stents. We demonstrate the feasibility and long-term efficacy of this strategy in a case report.

  19. Study on PTFE/Kevlar49/PA6 Composites

    Institute of Scientific and Technical Information of China (English)

    LI Ni; HAN Xi-en; WANG Shan-yuan

    2006-01-01

    The mechanical properties and material volume fractions of PTFE/Kevlar49/PA6 composite are studied. The focus of this paper is to get the relationship between the volume fraction of three constituents and the mechanical properties of the composite by doing tensile, hardness and wear test.The effect of the constituent volume fractions was evaluated. Short Kevlar49 fibers reinforced PA6(Polyamide 6) with PTFE filler were studied in five different combinations. The results of the experiments show that the mechanical properties increase with Kevlar fibers increase,then they decrease after the Kevlar fiber volume reaches one number.

  20. Auxetic coronary stent endoprosthesis

    DEFF Research Database (Denmark)

    Amin, Faisal; Ali, Murtaza Najabat; Ansari, Umar;

    2014-01-01

    BACKGROUND: Cardiovascular heart disease is one of the leading health issues in the present era and requires considerable health care resources to prevent it. The present study was focused on the development of a new coronary stent based on novel auxetic geometry which enables the stent to exhibit...... a negative Poisson's ratio. Commercially available coronary stents have isotropic properties, whereas the vascular system of the body shows anisotropic characteristics. This results in a mismatch between anisotropic-isotropic properties of the stent and arterial wall, and this in turn is not favorable...... for mechanical adhesion of the commercially available coronary stents with the arterial wall. It is believed that an auxetic coronary stent with inherent anisotropic mechanical properties and negative Poisson's ratio will have good mechanical adhesion with the arterial wall. METHODS: The auxetic design...

  1. Radial forces of stents used in thoracic endovascular aortic repair and bare self-expanding nitinol stents measured ex vivo - Rapid rescue for obstruction of the innominate artery using bare self-expanding nitinol stents.

    Science.gov (United States)

    Matsumoto, Takuya; Inoue, Kentaro; Tanaka, Shinichi; Aoyagi, Yukihiko; Matsubara, Yutaka; Matsuda, Daisuke; Yoshiya, Keiji; Yoshiga, Ryosuke; Ohkusa, Tomoko; Maehara, Yoshihiko

    2017-02-01

    Purpose Our objective was to compare the radial forces of several stents ex vivo to identify stents suitable for rescue of the unexpected coverage of aortic arch branches in thoracic endovascular aortic repair. Methods We measured the radial forces of two types of self-expanding bare nitinol stents (E-luminexx and Epic) used singly or as double-walled pairs, and of three endoprostheses used in thoracic endovascular aortic repair (TEVAR, Gore c-TAG, Relay, and Valiant) by compressing the stent using an MTS Instron universal testing machine (model #5582). We also examined the compressive effects of the TEVAR endoprostheses and the bare nitinol stents on each other. Results The radial force was greater in the center than at the edge of each stent. In all stents tested, the radial force decreased incrementally with increasing stent diameter. The radial force at the center was two times greater when using two stents than with a single stent. In the compression test, only E-luminexx used as a pair was not compressed after compressing a Relay endoprosthesis by 12 mm. Conclusion Two E-luminexx stents are appropriate to restore the blood flow if a TEVAR endoprosthesis covers the innominate artery following innominate-carotid-left subclavian arterial bypass.

  2. Hydrophilic treatment of porous PTFE for intractable glaucoma implant devices

    Science.gov (United States)

    Murahara, Masataka M.; Sato, Yuji; Fernandez, Viviana; Fantes, Francisco; Nose, Izuru; Lee, William E.; Milne, Peter J.; Parel, Jean-Marie A.

    2001-06-01

    Intractable glaucoma results from hindrances in the eyeball aqueous humor pathways that increase the intraocular pressure above normal physiological levels (over 20 mmHg). In this study porous PTFE membranes were made hydrophilic with a photochemical method that use ethyl alcohol and water for the chemical solution.

  3. Adhesion of Polymer Composite Melt to PTFE at Elevated Temperature

    Science.gov (United States)

    Pan, David; Debies, Thomas; McVeigh, Dan

    2007-03-01

    A novel technique for measuring the adhesive force between a thin molten polyester composite film and a PTFE surface is presented in the paper. The molten film was prepared by first depositing powdery composite particles on a substrate and then heating the powdery film on the substrate to the test temperature through a heated pressure nip between two conformable rollers comprising a PTFE overcoat at a speed up to 400 mm/s. The adhesive force is measured by wedging a bendable metal knife into the interface between the molten film and PTFE near the exit of the heating nip. Strain gauges were mounted on both sides of the metal knife. The differential strain gauge reading resulting from the degree of the knife bending is calibrated against standard weights. The technique was used to investigate the effects of the substrate, substrate roughness, molten film thickness, temperature and type of wax additive on the adhesion of the molten composite film to PTFE. On the effects of temperature and type of wax, we found that the adhesive force remains relatively constant at low temperature, and then drops significantly, in some instances to zero, as the temperature further increases. A phenomenological model is proposed to explain the effects of main temperature and the wax additive. The model is evidenced by the surface segregation of wax from the polyester composite film as determined by XPS.

  4. EPR/PTFE dosimetry for test reactor environments

    Energy Technology Data Exchange (ETDEWEB)

    Vehar, D.W.; Griffin, P.J.; Quirk, T.J. [Sandia National Laboratories, Albuquerque, NM 87185-1146 (United States)

    2011-07-01

    The use of Electron Paramagnetic Resonance (EPR) spectroscopy with materials such as alanine is well established as a technique for measurement of ionizing radiation absorbed dose in photon and electron fields such as Co-60, high-energy bremsstrahlung and electron-beam fields [1]. In fact, EPR/Alanine dosimetry has become a routine transfer standard for national standards bodies such as NIST and NPL. In 1992 the Radiation Metrology Laboratory (RML) at Sandia National Laboratories implemented EPR/Alanine capabilities for use in routine and calibration activities at its Co-60 and pulsed-power facilities. At that time it also investigated the usefulness of the system for measurement of absorbed dose in the mixed neutron/photon environments of reactors such as the Sandia Pulsed Reactor and the Annular Core Research Reactor used for hardness testing of electronics. The RML concluded that the neutron response of alanine was a sufficiently high fraction of the overall dosimeter response that the resulting uncertainties in the photon dose would be unacceptably large for silicon-device testing. However, it also suggested that non-hydrogenous materials such as polytetrafluoroethylene (PTFE) would exhibit smaller neutron response and might be useful in mixed environments. Preliminary research with PTFE in photon environments indicated considerable promise, but further development was not pursued at that time. Because of renewed interest in absorbed dose measurements that could better define the individual contributions of photon and neutron components to the overall dose delivered to a test object, the RML has re-initiated the development of an EPR/PTFE dosimetry system. This effort consists of three stages: 1) Identification of PTFE materials that may be suitable for dosimetry applications. It was speculated that the inconsistency of EPR signatures in the earlier samples may have been due to variability in PTFE manufacturing processes. 2) Characterization of dosimetry in

  5. Placement of Endovascular Stent across the Branching Arteries: Long-term Serial Evaluation of Stent-tissue Responses Overlying the Arterial Orifices in an Experimental Study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Young Il; Chung, Jin Wook, E-mail: chungjw@snu.ac.kr [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of); Kim, Hyun Beom [National Cancer Center of Korea, Department of Radiology and Center for Liver Cancer, Research Institute and Hospital (Korea, Republic of); Park, Jae Hyung [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of); Seo, Jeong Wook [Seoul National University College of Medicine, Department of Pathology (Korea, Republic of); Kim, Hyo-Cheol; Jae, Hwan Jun; Lee, Whal [Seoul National University College of Medicine, Department of Radiology (Korea, Republic of)

    2012-10-15

    PurposeThis study was designed to investigate the effects of stenting across the branching arteries on the patency and stent-tissue responses over the branching arterial orifices. Methods: Thirteen dogs were observed after placing aortic stents across the celiac arteries (CA), superior mesenteric arteries (SMA), and renal arteries (RA). The animals were grouped according to stent types: large-cell group (n = 6) and small-cell group (n = 7). Angiography was performed to evaluate the branching artery patency at 2, 6, and 12 months after stent insertion, and the stent-tissue responses covering the orifices were evaluated on histopathologic examination. Results: All branching arteries were patent on follow-up angiography; however, three patterns of stent-tissue responses over the orifices were observed: neointimal layering, bridging septa, and papillary hyperplasia. Although neointimal layering and bridging septa were evenly observed, severe papillary hyperplasia was more frequent at SMA and CA than RA. Four RA showed less than 50% ostial patency, and localized infarct was observed in six kidneys (24%). The ostial patency tended to decrease with small-cell stent during the follow-up period. Conclusions: Various stent-tissue responses over the branching artery orifices are induced by the aortic stent covering the branching arteries and may not be easily detected by conventional angiography. Subclinical renal infarct also may occur despite patent renal angiography.

  6. Custom-made covered transjugular intrahepatic portosystemic shunt (TIPS) in an infant with trisomy 22 and biliary atresia

    Energy Technology Data Exchange (ETDEWEB)

    Chlapoutaki, Chrysanthi Emmanouil; Franchi-Abella, Stephanie; Pariente, Daniele [Bicetre Hospital University Paris XI, Assistance Publique Hopitaux de Paris, Department of Paediatric Radiology, Paris (France); Habes, Dalila [Bicetre Hospital University Paris XI, Assistance Publique Hopitaux de Paris, Pediatric Hepatology and National Reference Center for Biliary Atresia, Paris (France)

    2009-07-15

    We report an 8-month-old girl with portal hypertension secondary to biliary atresia. The decision to treat with TIPS was made at the age of 8 months due to recurrent variceal bleeding. The procedure was carried out with a 6-mm bare stent due to her small size. Radiological follow-up with Doppler US showed gradual stenosis and finally occlusion of the stent 80 days after implantation. Revision was performed with placement of an additional 6-mm expanded polytetrafluoroethylene (e-PTFE) stent-graft that had remained patent for 9 months, proving that in small children with a portal vein diameter less than 8 mm, the combination of a bare stent and stent-graft can provide excellent results. (orig.)

  7. Infrarenal abdominal aortic aneurysm. Endovascular repair with stent grafts; Infrarenales Bauchaortenaneurysma. Endovaskulaere Stent-Graft-Therapie

    Energy Technology Data Exchange (ETDEWEB)

    Wagner, M.; Voshage, G.; Landwehr, P. [Klinik fuer Diagnostische und Interventionelle Radiologie, Gefaesszentrum Hannover, Diakoniekrankenhaus Henriettenstiftung gGmbH, Hannover (Germany); Busch, T. [Klinik fuer Gefaesschirurgie, Gefaesszentrum Hannover, Diakoniekrankenhaus Henriettenstiftung gGmbH, Hannover (Germany)

    2008-09-15

    As an alternative to surgery, endovascular therapy with stent grafts has become the second main treatment option for infrarenal abdominal aortic aneurysms. Unlike surgery, endovascular treatment with stent grafts is also applicable in patients unfit for open repair. Despite current improvements in endovascular repair devices, significant anatomic barriers still exclude this technique for a large number of patients. Computed tomography, magnetic resonance imaging, and ultrasound are essential for diagnostics, preintervention planning, and postintervention follow-up of abdominal aneurysms treated with stent grafts. This review covers etiology, pathology, and diagnostic aspects. Materials and methods for endovascular treatment of abdominal aortic aneurysms are presented in detail, and clinical results and complications are discussed. (orig.) [German] Die endovaskulaere Therapie des infrarenalen Bauchaortenaneurysmas hat sich als Alternative zur offenen chirurgischen Versorgung etabliert. Im Gegensatz zu Letzterer ist die Aneurysmatherapie mittels Stent-Grafts auch bei schwerkranken, nicht operationsfaehigen Patienten moeglich, wobei der Nutzen kontrovers diskutiert wird. Im Gegensatz zur klassischen transabdominellen Operation ist die Stent-Graft-Technik anatomischen Einschraenkungen unterworfen, die aber kuenftig aufgrund bereits abzusehender technischer Weiterentwicklungen eine geringere Rolle spielen werden. Die Diagnostik, die Entscheidung fuer eine endovaskulaere Therapie, die praeinterventionelle Planung und die Nachsorge erfordern den Einsatz bildgebender Verfahren, v. a. der Computer- und Magnetresonanztomographie sowie der Sonographie. Die fuer die endovaskulaere Aneurysmabehandlung relevanten Aspekte der Diagnostik werden dargestellt. Auf die Technik, die Materialien, die Ergebnisse und die Komplikationen der Stent-Graft-Behandlung wird ausfuehrlich eingegangen. (orig.)

  8. Biocompatibility of Coronary Stents

    Directory of Open Access Journals (Sweden)

    Thamarasee M. Jeewandara

    2014-01-01

    Full Text Available Cardiovascular disease is the dominant cause of mortality in developed countries, with coronary artery disease (CAD a predominant contributor. The development of stents to treat CAD was a significant innovation, facilitating effective percutaneous coronary revascularization. Coronary stents have evolved from bare metal compositions, to incorporate advances in pharmacological therapy in what are now known as drug eluting stents (DES. Deployment of a stent overcomes some limitations of balloon angioplasty alone, but provides an acute stimulus for thrombus formation and promotes neointimal hyperplasia. First generation DES effectively reduced in-stent restenosis, but profoundly delay healing and are susceptible to late stent thrombosis, leading to significant clinical complications in the long term. This review characterizes the development of coronary stents, detailing the incremental improvements, which aim to attenuate the major clinical complications of thrombosis and restenosis. Despite these enhancements, coronary stents remain fundamentally incompatible with the vasculature, an issue which has largely gone unaddressed. We highlight the latest modifications and research directions that promise to more holistically design coronary implants that are truly biocompatible.

  9. Forgotten urological stent.

    Science.gov (United States)

    Bhuiyan, Z H; Bhuiyan, N I; Khan, S A; Tawhid, M H; Islam, M F

    2011-10-01

    "Forgotten" Ureteral stent DJ stent related complication is not uncommon even in the era of modern urology in the developed world. In this context we have undertaken a retro-prospective study in relation to its various causes, complications, management and prevention of forgotten stents in a single teaching institute. The study period was from January'04 to December'09. The sample size was 60. The effect of "forgotten stent" in our study reflects mild UTI to various complications including severe renal failure. We had approached all of our cases judiciously using various modalities of minimal access endourological techniques either alone or in combinations with successful outcome. The study concluded that it is vary easy to prevent "forgotten stent" and so its complications. However if we confront such unwanted complications that could be managed successfully with the use of endourological techniques. We did not use other techniques like laparoscopy and open surgery in this study.

  10. Everolimus-eluting coronary stents

    Directory of Open Access Journals (Sweden)

    Alejandro Saez

    2010-09-01

    Full Text Available Alejandro Saez, Raul MorenoDivision of Interventional Cardiology, University Hospital La Paz, Madrid, SpainAbstract: Bare metal stents enabled a reduction in the risk of early procedural complications and restenosis in comparison with balloon angioplasty alone, but introduced a new and device-specific iatrogenic condition, ie, in-stent restenosis due to increased neointimal hyperplasia. Sirolimus- and paclitaxel-eluting stents reduce restenosis and the need for new revascularizations in comparison with bare metal stents, although at the cost of a slight increase in the risk of late stent thrombosis and a need for prolonged dual antiplatelet therapy. Everolimus is an analog of sirolimus with an increased solubility. In this review, the currently available evidence for everolimus-eluting stents is revised, including randomized trials against bare metal stents, and head-to-head trials comparing this stent with other drug-eluting stents.Keywords: coronary stents, restenosis, everolimus, review

  11. The application of Y-shaped self-expandable covered metal stents in the thoracostomach-airway fistula: a single center, 11 years experience%Y型一体化自膨式覆膜气道金属支架在胸腔胃-气道瘘中的应用

    Institute of Scientific and Technical Information of China (English)

    方毅; 李腾飞; 韩新巍; 吴刚; 任建庄; 任克伟; 路慧彬; 张全会; 李宗明

    2015-01-01

    目的 探讨Y型一体化自膨式覆膜气道金属支架(Y型支架)在胸腔胃-气道瘘治疗中的安全性和疗效.方法 回顾性分析2003年4月到2014年10月郑州大学第一附属医院放射介入科收治的108例胸腔胃-气道瘘患者临床及影像学资料,其中男90例,女18例,年龄41 ~75(60±10)岁.根据瘘口的位置、大小及相关气道直径,个体化设计1~3枚Y型支架(其中跨越隆突区域放置的支架简称大Y支架,跨越叶支气管分叉处放置的简称小Y支架).在X线监视下行病变处气道内支架置入,其中单一大Y支架置入65例、单一小Y支架置入16例、大Y+小Y支架组合置入26例,大Y+双小Y支架组合置入1例.结果 所有患者Y型支架均一次置入成功,104例术后即刻气道和食管造影均未见对比剂进入对侧,瘘口封堵完全,4例置入单Y支架后瘘口封堵不严,后改为大Y+小Y支架置入并封堵完全;术后患者卧位刺激性呛咳症状消失,可正常进食水,生活质量明显提高.术后92例患者获得完整随访,其中59例患者于术后3.1 ~9.0个月死亡,死因包括晚期肿瘤消耗(38例)、恶病质进展(14例)、肺部感染(5例)以及大咯血(2例);4例患者单Y支架置入2 ~10个月后瘘口增大,再次给予1枚Y型支架组合置入并证实瘘口封堵完全;余33例患者存活,生活质量满意.结论 Y型一体化自膨式覆膜金属支架气道内置入能有效封堵胸腔胃-气道瘘,技术可行,近期疗效可靠,能显著提高患者生活质量.%Objective To investigate the clinical feasibility and efficacy of Y-shaped selfexpandable covered metal stents (Y-stents) in the management of thoracostomach-airway fistula.Methods Retrospective analysis was performed for 108 patients treated for thoracostomach-airway fistula with Y-shaped self-expandable coated metal stents between April 2003 and October 2014.Y-stents were designed based on the dimensions of trachea and bronchus and sites of the

  12. Grade III Coronary Artery Perforation Following PCI and Unusual Stent Graft Delivery System

    Directory of Open Access Journals (Sweden)

    Sreckovic Miodrag

    2014-06-01

    Full Text Available Koronarne perforacije su retke ali izuzetno neugodne komlikacije perkutanih intervencija. Perforacije koronarnh arterija trećeg stepena po Elisu predstvaljaju najozbiljniju formu perforacija i zahtevaju hitno zbrinjavanje. Često je neophodno uraditi perikardiocentezu i primeniti brojne interventne tehnike kako bismo rešili perforaciju. Stentovi prekriveni politetrafluoroetilenom(PTFE postali su jedno od najčešće korišćenih perkutanih rešenja, ali su njihove mane visoki profil i slaba fleksibilnost. U našem slučaju, pokušali smo da poboljšamo plasiranje PTFE stenta montiranjem na metalni stent, koji smo iskoristili kao nosač.

  13. Characterization of PTFE Using Advanced Thermal Analysis Techniques

    Science.gov (United States)

    Blumm, J.; Lindemann, A.; Meyer, M.; Strasser, C.

    2010-10-01

    Polytetrafluoroethylene (PTFE) is a synthetic fluoropolymer used in numerous industrial applications. It is often referred to by its trademark name, Teflon. Thermal characterization of a PTFE material was carried out using various thermal analysis and thermophysical properties test techniques. The transformation energetics and specific heat were measured employing differential scanning calorimetry. The thermal expansion and the density changes were determined employing pushrod dilatometry. The viscoelastic properties (storage and loss modulus) were analyzed using dynamic mechanical analysis. The thermal diffusivity was measured using the laser flash technique. Combining thermal diffusivity data with specific heat and density allows calculation of the thermal conductivity of the polymer. Measurements were carried out from - 125 °C up to 150 °C. Additionally, measurements of the mechanical properties were carried out down to - 170 °C. The specific heat tests were conducted into the fully molten regions up to 370 °C.

  14. Endovascular Gene Delivery from a Stent Platform: Gene- Eluting Stents.

    Science.gov (United States)

    Fishbein, Ilia; Chorny, Michael; Adamo, Richard F; Forbes, Scott P; Corrales, Ricardo A; Alferiev, Ivan S; Levy, Robert J

    A synergistic impact of research in the fields of post-angioplasty restenosis, drug-eluting stents and vascular gene therapy over the past 15 years has shaped the concept of gene-eluting stents. Gene-eluting stents hold promise of overcoming some biological and technical problems inherent to drug-eluting stent technology. As the field of gene-eluting stents matures it becomes evident that all three main design modules of a gene-eluting stent: a therapeutic transgene, a vector and a delivery system are equally important for accomplishing sustained inhibition of neointimal formation in arteries treated with gene delivery stents. This review summarizes prior work on stent-based gene delivery and discusses the main optimization strategies required to move the field of gene-eluting stents to clinical translation.

  15. Robust non-wetting PTFE surfaces by femtosecond laser machining.

    Science.gov (United States)

    Liang, Fang; Lehr, Jorge; Danielczak, Lisa; Leask, Richard; Kietzig, Anne-Marie

    2014-08-08

    Nature shows many examples of surfaces with extraordinary wettability,which can often be associated with particular air-trapping surface patterns. Here,robust non-wetting surfaces have been created by femtosecond laser ablation of polytetrafluoroethylene (PTFE). The laser-created surface structure resembles a forest of entangled fibers, which support structural superhydrophobicity even when the surface chemistry is changed by gold coating. SEM analysis showed that the degree of entanglement of hairs and the depth of the forest pattern correlates positively with accumulated laser fluence and can thus be influenced by altering various laser process parameters. The resulting fibrous surfaces exhibit a tremendous decrease in wettability compared to smooth PTFE surfaces; droplets impacting the virgin or gold coated PTFE forest do not wet the surface but bounce off. Exploratory bioadhesion experiments showed that the surfaces are truly air-trapping and do not support cell adhesion. Therewith, the created surfaces successfully mimic biological surfaces such as insect wings with robust anti-wetting behavior and potential for antiadhesive applications. In addition, the fabrication can be carried out in one process step, and our results clearly show the insensitivity of the resulting non-wetting behavior to variations in the process parameters,both of which make it a strong candidate for industrial applications.

  16. Robust Non-Wetting PTFE Surfaces by Femtosecond Laser Machining

    Directory of Open Access Journals (Sweden)

    Fang Liang

    2014-08-01

    Full Text Available Nature shows many examples of surfaces with extraordinary wettability, which can often be associated with particular air-trapping surface patterns. Here, robust non-wetting surfaces have been created by femtosecond laser ablation of polytetrafluoroethylene (PTFE. The laser-created surface structure resembles a forest of entangled fibers, which support structural superhydrophobicity even when the surface chemistry is changed by gold coating. SEM analysis showed that the degree of entanglement of hairs and the depth of the forest pattern correlates positively with accumulated laser fluence and can thus be influenced by altering various laser process parameters. The resulting fibrous surfaces exhibit a tremendous decrease in wettability compared to smooth PTFE surfaces; droplets impacting the virgin or gold coated PTFE forest do not wet the surface but bounce off. Exploratory bioadhesion experiments showed that the surfaces are truly air-trapping and do not support cell adhesion. Therewith, the created surfaces successfully mimic biological surfaces such as insect wings with robust anti-wetting behavior and potential for antiadhesive applications. In addition, the fabrication can be carried out in one process step, and our results clearly show the insensitivity of the resulting non-wetting behavior to variations in the process parameters, both of which make it a strong candidate for industrial applications.

  17. Implantation study of a tissue-engineered self-expanding aortic stent graft (bio stent graft) in a beagle model.

    Science.gov (United States)

    Kawajiri, Hidetake; Mizuno, Takeshi; Moriwaki, Takeshi; Iwai, Ryosuke; Ishibashi-Ueda, Hatsue; Yamanami, Masashi; Kanda, Keiichi; Yaku, Hitoshi; Nakayama, Yasuhide

    2015-03-01

    The use of stent grafts for endovascular aortic repair has become an important treatment option for aortic aneurysms requiring surgery. This treatment has achieved excellent outcomes; however, problems like type 1 endoleaks and stent graft migration remain. Bio stent grafts (BSGs), which are self-expanding stents covered with connective tissue, were previously developed using "in-body tissue architecture" technology. We assessed their early adaptation to the aorta after transcatheter implantation in a beagle model. BSGs were prepared by subcutaneous embedding of acryl rods mounted with self-expanding nitinol stents in three beagles for 4 weeks (n = 3/dog). The BSGs were implanted as allografts into infrarenal abdominal aortas via the femoral artery of three other beagles. After 1 month of implantation, aortography revealed no stenosis or aneurysmal changes. The luminal surface of the BSGs was completely covered with neointimal tissue, including endothelialization, without any thrombus formation. The cover tissue could fuse the luminal surface of the native aorta with tight conjunctions even at both ends of the stents, resulting in complete impregnation of the strut into the reconstructed vascular wall, which is expected to prevent endoleaks and migration in clinical applications.

  18. Tissue Responses to Stent Grafts with Endo-Exo-Skeleton for Saccular Abdominal Aortic Aneurysms in a Canine Model

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Il Young; Chung, Jin Wook; Kim, Hyo Cheol [Dept. of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Clinical Research Institute, Seoul (Korea, Republic of); Choi, Young Ho; So Young Ho [Dept. of Radiology, Seoul National University Boramae Hospital, Seoul (Korea, Republic of); Kim, Hyun Beom [Dept. of Radiology, National Cancer Center, Goyang (Korea, Republic of); Min, Seung Kee [Dept. of Surgery, Seoul National University College of Medicine, Seoul (Korea, Republic of); Park, Jae Hyung [Dept. of Radiology, Gachon University Gil Medical Center, Incheon (Korea, Republic of)

    2014-10-15

    We evaluated the effect of close contact between the stent and the graft on the induction of endothelial covering on the stent graft placed over an aneurysm. Saccular abdominal aortic aneurysms were made with Dacron patch in eight dogs. The stent graft consisted of an inner stent, a expanded polytetrafluoroethylene graft, and an outer stent. After sacrificing the animals, the aortas with an embedded stent graft were excised. The aortas were inspected grossly and evaluated microscopically. The animals were sacrificed at two (n = 3), six (n = 3), and eight months (n = 2) after endovascular repair. In two dogs, the aortic lumen was occluded at two months after the placement. On gross inspection of specimens from the other six dogs with a patent aortic lumen, stent grafts placed over the normal aortic wall were covered by glossy white neointima, whereas, stent grafts placed over the aneurysmal aortic wall were covered by brownish neointima. On microscopic inspection, stent grafts placed over the normal aortic wall were covered by thin neointima (0.27 ± 0.05 mm, mean ± standard deviation) with an endothelial layer, and stent grafts placed over the aneurysmal aortic wall were covered by thick neointima (0.62 ± 0.17 mm) without any endothelial lining. Transgraft cell migration at the normal aortic wall was more active than that at the aneurysmal aortic wall. Close contact between the stent and the graft, which was achieved with stent grafts with endo-exo-skeleton, could not enhance endothelial covering on the stent graft placed over the aneurysms.

  19. Automated detection of vessel lumen and stent struts in intravascular optical coherence tomography to evaluate stent apposition and neointimal coverage

    Energy Technology Data Exchange (ETDEWEB)

    Nam, Hyeong Soo; Kim, Chang-Soo; Yoo, Hongki, E-mail: kjwmm@korea.ac.kr, E-mail: hyoo@hanyang.ac.kr [Department of Biomedical Engineering, Hanyang University, Seoul 04763 (Korea, Republic of); Lee, Jae Joong; Song, Joon Woo; Kim, Jin Won, E-mail: kjwmm@korea.ac.kr, E-mail: hyoo@hanyang.ac.kr [Division of Interventional Cardiology, Cardiovascular Center, Korea University Guro Hospital, Seoul 08308 (Korea, Republic of)

    2016-04-15

    Purpose: Intravascular optical coherence tomography (IV-OCT) is a high-resolution imaging method used to visualize the microstructure of arterial walls in vivo. IV-OCT enables the clinician to clearly observe and accurately measure stent apposition and neointimal coverage of coronary stents, which are associated with side effects such as in-stent thrombosis. In this study, the authors present an algorithm for quantifying stent apposition and neointimal coverage by automatically detecting lumen contours and stent struts in IV-OCT images. Methods: The algorithm utilizes OCT intensity images and their first and second gradient images along the axial direction to detect lumen contours and stent strut candidates. These stent strut candidates are classified into true and false stent struts based on their features, using an artificial neural network with one hidden layer and ten nodes. After segmentation, either the protrusion distance (PD) or neointimal thickness (NT) for each strut is measured automatically. In randomly selected image sets covering a large variety of clinical scenarios, the results of the algorithm were compared to those of manual segmentation by IV-OCT readers. Results: Stent strut detection showed a 96.5% positive predictive value and a 92.9% true positive rate. In addition, case-by-case validation also showed comparable accuracy for most cases. High correlation coefficients (R > 0.99) were observed for PD and NT between the algorithmic and the manual results, showing little bias (0.20 and 0.46 μm, respectively) and a narrow range of limits of agreement (36 and 54 μm, respectively). In addition, the algorithm worked well in various clinical scenarios and even in cases with a low level of stent malapposition and neointimal coverage. Conclusions: The presented automatic algorithm enables robust and fast detection of lumen contours and stent struts and provides quantitative measurements of PD and NT. In addition, the algorithm was validated using

  20. Effect of Rare Earths on Tribological Properties of Carbon Fibers Reinforced PTFE Composites

    Institute of Scientific and Technical Information of China (English)

    Shangguan Qianqian; Cheng Xianhua

    2007-01-01

    Carbon fibers (CF) were surface treated with air-oxidation and rare earths (RE), respectively. The effect of RE surface treatment on tensile strength and tribological properties of CF reinforced polytetrafluoroethylene (PTFE) composites was investigated. Experimental results revealed that RE was superior to air oxidation in improving the tensile strength, elongation, and the tensile modulus of CF reinforced PTFE (CF/PTFE) composite. Compared to the untreated and air-oxidated CF/PTFE composite, the RE treated composite had the lowest friction coefficient and specific wear rate under a given applied load and reciprocating sliding frequency. The RE treatment effectively improved the interfacial adhesion between CF and PTFE. With strong interfacial coupling, the carbon fibers carried most of the load, and direct contact and adhesion between PTFE and the counterpart were reduced, accordingly the friction and wear properties of the composite were improved.

  1. Wear resistant PTFE thin film enabled by a polydopamine adhesive layer

    Energy Technology Data Exchange (ETDEWEB)

    Beckford, Samuel [Microelectronics-Photonics Graduate Program, University of Arkansas, Fayetteville, AR 72701 (United States); Zou, Min, E-mail: mzou@uark.edu [Department of Mechanical Engineering, University of Arkansas, 863 West Dickson Street, Fayetteville, AR 72701 (United States); Institute for Nanoscience and Engineering, University of Arkansas, Fayetteville, AR 72701 (United States)

    2014-02-15

    The influence of a polydopamine (PDA) adhesive layer on the friction and wear resistance of polytetrafluoroethylene (PTFE) thin films coated on stainless steel was investigated. The friction and wear tests were carried out using a ball on flat configuration under a normal load of 50 g, sliding speed of 2.5 mm/s, and stroke length of 15 mm. It is found that the PDA/PTFE film is able to withstand approximately 500 times more rubbing cycles than the PTFE film alone. X-ray photoelectron spectroscopy (XPS) results show that a tenacious layer of PTFE remains adhered to the PDA layer, which enables the durability of the PDA/PTFE film. Because of the relatively low thickness of the film, PDA/PTFE shows great potential for use in applications where durable, thin films are desirable.

  2. Dielectric dilatometry on thin Teflon-PTFE films prepared by pulsed-laser deposition

    Science.gov (United States)

    Schwoediauer, Reinhard; Bauer-Gogonea, Simona; Bauer, Stefan; Heitz, J.; Arenholz, Enno; Baeuerle, Dieter

    1999-12-01

    Polytetrafluoroethylene (Teflon PTFE) films were grown by pulsed-laser deposition (PLD). Films prepared by ablation from press-sintered targets are found to be highly crystalline, with spherulite sizes adjustable over more than one order in magnitude by suitable thermal annealing. As revealed by dielectric dilatometry, PLD-PTFE films show characteristics remarkably similar to those of conventional PTFE, i.e. the same structural first-order phase transitions. Dielectric losses are low and indicate no tendency to film oxidation. PLD-PTFE films additionally show an excellent charge-stability, comparable and even superior to commercially available Teflon-PTFE foils. PLD-PTFE enlarges the family of Teflon materials and may thus become interesting for potential miniaturized electret devices. Furthermore, dielectric dilatometry provides an elegant means for the determination of the coefficient of thermal expansion in thin nonpolar films.

  3. Intravascular ultrasound assessed incomplete stent apposition and stent fracture in stent thrombosis after bare metal versus drug-eluting stent treatment the Nordic Intravascular Ultrasound Study (NIVUS)

    DEFF Research Database (Denmark)

    Kosonen, Petteri; Vikman, Saila; Jensen, Lisette Okkels;

    2013-01-01

    This prospective multicenter registry used intravascular ultrasound (IVUS) in patients with definite stent thrombosis (ST) to compare rates of incomplete stent apposition (ISA), stent fracture and stent expansion in patients treated with drug-eluting (DES) versus bare metal (BMS) stents. ST...... is a rare, but potential life threatening event after coronary stent implantation. The etiology seems to be multifactorial....

  4. A biomimetic peptide fluorosurfactant polymer for endothelialization of ePTFE with limited platelet adhesion

    OpenAIRE

    Larsen, Coby C.; Kligman, Faina; Tang, Chad; KOTTKE-MARCHANT, KANDICE; Marchant, Roger E.

    2007-01-01

    Endothelialization of expanded polytetrafluoroethylene (ePTFE) has the potential to improve long-term patency for small-diameter vascular grafts. Successful endothelialization requires ePTFE surface modification to permit cell attachment to this otherwise non-adhesive substrate. We report here on a peptide fluorosurfactant polymer (FSP) biomimetic construct that promotes endothelial cell (EC)-selective attachment, growth, shear stability, and function on ePTFE. The peptide FSP consists of a f...

  5. Renal Artery Stent Outcomes

    Science.gov (United States)

    Murphy, Timothy P.; Cooper, Christopher J.; Matsumoto, Alan H.; Cutlip, Donald E.; Pencina, Karol M.; Jamerson, Kenneth; Tuttle, Katherine R.; Shapiro, Joseph I.; D’Agostino, Ralph; Massaro, Joseph; Henrich, William; Dworkin, Lance D.

    2016-01-01

    BACKGROUND Multiple randomized clinical trials comparing renal artery stent placement plus medical therapy with medical therapy alone have not shown any benefit of stent placement. However, debate continues whether patients with extreme pressure gradients, stenosis severity, or baseline blood pressure benefit from stent revascularization. OBJECTIVES The study sought to test the hypothesis that pressure gradients, stenosis severity, and/or baseline blood pressure affects outcomes after renal artery stent placement. METHODS Using data from 947 patients with a history of hypertension or chronic kidney disease from the largest randomized trial of renal artery stent placement, the CORAL (Cardiovascular Outcomes in Renal Atherosclerotic Lesions) study, we performed exploratory analyses to determine if subsets of patients experienced better outcomes after stent placement than the overall cohort. We examined baseline stenosis severity, systolic blood pressure, and translesion pressure gradient (peak systolic and mean) and performed interaction tests and Cox proportional hazards analyses for the occurrence of the primary endpoint through all follow-up, to examine the effect of these variables on outcomes by treatment group. RESULTS There were no statistically significant differences in outcomes based on the examined variables nor were there any consistent nonsignificant trends. CONCLUSIONS Based on data from the CORAL randomized trial, there is no evidence of a significant treatment effect of the renal artery stent procedure compared with medical therapy alone based on stenosis severity, level of systolic blood pressure elevation, or according to the magnitude of the transstenotic pressure gradient. (Benefits of Medical Therapy Plus Stenting for Renal Atherosclerotic Lesions [CORAL]; NCT00081731) PMID:26653621

  6. Bare Metal Stenting for Endovascular Exclusion of Aortic Arch Thrombi

    Energy Technology Data Exchange (ETDEWEB)

    Mahnken, Andreas H., E-mail: mahnken@med.uni-marburg.de [University Hospital Giessen and Marburg, Philipps University of Marburg, Department of Diagnostic Radiology (Germany); Hoffman, Andras; Autschbach, Ruediger; Damberg, Anneke L. M., E-mail: anneke.damberg@rwth-aachen.de [University Hospital RWTH Aachen, Department of Thoracic, Cardiac and Vascular Surgery (Germany)

    2013-08-01

    BackgroundAortic thrombi in the ascending aorta or aortic arch are rare but are associated with a relevant risk of major stroke or distal embolization. Although stent grafting is commonly used as a treatment option in the descending aorta, only a few case reports discuss stenting of the aortic arch for the treatment of a thrombus. The use of bare metal stents in this setting has not yet been described.MethodsWe report two cases of ascending and aortic arch thrombus that were treated by covering the thrombus with an uncovered stent. Both procedures were performed under local anesthesia via a femoral approach. A femoral cutdown was used in one case, and a total percutaneous insertion was possible in the second case.ResultsBoth procedures were successfully performed without any periprocedural complications. Postoperative recovery was uneventful. In both cases, no late complications or recurrent embolization occurred at midterm follow-up, and control CT angiography at 1 respectively 10 months revealed no stent migration, freely perfused supra-aortic branches, and no thrombus recurrence.ConclusionTreating symptomatic thrombi in the ascending aorta or aortic arch with a bare metal stent is feasible. This technique could constitute a minimally invasive alternative to a surgical intervention or complex endovascular therapy with fenestrated or branched stent grafts.

  7. Tracheobronchial stents in children.

    Science.gov (United States)

    Antón-Pacheco, Juan L

    2016-06-01

    Tracheobronchial obstruction is infrequent in children and still remains a challenging matter of concern. Management alternatives vary from conservative treatment to complex surgical techniques or endoscopic interventional procedures. Airway stenting in children is relatively recent and follows the trail of the experience in adult patients. Nevertheless, there are basic differences between both age groups like the benign nature of most obstructions and the small size of the pediatric airway. These specific features raise the issues of the precise role of tracheobronchial stenting in children and the selection of the most adequate device. Stents fall into four main categories according to the material they are made of: metallic, plastic, hybrid, and biodegradable. Each type has its own advantages and drawbacks so the ideal stent is not yet available. Despite increasing experience with stenting, definite clinical criteria for their use in children are yet to be established. Even so, there seems to be a basic general agreement that stents may play a role in particular clinical settings in which there are no other therapeutic options. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Application of PTFE in copper clad laminate%PTFE在覆铜板中的应用

    Institute of Scientific and Technical Information of China (English)

    江恩伟; 杨中强

    2013-01-01

    This paper introduces the properties of Poly tetra fluor oethylene(PTFE) and the application of PTFE in copper clad laminate(CCL) and describes the main structure of PTFE CCLs. In the end, it provides comments about the status of domestic PTFE CCL.%  介绍了PTFE树脂的特性及其在覆铜板中的应用,阐述了PTFE覆铜板的主要种类,最后介绍国内PTFE覆铜板发展现状。

  9. Effects of Treated Nano-Lanthanum Oxide on the Mechanical and Tribological Properties of PTFE Nanocomposites

    Institute of Scientific and Technical Information of China (English)

    Wang Huaiyuan; Feng Xin; Shi Yijun; Lu Xiaohua

    2007-01-01

    The surface of nano-La2O3 was modified. Effects of various amount of treated nano-La2O3 on the mechanical and tribological properties of PTFE were investigated. Mechanisms that contribute to the properties of PTFE composites are also studied. Results indicate that treated nano-La2O3 can increase the mechanical and tribological properties of PTFE simultaneously. With 1wt.% of treated nano-La2O33, the rigidity, tensile strength, notched impact and wear resistance of PTFE nanocomposites were increased by 25.1%,14.1%,20.3% and 36.7% respectively over pure PTFE. The degradation temperature of PTFE was improved by 14℃ by adding only 5% nano-La2O3. The wear resistance reached the highest value when the composite contained 10% treated nano-La2O3, which is about 110 times higher than pure PTFE. Furthermore, treated nano-La2O3 strengthened the bonding between the transfer film and the counterpart surface. A coherent and smooth transfer film on the counterpart surface of PTFE composites can be observed, while pure PTFE can not do.

  10. Enterocutaneous fistula associated with ePTFE mesh: case report and review of the literature.

    Science.gov (United States)

    Foda, M; Carlson, M A

    2009-06-01

    A case of enterocutaneous fistula secondary to the erosion of an expanded polytetrafluoroethylene (ePTFE) prosthesis into the jejunum is described. This case is unusual secondary to the long experience with ePTFE and the lack of published cases similar to this one. The technical details of this case reveal extenuating circumstances associated with the fistula formation, and it is concluded that this particular case does not provide sufficient evidence to implicate ePTFE, by itself, as an etiologic agent for gastrointestinal fistulization. In addition, the published safety record of ePTFE in abdominal wall surgery is reviewed.

  11. Drug-eluting stents to prevent stent thrombosis and restenosis.

    Science.gov (United States)

    Im, Eui; Hong, Myeong-Ki

    2016-01-01

    Although first-generation drug-eluting stents (DES) have significantly reduced the risk of in-stent restenosis, they have also increased the long-term risk of stent thrombosis. This safety concern directly triggered the development of new generation DES, with innovations in stent platforms, polymers, and anti-proliferative drugs. Stent platform materials have evolved from stainless steel to cobalt or platinum-chromium alloys with an improved strut design. Drug-carrying polymers have become biocompatible or biodegradable and even polymer-free DES were introduced. New limus-family drugs (such as everolimus, zotarolimus or biolimus) were adopted to enhance stent performances. As a result, these new DES demonstrated superior vascular healing responses on intracoronary imaging studies and lower stent thrombotic events in actual patients. Recently, fully-bioresorbable stents (scaffolds) have been introduced, and expanding their applications. In this article, the important concepts and clinical results of new generation DES and bioresorbable scaffolds are described.

  12. Stent Fracture after Everolimus-Eluting Stent Implantation

    Directory of Open Access Journals (Sweden)

    Ali S. Almasood

    2011-01-01

    Full Text Available Compared with bare-metal stents, drug-eluting stents (DES have greatly reduced the risk of in-stent restenosis (ISR by inhibiting neointimal growth. Nevertheless, DES are still prone to device failure, which may lead to cardiac events. Recently, stent fracture (SF has emerged as a potential mechanism of DES failure that is associated with ISR. Stent fracture is strongly related to stent type, and prior reports suggest that deployment of sirolimus eluting stents (SES may be associated with a higher risk of SF compared to other DES. Everolimus eluting stents (EESs represent a new generation of DES with promising results. The occurrence of SF with EES has not been well established. The present paper describes two cases of EES fracture associated with ISR.

  13. Nanomaterial coatings applied on stent surfaces.

    Science.gov (United States)

    Bagheri, Mahsa; Mohammadi, Marzieh; Steele, Terry Wj; Ramezani, Mohammad

    2016-05-01

    The advent of percutaneous coronary intervention and intravascular stents has revolutionized the field of interventional cardiology. Nonetheless, in-stent restenosis, inflammation and late-stent thrombosis are the major obstacles with currently available stents. In order to enhance the hemocompatibility of stents, advances in the field of nanotechnology allow novel designs of nanoparticles and biomaterials toward localized drug/gene carriers or stent scaffolds. The current review focuses on promising polymers used in the fabrication of newer generations of stents with a short synopsis on atherosclerosis and current commercialized stents, nanotechnology's impact on stent development and recent advancements in stent biomaterials is discussed in context.

  14. Impacted calculus within a urethral stent: A rare cause of urinary retention

    Directory of Open Access Journals (Sweden)

    Shanmugasundaram Rajaian

    2011-01-01

    Full Text Available An elderly male presented to the emergency department with acute urinary retention. He had poor flow of urine associated with serosanguinous discharge per urethra for 3 days duration. Earlier he underwent permanent metallic urethral stenting for post TURP bulbar urethral stricture. Plain X-ray of Pelvis showed an impacted calculus within the urethral stent in bulbar urethra. Urethrolitholapaxy was done with semirigid ureteroscope. Urethral stent was patent and well covered. Subsequently he had an uneventful recovery. We describe a unique case of acute urinary retention due to calculus impaction within a urethral stent.

  15. The use of intravascular ultrasound as control procedure for the deployment of endovascular stented grafts

    DEFF Research Database (Denmark)

    Vogt, K C; Brunkwall, J; Malina, M;

    1997-01-01

    from guidewires or the introducer system. Imaging during stent deployment was abandoned after IVUS catheter damage in two of three cases. Postprocedural IVUS was able to evaluate the expansion of the stents and the adaptation to the aortic wall in all instances. In four (29%) cases a leak...... was identified. Additional intervention included deployment of a further stent (n = 2) or redilation (n = 2). Covering of the renal arteries could only be indirectly determined by IVUS. CONCLUSION: IVUS can provide important decisive information before and after stented graft deployment, with the limitations...

  16. Endovascular Treatment of Multiple HIV-related Aneurysms Using Multilayer Stents

    Energy Technology Data Exchange (ETDEWEB)

    Euringer, Wulf [University Hospital Freiburg, Department of Diagnostic Radiology (Germany); Suedkamp, Michael; Rylski, Bartosz [University Hospital Freiburg, Department of Cardiovascular Surgery (Germany); Blanke, Philipp, E-mail: philipp.blanke@uniklinik-freiburg.de [University Hospital Freiburg, Department of Diagnostic Radiology (Germany)

    2012-08-15

    Complex peripheral aneurysm anatomy with major artery branches in the immediate vicinity and mycotic aneurysm often impede endovascular management using covered stent grafts. The Cardiatis Multilayer Stent (Cardiatis, Isnes, Belgium) is a recently approved innovative stent system for peripheral aneurysm management. Its multilayer design aims at decreasing mean velocity and vorticity within the aneurysm sac to cause thrombus formation while maintaining patency of branching vessels due to laminar flow. We present a case of bilateral subclavian artery aneurysms and perivisceral aortic aneurysms in an AIDS patient successfully treated with the Cardiatis Multilayer Stent at 18 months' follow-up.

  17. Using COMSOL Multiphysics for Biomechanical Analysis of Stent Technology in Cerebral Aneurysms

    DEFF Research Database (Denmark)

    Rasmussen, Joachim; Thyregod, Jesper; Enevoldsen, Marie Sand;

    2009-01-01

    This work presents new fluid-structure interaction (FSI) models in both 2D and 3D of the effect of using vascular stents as treatment of cerebral berry aneurysms. The stent is positioned inside the cerebral artery covering the neck of the aneurysm. The stent is expected to alter the blood flow in...... and strut size, shape, and position are modeled in 2D and 3D FSI models. The models show that pore size and strut shape both have significant influence on stent efficiency....

  18. Cobalt chromium stents versus stainless steel stents in diabetic patients

    Directory of Open Access Journals (Sweden)

    Mahmoud Ahmed Tantawy

    2014-03-01

    Conclusions: We concluded that no significant statistical difference was found between the two stents (cobalt-chromium alloy bare metal stent versus conventional bare metal stainless steel stent in diabetic patients regarding (initial procedural success, in-hospital complications, the incidence of ISR at follow up, event-free survival at follow up.

  19. Measurements of prompt radiation induced conductivity in Teflon (PTFE).

    Energy Technology Data Exchange (ETDEWEB)

    Hartman, E. Frederick; Zarick, Thomas Andrew; Sheridan, Timothy J.; Preston, E. [ITT Exelis Mission Systems, Colorado Springs, CO

    2013-05-01

    We performed measurements of the prompt radiation induced conductivity (RIC) in thin samples of Teflon (PTFE) at the Little Mountain Medusa LINAC facility in Ogden, UT. Three mil (76.2 microns) samples were irradiated with a 0.5 %CE%BCs pulse of 20 MeV electrons, yielding dose rates of 1E9 to 1E11 rad/s. We applied variable potentials up to 2 kV across the samples and measured the prompt conduction current. Details of the experimental apparatus and analysis are reported in this report on prompt RIC in Teflon.

  20. Evaluation of Tribological Performance of PTFE Composite Filled with Rare Earths Treated Carbon Fibers under Water-Lubricated Condition

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Carbon fibers (CFs) were surface treated with air-oxidation, rare earths (RE) after air-oxidation, and rare earths, respectively. Erichsen test was conducted to study the interfacial adhesion of PTFE composites filled with carbon fibers treated with different treatment methods. Tribological properties of the PTFE composites, sliding against GCrl5 steel under water-lubricated condition, were investigated on a reciprocating ball-on-disk UMT-2MT tribometer. The worn surfaces of the composites were examined using scanning electron microscopy. Experimental results reveal that RE treatment is superior to air oxidation in promoting tribological properties of CF reinforced PTFE (CF/PTFE) composite. The friction and wear properties of PTFE composite filled with RE treated CF are the best of the PTFE composites. RE treatment is more effective than air oxidation to improve the tribological properties of CF/PTFE composite owing to the effective improvement of interfacial adhesion between carbon fibers and PTFE matrix.

  1. Preparation of PVDF and PTFE membranes for fuel cell use; Preparacao de membranas de PVDF e PTFE enxertadas e sulfonadas para uso em celula a combustivel

    Energy Technology Data Exchange (ETDEWEB)

    Geraldes, Adriana N.; Zen, Heloisa A.; Ferreira, Henrique P.; Parra, Duclerc F.; Lugao, Ademar B.; Linardi, Marcelo [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)], e-mail: angeral@ipen.br

    2007-07-01

    Grafting of styrene onto polyvinylidenefluoride (PVDF), polytetrafluoroethylene (PTFE) was studied using styrene/toluene solutions. First, PTFE and PVDF films were prepared and the process was conducted by radiation induced graft polymerization of styrene, by a Co{sup 60} source. Films of PTFE and PVDF were immersed in styrene/toluene at 1:1 (v/v) concentration and then submitted to gamma radiation at 20 kGy doses. After irradiation, the samples were evaluated at the period of 21 days at room temperature in order to observe the grafting degree. Chemical changes in the PVDF and PTFE films after styrene grafting were monitored and the results were evaluated by FTIR, DSC, TGA and degree of grafting (DOG). The ion exchange capacity (IEC) after sulfonation of 1, 2 and 24 hours were also determined. (author)

  2. Fluoropolymer-coated dacron versus PTFE grafts for femorofemoral crossover bypass: randomised trial

    DEFF Research Database (Denmark)

    Eiberg, J P; Røder, Ole Christian; Stahl-Madsen, Morten

    2006-01-01

    To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery.......To investigate whether patency of a thin walled 8 mm fluoropassivated Dacron graft was similar to that of a standard 8mm PTFE graft for femorofemoral crossover bypass surgery....

  3. Application of ion beam irradiated ePTFE to repair small vessel injuries

    Energy Technology Data Exchange (ETDEWEB)

    Takahashi, N. [Tokyo University of Science, 1-3 Kagurazaka, Shinjuku, Tokyo 162-8601 (Japan) and Beam Application Team, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan)]. E-mail: norikichi@ionbeams.riken.jp; Suzuki, Y. [Beam Application Team, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); Ujiie, H. [Tokyo Women' s Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666 (Japan); Hori, T. [Tokyo Women' s Medical University, 8-1 Kawada-cho, Shinjuku, Tokyo 162-8666 (Japan); Iwaki, M. [Beam Application Team, RIKEN, 2-1 Hirosawa, Wako, Saitama 351-0198 (Japan); Yamada, T. [Tokyo University of Science, 1-3 Kagurazaka, Shinjuku, Tokyo 162-8601 (Japan)

    2007-04-15

    In surgery, bleeding from small injured vessels often requires prompt hemostasis without occlusion. This study evaluated the usefulness of 0.06 mm thick ion beam irradiated ePTFE sheets to repair small holes in vessels. Both surfaces of ePTFE sheets were irradiated with a 150 keV-Ar{sup +} beam with fluences of 5 x 10{sup 14} ions/cm{sup 2}. A small hole up to 2 mm in diameter was created in the common carotid artery of a rabbit. The defect was wrapped with an ion beam irradiated or non-irradiated ePTFE sheet. Fibrin glue was used to fix the ePTFE sheets to the common carotid artery. Hemostasis was instantly obtained with ion beam irradiated ePTFE but was rather difficult when using a non-irradiated ePTFE sheet. Three weeks after implantation, no occlusion was observed. Histological examination showed that the ePTFE sheets functioned as a scaffold for vessel wall regeneration. Thin ion beam irradiated ePTFE would be useful in vascular surgery.

  4. Wear and Failure Mechanism of PTFE/SiO2/Epoxy Composites

    NARCIS (Netherlands)

    Shen, J.T.; Pei, Y.T.; De Hosson, J.Th.M.

    2016-01-01

    In this work, the wear and failure mechanism of polytetrafluoroethylene (PTFE)/SiO2/epoxy composites with a high concentration of SiO2 particles under dry sliding is examined. In the composite with 12.5 wt.% PTFE, a significant rise of the coefficient of friction (COF) appears after sliding over

  5. 涂覆承载质粒DNA水凝胶的覆膜血管内支架置入主动脉局部基因转染的实验研究%Gene delivery of plasmid DNA to rabbit aorta by genetic engineering of cationized gelatin hydrogel coated partially covered endovascular stent graft

    Institute of Scientific and Technical Information of China (English)

    钟红珊; 徐克; 刘屹; 松井 修

    2008-01-01

    Objective To genetically engineer endovascular stent grafts that facilitate plasmid DNA delivery and offer the promise ofcular delivery system of therapeutic materials. Methods Partially covered polyester stent-grafts coated with cationized gelatin hydrogels (CGH) containing pCAGGS-LacZ or pEGFP were implanted in the descending aorta of 8 rabbits, which had neointima due to balloon injury four weeks ago. The aorta with stent-graft containing pCAGGS-LacZ and the one containing pEGFP was taken as negative control for each other. Expression of the plasmid-encoded marker genes, (3-galactosidase and enhanced green fluorescence protein (EGFP) were evaluated at 3 days after implantations by X-Gal staining and RT-PCR or fluorescence microscopy. Results Local plasmid DNA transfer was confined to the vessel wall at the site of stent-graft implantation, especially where the graft was compressed firmly to the vessel by metal struts. Plasmid DNA was not detected in vessel segments immediately proximal or distal to the stent graft and dissemination of plasmid DNA to brain, heart, lung, liver or kidney was not observed. The (3-galactosidase-expressed cells were identified as endothelial cells, and smooth muscle cells by pathological analysis. Fluorescence microscopy identified the EGFP expression which demonstrated the transgene delivery of plasmid DNA and it was not related to the plasmid-encoded marker genes. No signal was detected in the aorta of the rabbits that received cationized gelatin hydrogels coated stent-grafts without plasmid DNA. Conclusions Cationized gelatin hydrogels coated partially covered stent grafts provide a new access for transgene delivery to the cells of aortic wall.%目的 用部分覆膜血管内支架涂覆阳离子胶原水凝胶(CGH)承载质粒DNA实现主动脉局部的基因转染,为核酸等大分子治疗物质经血管导入提供理论依据.方法 将CGH涂覆于部分覆膜血管内支架的覆膜织物上,以CGH涂层分别承载2种质

  6. Detection of very early stent healing after primary angioplasty: an optical coherence tomographic observational study of chromium cobaltum and first-generation drug-eluting stents. The DETECTIVE study.

    Science.gov (United States)

    Prati, Francesco; Stazi, Filippo; Dutary, Jaime; La Manna, Alessio; Di Giorgio, Alessandro; Pawlosky, Tomasz; Gonzalo, Nieves; Di Salvo, Maria Elena; Imola, Fabrizio; Tamburino, Corrado; Albertucci, Mario; Alfonso, Fernando

    2011-11-01

    Lack of stent coverage appears to be associated with stent thrombosis, a problem of particular concern in patients with ST elevation myocardial infarction (STEMI). The DETECTIVE European Multicenter Registry was set up to address the early modality of stent healing in the setting of STEMI. The Registry compared, with an early optical coherence tomography (OCT) evaluation performed at 3-7 days, the patterns of coverage and apposition of the first generation of drug-eluting stents (DESs) and cobalt chromium non-drug-eluting stents (CCSs) that were deployed in culprit lesions and in non-culprit segments. The Registry included only patients with a multi-vessel disease to allow, at 3-7 days from the first angioplasty, a deferred OCT examination and a staged intervention in another vessel. 28 stented lesions (15 patients) eventually entered the final OCT assessment. 13 stents were first-generation DESs, while the remaining 15 were CCSs. 18 stents (64%) were deployed at culprit STEMI lesions, and the remaining 10 (36%) were deployed at non-culprit sites. The distribution of clinical and procedural variables in DES and CCS as well as in culprit and non-culprit sites was not different. In total, 27,019 struts were analysed in 28 stents. The percentage of stent uncoverage in the overall analysis was 11.7%, while the percentage of malapposition and that of struts covered with thrombus were 4.8% and 2.2%, respectively. A low percentage of strut uncoverage was found in all the four studied subgroups: DES 12.8%, CCS 10.9%, stents deployed in culprit lesions 13.2% and stents deployed in non-culprit lesions 8.7%. In conclusion, our data show that in patients with STEMI, a very high percentage of stent struts is covered by an early thin rim of tissue within 7 days after stent positioning. The present data bring new insights in the mechanism and timing of strut coverage.

  7. In vivo clinical dosimetry with LiF: PTFE dosimeters

    Energy Technology Data Exchange (ETDEWEB)

    Delgado, A. (Junta de Energia Nuclear, Madrid (Spain)); Manzanas, M.J.; Fernandez Leton, P. (Clinica Seg. Soc. 1. Octubre, Madrid (Spain))

    1984-01-01

    The purpose of this report is to describe the implementation of a dosimetric system suitable for ''in vivo'' measurements in some clinical applications. This system is based in re-usable thermoluminiscent dosimeters of Lithium fluoride embebded in teflon (PTFE). The results obtained in the utilization of these dosimeters for the determination of entrance absorbed doses on an antropomorphical phantom and patients are also presented. The irradiations have been made in several anatomical localizations with /sup 60/Co gamma rays. A great number of measurements has been made to determine properly the precision that can be reached with LiF: PTFE dosimeters. A considerable improvement of this precission has been obtained calibrating individually each dosimeter. The effects of the remanent sensibilization of the dosimeters that have received relatively high doses (approx. 1 Gy) are also reported. In order to take into account this unwanted effect it is necessary to calibrate frequently the dosimeters during their useful life, lowering, in this way, the risk of making wrong assignation of absorbed doses. From the results obtained in the measurements of absorbed doses in patients, it is clearly deduced that, even in anatomical localizations without special difficulties, such as the abdominal: flat and without problems to maintain the treatment position, rather high discrepancies can be found between the planned doses and those really imparted in practice. These results confirms the usefulness of making patient dose measurements in order to have effective control of the necessary quality of the therapeutical treatments.

  8. Analysis of Trap-controlled Conduction in Modified PTFE

    Institute of Scientific and Technical Information of China (English)

    WU Jiang; WANG Jin-feng; SHEN Bin; ZHENG Xiao-quan

    2011-01-01

    The reasonable conduction property is beneficial to release the deposited charges by conduction current in di- electric space charging environment, thus the level of the deep charging and the pulse discharge can effectively be weakened and inhibited. A traditional method for conductivity measuring under ground circumstance was used, and both the applied voltage and temperature were varied to determine the dependence of volume conductivity in PTFE modified by different filler contents. The results inferred the volume conductivity was significantly affected by the phenomenon of the percolation conduction, as well as the high-field conduction. The shallow and deep charge traps were considered to be a key factor in volume conductivity variation. In this theory, modified by inorganic semi conductive filler, the distribution of trap density and depth in PTFE can be controlled to achieve the ideal temperature dependent conduction property and high-field conduction property, which will finally lead to gentle release of the deposi ted charges while the electrostatic field reaches the conductivity-variation threshold.

  9. Calcium phosphate nucleation on surface-modified PTFE membranes.

    Science.gov (United States)

    Grøndahl, Lisbeth; Cardona, Francisco; Chiem, Khang; Wentrup-Byrne, Edeline; Bostrom, Thor

    2003-06-01

    Highly porous PTFE membranes are currently being used in facial reconstructive surgery. The present study aims at improving this biomaterial through creating a more bioactive surface by introducing ionic groups onto the surface. The unmodified PTFE membrane does not induce inorganic growth after immersion in simulated body fluid (SBF) for up to 4 weeks. Copolymeric grafting with acrylic acid (AAc) by means of gamma irradiation and subsequent in vitro testing in SBF reveals that this copolymer initially acts as an ion-exchange material and subsequently induces growth of a calcium phosphate phase (Ca/P=2.7) when large amounts (15%) of pAAc are introduced onto the membrane surface. This copolymer is not expected to function well from a biomaterials perspective since SEM showed the pores on the surface to be partly blocked. In contrast, the surface of monoacryloxyethyl phosphate (MAEP)-modified samples is altered at a molecular level only. Yet the modified materials are able to induce calcium phosphate nucleation when the external surface coverage is 44% or above. The initial inorganic growth on these membranes in SBF has a (Ca+Mg)/P ratio of 1.1 (presumably Brushite or Monetite). The secondary growth, possibly calcium-deficient apatite or tricalcium phosphate, has a (Ca+Mg)/P ratio of 1.5. This result is a promising indicator of a bioactive biomaterial.

  10. The wettability of PTFE and glass surfaces by nanofluids.

    Science.gov (United States)

    Chaudhuri, Rajib Ghosh; Paria, Santanu

    2014-11-15

    Wetting of solid surfaces by surfactant solutions is well focused in the literature compared that of nanofluids. Similar to the surfactant solutions nanofluids are also able to reduce the surface tension as well as influence on contact angle at the solid, liquid and gas interface. The surface tension and wettability of two different nanofluids containing hydrophilic (TiO2) and hydrophobic (S) particles have been experimentally studied here. The surface tension reduction of nanofluids strongly depends on material property, particle size and as well as concentration. These parameters also influence the change in contact angle on both hydrophilic (glass) and hydrophobic (PTFE) surfaces. Three important factors such as surface tension, surface hydrophobicity after deposition of particles on a solid surface, and the disjoining pressure influence the final contact angle of nanofluids on a solid surface. Sulfur nanofluids show maximum enhancement in contact angle (30.6°) on the glass surface; on the other hand TiO2 nanofluids show maximum reductions in surface tension (25.4 mN/m) and contact angle on the PTFE surface (17.7°) with respect to pure water.

  11. Improving the Hydrophobicity of ZnO by PTFE Incorporation

    Directory of Open Access Journals (Sweden)

    Meenu Srivastava

    2011-01-01

    Full Text Available The objective of the present study is to obtain a zinc oxide- (ZnO- based superhydrophobic surface in a simple and cost-effective manner. Chemical immersion deposition being simple and economical has been adopted to develop modified ZnO coating on glass substrate. Several modifications of ZnO like treatment with alkanoic acid (stearic acid and fluoroalkylsilane to tune the surface wettability (hydrophobicity were attempted. The effect of thermal treatment on the hydrophobic performance was also studied. It was observed that thermal treatment at 70°C for 16 hrs followed by immersion in stearic acid resulted in high water contact angle (WCA, that is, a superhydrophobic surface. Thus, a modified ZnO superhydrophobic surface involves the consumption of large amount of electrical energy and time. Hence, the alternate involved the incorporation of low surface energy fluoropolymer polytetrafluoroethylene (PTFE in the ZnO coating. The immersion deposited ZnO-PTFE composite coating on modification with either stearic acid or fluoroalkylsilane resulted in a better superhydrophobic surface. The coatings were characterized using Scanning Electron Microscope (SEM for the surface morphology. It was found that microstructure of the coating was influenced by the additives employed. A flower-like morphology comprising of needle-like structure arranged in a radial manner was exhibited by the superhydrophobic coating.

  12. Tensile Properties of Surface-Treated Glass Fiber Reinforced PTFE Composite with Rare Earth Elements

    Institute of Scientific and Technical Information of China (English)

    薛玉君; 程先华

    2003-01-01

    The optimum amount of rare earth elements (RE) for treating glass fiber surface and its effect on the tensile properties of glass fiber reinforced polytetrafluoroethylene (GF/PTFE) composites were investigated. The tensile properties of GF/PTFE composites with different surface treatment conditions were measured. The fracture surface morphologies were observed and analyzed by SEM. The results indicate that rare earth elements can effectively promote the interfacial adhesion between the glass fiber and PTFE, owing to the effects of rare earth elements on the compatibility. The tensile properties of GF/PTFE composites can be improved considerably when the content of RE in surface modifier is 0.2%~0.4%, and the optimum performance of GF/PTFE composites is obtained at 0.3%RE content.

  13. Modeling the constitutive and frictional behavior of PTFE flexible stamps for nanoimprint lithography

    DEFF Research Database (Denmark)

    Sonne, Mads Rostgaard; Hattel, Jesper Henri

    2013-01-01

    In the present work, the deformation on micro-scale of PTFE flexible stamps for nanoimprint lithography is modeled. This is achieved via a combination of proper models for the constitutive behavior as well as the frictional conditions between the deforming PTFE stamp and the steel tool. The model...... was verified through an experiment, where a PTFE sheet was deformed by a steel sphere mounted in a tensile test machine. Good agreement between simulations and experimental results is found, both regarding force–displacement and corresponding principal strain measurements. As expected, applying the correct...... frictional behavior between PTFE and steel on micro-scale is shown to be of major importance in order to accurately simulate the strain field in the deformed PTFE stamp. © 2013 Elsevier B.V. All rights reserved...

  14. Electrophoretic deposition of PTFE particles on porous anodic aluminum oxide film and its tribological properties

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Dongya; Dong, Guangneng, E-mail: donggn@mail.xjtu.edu.cn; Chen, Yinjuan; Zeng, Qunfeng

    2014-01-30

    Polytetrafluoroethylene (PTFE) composite film was successfully fabricated by depositing PTFE particles into porous anodic aluminum oxide film using electrophoretic deposition (EPD) process. Firstly, porous anodic aluminum oxide film was synthesized by anodic oxidation process in sulphuric acid electrolyte. Then, PTFE particles in suspension were directionally deposited into the porous substrate. Finally, a heat treatment at 300 °C for 1 h was utilized to enhance PTFE particles adhesion to the substrate. The influence of anodic oxidation parameters on the morphology and micro-hardness of the porous anodic aluminum oxide film was studied and the PTFE particles deposited into the pores were authenticated using energy-dispersive spectrometer (EDS) and scanning electron microscopy (SEM). Tribological properties of the PTFE composite film were investigated under dry sliding. The experimental results showed that the composite film exhibit remarkable low friction. The composite film had friction coefficient of 0.20 which deposited in 15% PTFE emulsion at temperature of 15 °C and current density of 3 A/dm{sup 2} for 35 min. In addition, a control specimen of porous anodic aluminum oxide film and the PTFE composite film were carried out under the same test condition, friction coefficient of the PTFE composite film was reduced by 60% comparing with the control specimen at 380 MPa and 100 mm/s. The lubricating mechanism was that PTFE particles embedded in porous anodic aluminum oxide film smeared a transfer film on the sliding path and the micro-pores could support the supplement of solid lubricant during the sliding, which prolonged the lubrication life of the aluminum alloys.

  15. Electrophoretic deposition of PTFE particles on porous anodic aluminum oxide film and its tribological properties

    Science.gov (United States)

    Zhang, Dongya; Dong, Guangneng; Chen, Yinjuan; Zeng, Qunfeng

    2014-01-01

    Polytetrafluoroethylene (PTFE) composite film was successfully fabricated by depositing PTFE particles into porous anodic aluminum oxide film using electrophoretic deposition (EPD) process. Firstly, porous anodic aluminum oxide film was synthesized by anodic oxidation process in sulphuric acid electrolyte. Then, PTFE particles in suspension were directionally deposited into the porous substrate. Finally, a heat treatment at 300 °C for 1 h was utilized to enhance PTFE particles adhesion to the substrate. The influence of anodic oxidation parameters on the morphology and micro-hardness of the porous anodic aluminum oxide film was studied and the PTFE particles deposited into the pores were authenticated using energy-dispersive spectrometer (EDS) and scanning electron microscopy (SEM). Tribological properties of the PTFE composite film were investigated under dry sliding. The experimental results showed that the composite film exhibit remarkable low friction. The composite film had friction coefficient of 0.20 which deposited in 15% PTFE emulsion at temperature of 15 °C and current density of 3 A/dm2 for 35 min. In addition, a control specimen of porous anodic aluminum oxide film and the PTFE composite film were carried out under the same test condition, friction coefficient of the PTFE composite film was reduced by 60% comparing with the control specimen at 380 MPa and 100 mm/s. The lubricating mechanism was that PTFE particles embedded in porous anodic aluminum oxide film smeared a transfer film on the sliding path and the micro-pores could support the supplement of solid lubricant during the sliding, which prolonged the lubrication life of the aluminum alloys.

  16. Drug-eluting stents: current issues

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); A.T.L. Ong (Andrew)

    2005-01-01

    textabstractEarly stent thrombosis occurs in about 1% to 1.5% of patients with drug-eluting stents, very similar to the rate with bare-metal stents. Late stent thrombosis is more of a concern with drug-eluting stents, with an incidence of at least 0.35%. I would urge caution if you feel you have to

  17. Drug-eluting stents: current issues

    NARCIS (Netherlands)

    P.W.J.C. Serruys (Patrick); A.T.L. Ong (Andrew)

    2005-01-01

    textabstractEarly stent thrombosis occurs in about 1% to 1.5% of patients with drug-eluting stents, very similar to the rate with bare-metal stents. Late stent thrombosis is more of a concern with drug-eluting stents, with an incidence of at least 0.35%. I would urge caution if you feel you have to

  18. [Physical properties of Strecker stents].

    Science.gov (United States)

    Okuda, Y; Sawada, S; Morioka, N; Kodani, K; Ihaya, T; Tanigawa, N; Kobayashi, M; Hashimoto, M; Oouchi, Y; Shimatani, Y

    1995-02-01

    Strecker stent is a balloon-expandable metallic stent that is made of knitted tantalum wire mesh in order to Maintain flexibility. Therefore, the prosthesis is well suited to irregular and tortuous tube organs. We performed several physical experiments using 8 mm and 6 mm diameter stents made of 0.1 mm diameter wire filament. The bearing power of the 8 mm diameter stent against the circumferential compression pressure was divided into two groups, that is, 77-100% and under 66% of expansile rate. The capacity bearing the circumferential compression pressure of the latter group was greater than that of the former. Further, the bearing power of the 6 mm diameter stent was greater than that of the 56% expansile rate of the 8 mm diameter stent. The smaller the expansile rate of the stent, the smaller the minimum radius of curvature within the limits of the stent's plastic. To evaluate the suitability of the stent in clinical use, we made two projections on the inner surface of rubber tubes, and the stents were placed into the rubber tubes at different expansile rates. We evaluated the degree of contact of the stents against the rubber wall by taking soft X-ray photographs. The stents showed good suitability under the condition of incomplete expansion. For the above reasons, we concluded that, from the view-point of bearing power, the stent should be placed in the full expansile state. From the viewpoint of contact against the vessel wall, the stent should be placed in the incomplete expansile state.

  19. Rigid Nylon Foil-Anchored Polytetrafluoroetyhlene (Gor-Tex) Sheet Stenting For Conjunctival Fornix Reconstruction

    Science.gov (United States)

    Demirci, Hakan; Elner, Susan G.; Elner, Victor M.

    2011-01-01

    Purpose To describe a surgical technique that deepens foreshortened conjunctival fornices by providing a scaffold for epithelialization that opposes contractile forces during wound healing. Design Retrospective interventional case series Participants Seventeen patients with anophthalmic sockets containing foreshortened conjunctival fornices Methods Conjunctival fornices was reconstructed with stents of expanded polytetrafluoroethylene (e-PTFE) sheet draped over rigid, 0.8 mm thick nylon strips that were anchored to the orbital rim. Preoperative and postoperativesymptoms, prosthesis retention, fornix depth, and lagophthalmos were assessed. Main Outcome Measure Prosthesis retention, fornix depth, and lagophthalmos Results All 17 patients had preoperative inability to retain their prosthesis. After postoperative follow-up of 47 ± 43 months, retention was improved in all patients and was entirely satisfactory in 15 (88%) patients. After reconstruction, the repaired fornix was deep in 7 (41%) patients, adequate to retain a prosthesis in 9 (53%) patients, and shallow in 1 (6%) patient. Lagophthalmos improved in 15 (88%) patients and remained unchanged in 2 (12%) patients. Superior fornix was reconstructed concurrently with the inferior fornix in 6 patients. In these patients, the superior fornix improved to deep (3 patients; 50%) or adequate (2; 33%). In 1 (17%) patient, it remained shallow. Conclusion Rigid, nylon-foil anchored e-PTFE stenting opposes postoperative contracture, improving prosthesis retention, and lagophthalmos. It does not require an additional surgical site for graft harvesting. PMID:20691479

  20. 食管癌合并糖尿病患者食管带膜支架植入术的护理%Nursing of esophagus carcinoma complicated with diabetes around membrana-covered esophageal stent implantation

    Institute of Scientific and Technical Information of China (English)

    罗伟玲; 刘启; 陈春梅; 高建芳

    2011-01-01

    Objective:To investigate the nursing measures of esophagus complicated with diabetes.Methods:The data of 18 cases of esophagus carcinoma complicated with diabetes was retrospective studied.Results:Stent implantation was successful and received in all patients.The syndrome like dysphagia improved.After operation, there was 1 case with inhalation pneumonia, 3 cases with reflux esophagitis and 9 cases with chest discomfort, all the patients recovered after treating and caring actively.Conclusion:Perfect nursing care, nursing assessment., glucose control, careful observation of disease development perioperative, good special care and basic nursing after operation may be the key to enhance the treatment effect, to reduce the complications.%目的:探讨食管癌合并糖尿病患者食管带膜支架植入术的护理对策.方法:回顾性分析18 例食管癌合并糖尿病患者行食管带膜支架植入手术治疗的护理,总结术前、术后的护理特点.结果:18 例患者置入支架全部一次成功,全组病例术后吞咽困难症状均得到改善,术后发生吸入性肺炎1 例,反流性食管炎3 例,胸痛9例,经积极治疗与护理均康复出院.结论:术前做好心理护理、护理评估、血糖控制,术后严密观察病情,加强专科及基础护理,是提高手术成功率、减少并发症、提高治疗效果的保证.

  1. Exploring PTFE/F-CNTs/BMI Tribological Composites%PTFE/F-CNTs/BMI三元复合摩擦材料的研究

    Institute of Scientific and Technical Information of China (English)

    杨帆; 颜红侠; 李朋博; 王艳丽

    2012-01-01

    Polytetrafluoroethene(PTFE) has very low friction coefficient.We use bismaleimide(BMI) modified with fluorinated carbon nanotubes(F-CNTs) as resin matrix to prepare PTFE/F-CNTs/BMI composites so as to obtain a high-performance anti-wear composite material.We study the effect of PTFE on the mechanical and tribological properties of PTFE/F-CNTs/BMI composites.The study results show that the PTFE of an appropriate content can enhance the toughness of the modified resin matrix.When the content of PTFE is 2.0ωt%,its impact is the best.The impact of nanocomposites is 7.39 kJ/m2,an increase of 54.07% compared with F-CNTs/BMI composite.PTFE can decrease the friction coefficient of F-CNTs/BMI composite but has little effect to its wear rate.The friction coefficient of the F-CNTs/BMI composite with 2.0ωt% PTFE decreases remarkably from 0.38 to 0.29.%聚四氟乙烯(PTFE)具有较低的摩擦系数,将PTFE作为填料加入到氟化碳纳米管(F-CNTs)/双马来酰亚胺(BMI)树脂中,以期得到一种高性能的摩擦材料。以含有活性稀释剂的BMI为基体,F-CNTs和PTFE的混合物为填料,制备PTFE/F-CNTs/BMI复合材料。研究了PTFE的含量对PTFE/F-CNTs/BMI体系力学性能和摩擦学性能的影响。结果表明:适量的PTFE对F-CNTs/BMI体系具有一定的增韧作用,当PTFE的含量为2.0ωt%时,PTFE/F-CNTs/BMI复合材料的冲击强度最大,其冲击强度为7.39 kJ/m2,比F-CNTs/BMI体系提高了54.07%。并且PTFE可明显降低F-CNTs/BMI体系的摩擦系数,使其从0.38降低到0.29,但对其耐磨性影响不大。

  2. A Novel Type of Ureteral Stents in the Treatment of a Bilateral Iatrogenic Transaction of the Ureters

    Directory of Open Access Journals (Sweden)

    Ernesto Mazza

    2013-01-01

    Full Text Available This report illustrates the case of a patient who suffered an iatrogenic complete injury of both ureters after a complex surgical procedure to remove a large sacral chordoma. Ureteral recanalization was achieved with two removable, autoexpandable, and polytetrafluoroethylene covered nitinol stents. To our knowledge, we describe the first application of this type of stents to treat a bilateral ureteral transection. Despite the bad general conditions of the patient, the ureteral stents successfully restored and maintained the bilateral ureteral continuity.

  3. Hepatocellular Carcinoma Complicated by Gastroduodenal Obstruction: Palliative Treatment with Metallic Stent Placement

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Ye Jin; Kim, Jin Hyoung, E-mail: m1fenew@daum.net; Song, Ho-Young; Park, Jung-Hoon; Na, Han Kyu; Kim, Pyeong Hwa; Fan, Yong [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of)

    2012-10-15

    Purpose: To evaluate the clinical effectiveness of self-expandable metallic stents in seven patients with malignant gastroduodenal obstruction caused by inoperable hepatocellular carcinoma (HCC). Methods: Seven patients with gastroduodenal obstruction caused by advanced HCC underwent metallic stent placement from 2003 to 2010. These patients had total dysphagia (n = 5) or were able to eat only liquids (n = 2) before stent placement. Patients had Eastern Cooperative Oncology Group performance scores of 2 or 3, and Child-Pugh classification B or C. Results: Stent placement was technically successful in all seven patients (100%) and clinically successful in six (86%). Five patients could eat a soft diet, and one patient tolerated regular diet after stent placement. Stent-related obstructive jaundice occurred in one patient. One patient had hematemesis 11 days after stent placement. Overall mean survival was 51 days (range, 10-119 days). Stent patency was preserved in six patients with clinical success until death. Conclusion: Placement of a covered self-expandable metallic stent may offer good palliation in patients with gastroduodenal obstruction due to advanced HCC.

  4. Small bowel perforation caused by pancreaticojejunal anastomotic stent migration after pancreaticoduodenectomy for periampullary carcinoma.

    Science.gov (United States)

    Mari, Giulio; Costanzi, Andrea; Monzio, Nicola; Miranda, Angelo; Rigamonti, Luca; Crippa, Jacopo; Sartori, Paola; Maggioni, Dario

    2015-03-20

    Pancreaticoduodenectomy is the gold standard for patients with resectable periampullary carcinoma. The protection of the anastomosis by positioning of an intraluminal stent is a technique used to lower the frequency of anastomotic fistulas. However the use of anastomotic stents is still debated and stent related complications are reported. A fifty-three-year old male underwent pancreaticoduodenectomy (PD) for a T2N0 periampullary carcinoma with a pancreaticojejunal (duct to mucosa) anastomosis protected by a free floating 6 Fr Nelaton stent in the Wirsung duct. Twenty-three months after surgery the patient accessed Emergency Department for severe abdominal pain associated to temperature, high white blood cell count and an significant increase in C reactive protein. Method Abdominal CT scan shown the presence of a tubular stent in the mesogastrium/lower right quadrant. No evident free intra-abdominal air was detected. The patient was submitted to explorative laparotomy. After debridement for localized peritonitis the Nelaton trans anastomotic stent was found in the abdomen. There was no evidence of bowel perforation, but intestinal loops covered with fibrin and suspect for impending perforation were resected. There is a lack of evidence about the true rate of post-operative complications related to pancreatic stenting. We believe that in patients presenting with abdominal pain or peritonitis that previously underwent PD with stent-guided pancreaticojejunal anastomosis, the hypothesis of stent migration should at least be taken into consideration.

  5. An automatic algorithm for detecting stent endothelialization from volumetric optical coherence tomography datasets

    Energy Technology Data Exchange (ETDEWEB)

    Bonnema, Garret T; Barton, Jennifer K [College of Optical Sciences, University of Arizona, Tucson, AZ (United States); Cardinal, Kristen O' Halloran [Biomedical and General Engineering, California Polytechnic State University (United States); Williams, Stuart K [Cardiovascular Innovation Institute, University of Louisville, Louisville, KY 40292 (United States)], E-mail: barton@u.arizona.edu

    2008-06-21

    Recent research has suggested that endothelialization of vascular stents is crucial to reducing the risk of late stent thrombosis. With a resolution of approximately 10 {mu}m, optical coherence tomography (OCT) may be an appropriate imaging modality for visualizing the vascular response to a stent and measuring the percentage of struts covered with an anti-thrombogenic cellular lining. We developed an image analysis program to locate covered and uncovered stent struts in OCT images of tissue-engineered blood vessels. The struts were found by exploiting the highly reflective and shadowing characteristics of the metallic stent material. Coverage was evaluated by comparing the luminal surface with the depth of the strut reflection. Strut coverage calculations were compared to manual assessment of OCT images and epi-fluorescence analysis of the stented grafts. Based on the manual assessment, the strut identification algorithm operated with a sensitivity of 93% and a specificity of 99%. The strut coverage algorithm was 81% sensitive and 96% specific. The present study indicates that the program can automatically determine percent cellular coverage from volumetric OCT datasets of blood vessel mimics. The program could potentially be extended to assessments of stent endothelialization in native stented arteries.

  6. An automatic algorithm for detecting stent endothelialization from volumetric optical coherence tomography datasets

    Science.gov (United States)

    Bonnema, Garret T.; O'Halloran Cardinal, Kristen; Williams, Stuart K.; Barton, Jennifer K.

    2008-06-01

    Recent research has suggested that endothelialization of vascular stents is crucial to reducing the risk of late stent thrombosis. With a resolution of approximately 10 µm, optical coherence tomography (OCT) may be an appropriate imaging modality for visualizing the vascular response to a stent and measuring the percentage of struts covered with an anti-thrombogenic cellular lining. We developed an image analysis program to locate covered and uncovered stent struts in OCT images of tissue-engineered blood vessels. The struts were found by exploiting the highly reflective and shadowing characteristics of the metallic stent material. Coverage was evaluated by comparing the luminal surface with the depth of the strut reflection. Strut coverage calculations were compared to manual assessment of OCT images and epi-fluorescence analysis of the stented grafts. Based on the manual assessment, the strut identification algorithm operated with a sensitivity of 93% and a specificity of 99%. The strut coverage algorithm was 81% sensitive and 96% specific. The present study indicates that the program can automatically determine percent cellular coverage from volumetric OCT datasets of blood vessel mimics. The program could potentially be extended to assessments of stent endothelialization in native stented arteries.

  7. Preparation and Properties of PTFE-PMMA Core-Shell Nanoparticles and Nanocomposites

    Directory of Open Access Journals (Sweden)

    Diego Antonioli

    2012-01-01

    Full Text Available The preparation of polytetrafluoroethylene-poly(methyl methacrylate (PTFE-PMMA core-shell particles was described, featuring controlled size and narrow size distribution over a wide compositional range, through a seeded emulsion polymerization starting from a PTFE seed of 26 nanometers. Over the entire MMA/PTFE range, the particle size increases as the MMA/PTFE ratio increases. A very precise control over the particle size can be exerted by properly adjusting the ratio between the monomer and the PTFE seed. Particles in the 80–240 nm range can be prepared with uniformity indexes suited to build 2D and 3D colloidal crystals. These core-shell particles were employed to prepare nanocomposites with different compositions, through an annealing procedure at a temperature higher than the glass transition temperature of the shell forming polymer. A perfect dispersion of the PTFE particles within the PMMA matrix was obtained and optically transparent nanocomposites were prepared containing a very high PTFE amount.

  8. High Strain, Strain Rate Behavior of PTFE/Al/W

    Science.gov (United States)

    Addiss, John; Cai, Jing; Walley, Steve; Proud, William; Nesterenko, Vitali

    2007-06-01

    Conventional dropweight technique was modified to accommodate low amplitude signals from low strength, cold isostatically pressed energetic ``heavy'' composites of polytetrafluoroethylene (PTFE)/AL/W. The fracture strength, strain and post-critical behaviour of fractured samples were measured for samples of different porosity and W grain size (the masses of each component being the same in each case). Unusual phenomenon of significantly higher strength (55 MPa) of porous composites (density 5.9 g/cc) with small tungsten particles (1 micron) in comparison with strength (32 MPa) of dense composites (7.1 g/cc) with larger tungsten particles (20 micron) was observed. This is attributed to force chains created by a network of small tungsten particles. Interrupted tests at the different level of strains revealed mechanism of fracture under dynamic compression.

  9. Fluid structure interaction simulation in three-layered aortic aneurysm model under pulsatile flow: comparison of wrapping and stenting.

    Science.gov (United States)

    Gao, Feng; Ueda, Hiroshi; Gang, Li; Okada, Hiroshi

    2013-04-26

    One treatment method for aortic aneurysm is the invasive insertion of a stent into the aneurysm. Another method is wrapping the aneurysm using newly developed expanded polytetrafluoroethylene (PTFE) material. A virtual stented aneurysm model and a wrapped aneurysm model were created to study the flow and wall dynamics by means of fluid-structure interaction analyses. The flow velocity and pressure distribution as well as the deformation and wall stress were investigated. Stenting significantly changed the blood flow pattern and the vortexes in the aneurysm. Wrapping increased the thickness of the aneurysm wall and increased the strength of the vessel wall. The maximum von Mises stress in the stented model was found to be 220,494 Pa and 228,218 Pa at the time of peak flow and peak pressure, respectively. This was reduced by 37.8% and 36.7% to 137,200 and 144,354 Pa, respectively, in the wrapped model. Our results provide information that may improve the understanding of the biomechanics of stenting and wrapping.

  10. Pulse electrodeposition of self-lubricating Ni–W/PTFE nanocomposite coatings on mild steel surface

    Energy Technology Data Exchange (ETDEWEB)

    Sangeetha, S. [Advanced Nanocomposite Coatings Laboratory, Department of Industrial Chemistry, Alagappa University, Karaikudi 630 003 (India); Kalaignan, G. Paruthimal, E-mail: pkalaignan@yahoo.com [Advanced Nanocomposite Coatings Laboratory, Department of Industrial Chemistry, Alagappa University, Karaikudi 630 003 (India); Anthuvan, J. Tennis [M. Kumarasamy College of Engineering, Karur, Tamil Nadu (India)

    2015-12-30

    Graphical abstract: - Highlights: • PTFE polymer inclusion on Ni–W alloy matrix was electrodeposited by pulse current method. • Tribological properties and electrochemical characterizations of the nanocomposite coatings were analyzed. • The hydrophobic behaviour of Ni–W/PTFE nanocomposite coating was measured. • Ni–W/PTFE nanocomposite coatings have showed superior tribological properties and corrosion resistance relative to that of the Ni–W alloy matrix. - Abstract: Ni–W/PTFE nanocomposite coatings with various contents of PTFE (polytetafluoroethylene) particles were prepared by pulse current (PC) electrodeposition from the Ni–W plating bath containing self lubricant PTFE particles to be co-deposited. Co-deposited PTFE particulates were uniformly distributed in the Ni–W alloy matrix. The coatings were characterized by Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Analysis (EDAX), X-ray Diffractometry (XRD) and Vicker's micro hardness tester. Tafel Polarization and electrochemical Impedance methods were used to evaluate the corrosion resistance behaviour of the nanocomposite coatings in 3.5% NaCl solution. It was found that, the Ni–W/PTFE nanocomposite coating has better corrosion resistance than the Ni–W alloy coating. Surface roughness and friction coefficient of the coated samples were assessed by Mitutoyo Surftest SJ-310 (ISO1997) and Scratch tester TR-101-M4 respectively. The contact angle (CA) of a water droplet on the surface of nanocomposite coating was measured by Optical Contact Goniometry (OCA 35). These results indicated that, the addition of PTFE in the Ni–W alloy matrix has resulted moderate microhardness, smooth surface, less friction coefficient, excellent water repellency and enhanced corrosion resistance of the nanocomposite coatings.

  11. Ureteroscopic removal of forgotten ureteral stent

    Science.gov (United States)

    Kawahara, Takashi; Ishida, Hiroaki; Kubota, Yoshinobu; Matsuzaki, Junichi

    2012-01-01

    A 69-year-old female had a right ureteral stent placed due to ureteral stricture resulting from cervical cancer in March 2008. The ureteral stent migrated to the ureter and was not exchanged. A new ureteral stent was inserted, and was exchanged every 3 months. The patient was referred to our department to remove the forgotten ureteral stent. In January 2012, her old ureteral stent was removed ureteroscopically, and no ureteral stent encrustation was found. PMID:22707678

  12. Delayed complications after flow-diverter stenting: reactive in-stent stenosis and creeping stents.

    Science.gov (United States)

    Cohen, José E; Gomori, John Moshe; Moscovici, Samuel; Leker, Ronen R; Itshayek, Eyal

    2014-07-01

    We assessed the frequency and severity of changes in stent configuration and location after the treatment of intracranial aneurysms, and patterns of in-stent stenosis. We retrospectively reviewed data for consecutive aneurysm patients managed with endovascular implantation of flow-diverter stents (Silk Flow Diverter [Balt Extrusion, Montmorency, France] and Pipeline Embolization Device [ev3/Coviden, Minneapolis, MN, USA]) from October 2011 to July 2012. Routine 2, 6, 9-12, and 16-20 month follow-up angiograms were compared, with a focus on changes in stent configuration and location from immediately after deployment to angiographic follow-up, and the incidence and development of in-stent stenosis. Thirty-four patients with 42 aneurysms met inclusion criteria. The Silk device was implanted in 16 patients (47%, single device in 15), the Pipeline device in 18 (53%, single device in 16). On first follow-up angiography, in-stent stenosis was observed in 38% of Silk devices and 39% of Pipeline devices. In-stent stenosis was asymptomatic in 12 of 13 patients. One woman presented with transient ischemic attacks and required stent angioplasty due to end tapering and mild, diffuse in-stent stenosis. Configuration and location changes, including stent creeping and end tapering were seen in 2/16 patients (13%) with Silk devices, and 0/18 patients with Pipeline devices. We describe stent creeping and end tapering as unusual findings with the potential for delayed clinical complications. In-stent stenosis, with a unique behavior, is a frequent angiographic finding observed after flow-diverter stent implant. The stenosis is usually asymptomatic; however, close clinical and angiographic monitoring is mandatory for individualized management. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Durable and Efficient PTFE Sandwiched SPEEK Membrane for Vanadium Flow Batteries.

    Science.gov (United States)

    Yu, Lihong; Xi, Jingyu

    2016-09-14

    To overcome the poor cycling stability of sulfonated poly(ether ether ketone) (SPEEK) membrane in vanadium flow batteries (VFB), we demonstrate a facile and effective sandwich design by using hydrophilic porous poly(tetrafluoroethylene) (PTFE) films as a stress protective and electrolyte buffer layer for SPEEK membrane. VFB based on this novel sandwich PTFE/SPEEK/PTFE membrane exhibits super long-life properties, which can steadily run (98.5% of Coulombic efficiency and 85.0% of energy efficiency @ 80 mA cm(-2)) with 2.0 M vanadium electrolyte for more than 1000 cycles. This simple and powerful strategy may also be applied to other nonfluoride membranes.

  14. Use of Micropatterned Thin Film Nitinol in Carotid Stents to Augment Embolic Protection

    Directory of Open Access Journals (Sweden)

    Mahdis Shayan

    2016-12-01

    Full Text Available Stenting is an alternative to endarterectomy for the treatment of carotid artery stenosis. However, stenting is associated with a higher risk of procedural stroke secondary to distal thromboembolism. Hybrid stents with a micromesh layer have been proposed to address this complication. We developed a micropatterned thin film nitinol (M-TFN covered stent designed to prevent thromboembolism during carotid intervention. This innovation may obviate the need or work synergistically with embolic protection devices. The proposed double layered stent is low-profile, thromboresistant, and covered with a M-TFN that can be fabricated with fenestrations of varying geometries and sizes. The M-TFN was created in multiple geometries, dimensions, and porosities by sputter deposition. The efficiency of various M-TFN to capture embolic particles was evaluated in different atherosclerotic carotid stenotic conditions through in vitro tests. The covered stent prevented emboli dislodgement in the range of 70%–96% during 30 min duration tests. In vitro vascular cell growth study results showed that endothelial cell elongation, alignment and growth behaviour silhouettes significantly enhance, specifically on the diamond-shape M-TFN, with the dimensions of 145 µm × 20 µm and a porosity of 32%. Future studies will require in vivo testing. Our results demonstrate that M-TFN has a promising potential for carotid artery stenting.

  15. Use of Micropatterned Thin Film Nitinol in Carotid Stents to Augment Embolic Protection

    Science.gov (United States)

    Shayan, Mahdis; Jankowitz, Brian T.; Shridhar, Puneeth; Chun, Youngjae

    2016-01-01

    Stenting is an alternative to endarterectomy for the treatment of carotid artery stenosis. However, stenting is associated with a higher risk of procedural stroke secondary to distal thromboembolism. Hybrid stents with a micromesh layer have been proposed to address this complication. We developed a micropatterned thin film nitinol (M-TFN) covered stent designed to prevent thromboembolism during carotid intervention. This innovation may obviate the need or work synergistically with embolic protection devices. The proposed double layered stent is low-profile, thromboresistant, and covered with a M-TFN that can be fabricated with fenestrations of varying geometries and sizes. The M-TFN was created in multiple geometries, dimensions, and porosities by sputter deposition. The efficiency of various M-TFN to capture embolic particles was evaluated in different atherosclerotic carotid stenotic conditions through in vitro tests. The covered stent prevented emboli dislodgement in the range of 70%–96% during 30 min duration tests. In vitro vascular cell growth study results showed that endothelial cell elongation, alignment and growth behaviour silhouettes significantly enhance, specifically on the diamond-shape M-TFN, with the dimensions of 145 µm × 20 µm and a porosity of 32%. Future studies will require in vivo testing. Our results demonstrate that M-TFN has a promising potential for carotid artery stenting. PMID:27983574

  16. Angioplasty and stent - heart - discharge

    Science.gov (United States)

    Drug-eluting stents - discharge; PCI - discharge; Percutaneous coronary intervention - discharge; Balloon angioplasty - discharge; Coronary angioplasty - discharge; Coronary artery angioplasty - discharge; Cardiac ...

  17. Unusual balloon rupture during direct stenting with a TaxusExpress stent in a venous graft complicated by vessel rupture: a device-related fatal event

    DEFF Research Database (Denmark)

    Christiansen, Evald H

    2007-01-01

    proximally with a diameter of 4.5 mm, and the balloon ruptured. Angiography showed rupture of the vessel proximal to the implanted stent, and the patient developed severe hypotension. The rupture was treated with a covered stent and pericardiocentesis was performed with evacuation of 600 mL blood. However......, it was not possible to resuscitate the patient, who died due to severe pump failure and incessant ventricular fibrillation. Udgivelsesdato: 2007-Feb...

  18. Erosion of esophageal stent into left main bronchus causing airway compromise

    Science.gov (United States)

    Aneeshkumar, S; Sundararajan, L; Santosham, Rajan; Palaniappan, Rajkumar; Dhus, Ubal

    2017-01-01

    Covered or uncovered self-expanding metal stents are currently used for the palliative treatment of neoplastic esophageal strictures or compressions and esophageal leaks or fistulas due to malignancies. Erosion of esophageal stents into the respiratory tract is a rare complication and that too has been reported mostly as an early complication within few days or weeks. Here, we present the case of a 31-year-old female, who presented with a late complication of an esophageal stent eroding into the left main bronchus causing respiratory distress. She was stented for a benign corrosive esophageal stricture following caustic soda ingestion 3 years ago. She underwent a thoracotomy and closure of esophagobronchial fistula along with laparoscopic esophagectomy and gastric pull through. Postoperatively, patient developed an anastomotic leak which was corrected by placing a temporary stent. PMID:28144066

  19. Retrievable Airway Stent Placement for Stoma Stricture after Anterior Mediastinal Tracheostomy: Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Jae Yeon; Shin, Ji Hoon; Kim, Yong Hee; Song, Ho Young; Kim, Jin Hyoung [Dept. of University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of); Lee, Yeoun Joo [Dept. of Pediatrics, Pusan National University Children' s Hospital, Yangsan (Korea, Republic of)

    2013-06-15

    Anterior mediastinal tracheostomy (AMT) is performed to establish an airway after resection of advanced tumors in the cervicothoracic region. We report a case of successful placement of a covered retrievable self-expandable nitinol stent for a stoma stricture that developed after AMT in a patient with adenoid cystic carcinoma of the trachea. Two stent placements and removals, at two and three months after their initial placement, were performed due to loosening of the stents. Although we did not achieve long-term results as the patient died of massive hemorrhage, the stent placement was both feasible and safe, thus suggesting that temporary stent placement may be a valuable option for treating stoma stricture occurring after AMT.

  20. Surface, thermal, and mechanical properties of composites and nanocomposites of polyurethane/PTFE nanoparticles

    Science.gov (United States)

    Anbinder, P. S.; Peruzzo, P. J.; de Siervo, A.; Amalvy, J. I.

    2014-08-01

    Films from blends of polyurethane and nano-polytetrafluoroethylene aqueous dispersions (PU/nanoPTFE) were prepared, and the effect of the addition of different amounts of PTFE nanoparticles (50 nm) was studied. The changes in the superficial properties of the films were studied by means of XPS, ATR/FTIR, and contact angle measurements. SEM and TEM results are also included. The contact angle values confirm the surface hydrophobicity of composite films. Even though nanoparticles are present in the bulk, higher concentrations of particles appear at the surface in samples with lower nanoPTFE content (up to 10 wt%), as revealed by XPS. Higher amounts of nanoPTFE particles cause aggregation. The mechanical and thermal properties of composites are also discussed.

  1. Non-Cyanide Electrodeposited Ag–PTFE Composite Coating Using Direct or Pulsed Current Deposition

    Directory of Open Access Journals (Sweden)

    Raymond Sieh

    2016-07-01

    Full Text Available The effects of FC-4 cationic surfactant on electrodeposited Ag–PTFE composite coating using direct or pulsed currents were studied using scanning electron microscope (SEM, energy dispersive X-ray (EDS, optical microscope, and a linear tribometer. FC-4:PTFE in various ratios were added to a non-cyanide succinimide silver complex bath. Direct or pulsed current method was used at a constant current density to enable comparison between both methods. A high incorporation rate of PTFE was successfully achieved, with pulsed current being highly useful in increasing the amount of PTFE in the composite coating. The study of coating wear under sliding showed that a large majority of the electrodeposited coatings still managed to adhere to the substrate, even after 10 wear cycles of sliding tests. Performance improvements were achieved on all the samples with a coefficient of friction (CoF between 0.06 and 0.12.

  2. Highly oriented poly(di-n-alkylsilylene) films on oriented PTFE substrates

    NARCIS (Netherlands)

    Frey, H.H.; Frey, Holger; Sheiko, Sergej; Sheiko, S.; Moller, M.; Möller, Martin; Wittmann, Jean-Claude; Lot, Bernard

    1993-01-01

    Highly oriented polysilylene layers have potential applications in electrophotography, nonlinear optics, display fabrication, and microlithography. The preparation of such layers by crystallization on a highly oriented PTFE substrate is reported, and their assessment by optical birefringence, electr

  3. Hemodynamics in Idealized Stented Coronary Arteries: Important Stent Design Considerations.

    Science.gov (United States)

    Beier, Susann; Ormiston, John; Webster, Mark; Cater, John; Norris, Stuart; Medrano-Gracia, Pau; Young, Alistair; Cowan, Brett

    2016-02-01

    Stent induced hemodynamic changes in the coronary arteries are associated with higher risk of adverse clinical outcome. The purpose of this study was to evaluate the impact of stent design on wall shear stress (WSS), time average WSS, and WSS gradient (WSSG), in idealized stent geometries using computational fluid dynamics. Strut spacing, thickness, luminal protrusion, and malapposition were systematically investigated and a comparison made between two commercially available stents (Omega and Biomatrix). Narrower strut spacing led to larger areas of adverse low WSS and high WSSG but these effects were mitigated when strut size was reduced, particularly for WSSG. Local hemodynamics worsened with luminal protrusion of the stent and with stent malapposition, adverse high WSS and WSSG were identified around peak flow and throughout the cardiac cycle respectively. For the Biomatrix stent, the adverse effect of thicker struts was mitigated by greater strut spacing, radial cell offset and flow-aligned struts. In conclusion, adverse hemodynamic effects of specific design features (such as strut size and narrow spacing) can be mitigated when combined with other hemodynamically beneficial design features but increased luminal protrusion can worsen the stent's hemodynamic profile significantly.

  4. Development of a New Hanging-Type Esophageal Stent for Preventing Migration: A Preliminary Study in an Animal Model of Esophagotracheal Fistula

    Energy Technology Data Exchange (ETDEWEB)

    Endo, Masayuki, E-mail: masay010@yahoo.co.jp; Kaminou, Toshio, E-mail: kaminout@med.tottori-u.ac.jp; Ohuchi, Yasufumi, E-mail: oyasu@med.tottori-u.ac.jp [Tottori University, Department of Radiology, Faculty of Medicine (Japan); Sugiura, Kimihiko, E-mail: kimihikosugiura@gmail.com [Yonago Medical Center, Department of Radiology (Japan); Yata, Shinsaku, E-mail: yata-s@med.tottori-u.ac.jp; Adachi, Akira, E-mail: july1st@med.tottori-u.ac.jp; Kawai, Tsuyoshi, E-mail: prgr-xxio@kuc.biglobe.ne.jp; Takasugi, Syohei, E-mail: stakasugi@med.tottori-u.ac.jp; Yamamoto, Shuichi, E-mail: yamamotoshu@med.tottori-u.ac.jp; Matsumoto, Kensuke, E-mail: matsumoto-k@v103.vaio.ne.jp [Tottori University, Department of Radiology, Faculty of Medicine (Japan); Hashimoto, Masayuki, E-mail: hashimotom@pref.tottori.jp [Tottori Prefectural Kosei Hospital, Department of Radiology (Japan); Ihaya, Takashi, E-mail: iahaya@orange.ocn.ne.jp [Sanin Rosai Hospital, Department of Radiology (Japan); Ogawa, Toshihide, E-mail: ogawa@med.tottori-u.ac.jp [Tottori University, Department of Radiology, Faculty of Medicine (Japan)

    2012-10-15

    Purpose: Covered, self-expandable metallic stents (SEMS) have been enthusiastically adopted for the treatment of esophagotracheal fistula, but problems with stent migration have yet to be resolved. To overcome this problem, we have developed a new hanging-type esophageal stent designed to prevent migration, and we conducted an animal study to assess the efficacy of our method. Methods: A total of six female pigs were used in this study. The main characteristic of our stent was the presence of a string tied to the proximal edge of the stent for fixation under the skin of the neck. The first experiment was performed to confirm technical feasibility in three pigs with esophagotracheal fistula. The second experiment was performed to evaluate stent migration and esophagotracheal fistula in three pigs. Results: Creation of the esophagotracheal fistula and stent placement were technically successful in all pigs. In the first experiment, esophagotracheal fistula was sealed by stent placement. In the second experiment, no stent migration was seen 11 or 12 days after stent placement. Gross findings showed no fistulas on the esophageal or tracheal wall. Conclusions: Our new hanging-type esophageal stent seems to offer a feasible method for preventing stent migration.

  5. Acid Aging Effects on Surfaces of PTFE Gaskets Investigated by Thermal Analysis

    Directory of Open Access Journals (Sweden)

    C. Fragassa

    2016-12-01

    Full Text Available This paper investigates the effect of a prolonged acid attack on the surface of PTFE by Thermogravimetric Analysis (TGA and Differential Scanning Calorimetry (DSC. PTFE is very non-reactive, partly because of the strength of carbon–fluorine bonds and for its high crystallinity, and, as a consequence, it is often used in containers and pipework with reactive and corrosive chemicals. The PTFE under analysis is commercialized by two alternative producers in form of Teflon tapes. These tapes are adopted, as gaskets, in process plants where tires moulds are cleaned by acid solutions inside a multistage ultrasonic process. In this case, PTFE shows, in a relatively short operation time, inexplicably phenomena of surface degradation, which could be related, in general terms, to an acid attack. But, even considering the combined effect of ultrasonic waves, temperature, humidity and acid attack, the PTFE properties of resistance nominally exclude the risk of the extreme erosion phenomena as observed. The present experimental research aim at investigating this contradiction. A possible explanation could be related to the presence in the cleaning solution of unexpected fluorides, able to produce fluorinating agents and, thus, degrade carbon-fluorine bonds. Considering more the 300 chemical elements a tire compound consists in, it is really complex to preserve the original chemical composition of the cleaning solution. In this research PTFE samples have been treated with different mixtures of acids with the aim at investigating the different aging effects. The thermal analysis has permitted the experimental characterization of PTFE surface properties after acid attack, providing evidence of the degradation phenomena. In particular, the different acid treatments adopted for accelerating the aging of gaskets have highlighted the different behaviour of the PTFE matrix, but also differences between manufacturers.

  6. Radiation grafting of styrene and maleic anhydride onto PTFE membranes and sequent sulfonation for applications of vanadium redox battery

    Energy Technology Data Exchange (ETDEWEB)

    Qiu Jingyi; Ni Jiangfeng [Beijing National Laboratory for Molecular Science, Department of Applied Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871 (China); Zhai Maolin [Beijing National Laboratory for Molecular Science, Department of Applied Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871 (China)], E-mail: mlzhai@pku.edu.cn; Peng Jing [Beijing National Laboratory for Molecular Science, Department of Applied Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871 (China); Zhou Henghui [Beijing National Laboratory for Molecular Science, Department of Applied Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871 (China)], E-mail: hhzhou@pku.edu.cn; Li Jiuqiang; Wei Genshuan [Beijing National Laboratory for Molecular Science, Department of Applied Chemistry, College of Chemistry and Molecular Engineering, Peking University, Beijing 100871 (China)

    2007-11-15

    Using {gamma}-radiation technique, poly(tetrafluoroethylene) (PTFE) membrane was grafted with styrene (St) (PTFE-graft-PS) or binary monomers of St and maleic anhydride (MAn) (PTFE-graft-PS-co-PMAn), respectively. Then grafted membranes were further sulfonated with chlorosulfonic acid into ion-exchange membranes (denoted as PTFE-graft-PSSA and PTFE-graft-PSSA-co-PMAc, respectively) for application of vanadium redox battery (VRB). Micro-FTIR analysis indicated that PTFE was successfully grafted and sulfonated at the above two different conditions. However, a higher degree of grafting (DOG) was obtained in St/MAn binary system at the same dose due to a synergistic effect. Comparing with PTFE-graft-PSSA, PTFE-graft-PSSA-co-PMAc membrane showed higher water uptake and ion-exchange capacity (IEC) and lower area resistance (AR) at the same DOG. In addition, PTFE-graft-PSSA-co-PMAc with 6% DOG also showed a higher IEC and higher conductivity compared to Nafion membrane. Radiation grafting of PTFE in St/MAn binary system and sequent sulfonation is an appropriate method for preparing ion-exchange membrane of VRB.

  7. Preparation, Properties, and Self-Assembly Behavior of PTFE-Based Core-Shell Nanospheres

    Directory of Open Access Journals (Sweden)

    Katia Sparnacci

    2012-01-01

    Full Text Available Nanosized PTFE-based core-shell particles can be prepared by emulsifier-free seed emulsion polymerization technique starting from spherical or rod-like PTFE seeds of different size. The shell can be constituted by the relatively high Tg polystyrene and polymethylmethacrylate as well as by low Tg polyacrylic copolymers. Peculiar thermal behavior of the PTFE component is observed due to the high degree of PTFE compartmentalization. A very precise control over the particle size can be exerted by properly adjusting the ratio between the monomers and the PTFE seed. In addition, the particle size distribution self-sharpens as the ratio monomer/PTFE increases. Samples with uniformity ratios suited to build 2D and 3D colloidal crystals are easily prepared. In particular, 2D colloidal crystal of spheres leads to very small 2D nanostructuration, useful for the preparation of masks with a combination of nanosphere lithography and reactive ion etching. 3D colloidal crystals were also obtained featuring excellent opal quality, which is a direct consequence of the monodispersity of colloids used for their growth.

  8. Pulse electrodeposition of self-lubricating Ni-W/PTFE nanocomposite coatings on mild steel surface

    Science.gov (United States)

    Sangeetha, S.; Kalaignan, G. Paruthimal; Anthuvan, J. Tennis

    2015-12-01

    Ni-W/PTFE nanocomposite coatings with various contents of PTFE (polytetafluoroethylene) particles were prepared by pulse current (PC) electrodeposition from the Ni-W plating bath containing self lubricant PTFE particles to be co-deposited. Co-deposited PTFE particulates were uniformly distributed in the Ni-W alloy matrix. The coatings were characterized by Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray Analysis (EDAX), X-ray Diffractometry (XRD) and Vicker's micro hardness tester. Tafel Polarization and electrochemical Impedance methods were used to evaluate the corrosion resistance behaviour of the nanocomposite coatings in 3.5% NaCl solution. It was found that, the Ni-W/PTFE nanocomposite coating has better corrosion resistance than the Ni-W alloy coating. Surface roughness and friction coefficient of the coated samples were assessed by Mitutoyo Surftest SJ-310 (ISO1997) and Scratch tester TR-101-M4 respectively. The contact angle (CA) of a water droplet on the surface of nanocomposite coating was measured by Optical Contact Goniometry (OCA 35). These results indicated that, the addition of PTFE in the Ni-W alloy matrix has resulted moderate microhardness, smooth surface, less friction coefficient, excellent water repellency and enhanced corrosion resistance of the nanocomposite coatings.

  9. Temporary endoscopic metallic stent for idiopathic esophageal achalasia.

    Science.gov (United States)

    Coppola, Franco; Gaia, Silvia; Rolle, Emanuela; Recchia, Serafino

    2014-02-01

    Idiopathic achalasia is a motor disorder of the esophagus of unknown etiology caused by loss of motor neurons determining an altered motility. It may determine severe symptoms such as progressive dysphagia, regurgitations, and pulmonary aspirations. Many therapeutic options may be offered to patients with achalasia, from surgery to endoscopic treatments such as pneumatic dilation, botulinum injection, peroral endoscopic myotomy, or endoscopic stenting. Recently, temporary placement of a stent was proposed by Cheng as therapy for achalasia disorders, whereas no Western authors have dealt with it up to date. The present study reports our preliminary experience in 7 patients with achalasia treated with a temporary stent. Partially covered self-expanding metallic stents (Micro-Tech, Nanjin, China) 80 mm long and 30 mm wide were placed under fluoroscopic control and removed after 6 days. Clinical follow-up was scheduled to check endoscopic success, symptoms release, and complications. The placement and the removal of the stents were obtained in all patients without complications. Mean clinical follow-up was 19 months. Five out of 7 patients referred total symptoms release and 2 experienced significant improvement of dysphagia. The procedure was not time consuming and was safe; no mild or severe complications were registered. In conclusion, our results may suggest a possible safe and effective endoscopic alternative treatment in patients with achalasia; however, further larger studies are necessary to confirm these promising, but very preliminary, data.

  10. Endoprótese revestida de jugular preservada de bovino: estudo comparativo da resposta tecidual em aorta torácica descendente e veia cava inferior de suínos Bovine preserved jugular covered stent-graft: comparative study of tissue response at swine thoracic descendent aorta and inferior vena cava

    Directory of Open Access Journals (Sweden)

    Celso Luiz Muhlethaler Chouin

    2008-08-01

    Full Text Available OBJETIVO: Avaliar e comparar a resposta tecidual de uma endoprótese biosintetica implantada na aorta torácica descendente e veia cava inferior de suínos. MÉTODO: Foi implantada uma endoprótese auto-expansível composta de aço inoxidável, revestida por veia jugular de bovino, processada pelo método L-hydro, com auxilio de uma bainha de liberação Taheri-Leonhardt (Flórida, EUA na aorta torácica descendente, e a veia cava infra-renal de 10 suínos. Sessenta dias após, as endopróteses foram retiradas e analisadas sob o ponto de vista macro e microscópicos. Foram observados: perviedade, grau de incorporação a parede do vaso, tipo de reação inflamatória, e local de maior resposta, tanto em relação a camada do vaso quanto ao local de contato com o anel de aço RESULTADOS: Todas as endopróteses encontravam-se pérvias, e incorporadas à parede. No setor venoso, seis apresentaram traves fibrosas em sua luz, e quatro apresentaram fibrose perivascular. No setor arterial somente uma prótese apresentou discreta estenose, sem fibrose perivascular. A reação inflamatória crônica tipo corpo estranho ocorreu em 100% das peças, a camada média foi a mais acometida no setor venoso, enquanto a íntima foi mais constante na artéria, o grau de incorporação foi mais firme na veia em comparação a artéria. A reação tecidual mostrou maior tendência nas áreas em intimo contato com o anel de aço (intra-anelar, mais intensa na artéria do que na veia. CONCLUSÃO: A prótese apresentou baixa trombogenicidade em ambos os sistemas, houve maior reação tecidual e baixa biocompatibilidade no setor venoso.BACKGROUND: To evaluate and compare the tissue response, in swine, to a biosynthetic stent-graft when implanted in both thoracic aorta and inferior vena cava. METHOD: It was used a self-expanding stainless stent, covered by segment of bovine jugular veins, processed by the method L-hydro, and delivered by Taheri-Leonhardt system (Florida

  11. A novel electrical potential sensing method for in vitro stent fracture monitoring and detection.

    Science.gov (United States)

    Park, Chan-Hee; Tijing, Leonard D; Yun, Yeoheung; Kim, Cheol Sang

    2011-01-01

    This article describes a preliminary investigation and prototype fabrication of a novel potential sensing method to continuously monitor vascular stent fractures. A potential measurement system consisting of Wheatstone bridge circuit and signal conditioning circuit was designed for the cardiovascular stent durability and fatigue test. Each end of a bare and polyurethane-covered Nitinol vascular stent was electrically connected to the potential measurement system and then immersed either in simulated body fluid (SBF) media or distilled water at 36.4 ± 1 °C. When the stent experienced fracture (i.e., a cut), its electrical potential decreased with an increase in electrical resistance. This method successfully measured fractures in the stent regardless of location. Furthermore, the number of cycles at the onset of stent fracture was accurately detected and continuously monitored using this technique. Thus, the present fracture detection method, which to our knowledge is the first ever report to use electrical potential measurement for stent durability test, gives a fast, real-time, accurate and efficient detection of fractures in stent during in vitro fatigue and durability test.

  12. Sensor to detect endothelialization on an active coronary stent

    Directory of Open Access Journals (Sweden)

    Coffey Arthur C

    2010-11-01

    Full Text Available Abstract Background A serious complication with drug-eluting coronary stents is late thrombosis, caused by exposed stent struts not covered by endothelial cells in the healing process. Real-time detection of this healing process could guide physicians for more individualized anti-platelet therapy. Here we present work towards developing a sensor to detect this healing process. Sensors on several stent struts could give information about the heterogeneity of healing across the stent. Methods A piezoelectric microcantilever was insulated with parylene and demonstrated as an endothelialization detector for incorporation within an active coronary stent. After initial characterization, endothelial cells were plated onto the cantilever surface. After they attached to the surface, they caused an increase in mass, and thus a decrease in the resonant frequencies of the cantilever. This shift was then detected electrically with an LCR meter. The self-sensing, self-actuating cantilever does not require an external, optical detection system, thus allowing for implanted applications. Results A cell density of 1300 cells/mm2 on the cantilever surface is detected. Conclusions We have developed a self-actuating, self-sensing device for detecting the presence of endothelial cells on a surface. The device is biocompatible and functions reliably in ionic liquids, making it appropriate for implantable applications. This sensor can be placed along the struts of a coronary stent to detect when the struts have been covered with a layer of endothelial cells and are no longer available surfaces for clot formation. Anti-platelet therapy can be adjusted in real-time with respect to a patient's level of healing and hemorrhaging risks.

  13. Heparin-Coated Coronary Stents.

    Science.gov (United States)

    van Der Giessen WJ; van Beusekom HM; Larsson; Serruys

    1999-09-01

    The development of the heparin-coated (HC)-stent should be viewed against the backdrop of the early unfavorable results with noncoated stents in the pre-intravascular ultrasound and pre-ticlopidine era. Notwithstanding, results of pilot and randomized trials show a surprisingly low incidence of (sub)acute stent thrombosis under challenging circumstances, such as acute coronary syndromes. Considering the quite low incidence of early complications with noncoated second-generation stents, it may require large trials to prove the clinical efficacy of the heparin- coating against noncoated devices. However, even if the "added value" of the heparin-coating will never be clinically proven, it has helped to enhance the penetration of stent therapy in interventional cardiology. Unlike the situation in 1992, very few cardiologists will now disagree with the statement that stents contribute to the state-of-the-art treatment of patients with angina pectoris or acute myocardial infarction. A preliminary comparison of available trials also suggests that the heparin-coated Palmaz-Schatz stent (Cordis Corp., Waterloo, Belgium) is as effective as the noncoated stent plus abciximab treatment.

  14. A new removable airway stent

    Directory of Open Access Journals (Sweden)

    Tore Amundsen

    2016-09-01

    Full Text Available Background: Malignant airway obstruction is a feared complication and will most probably occur more frequently in the future because of increasing cancer incidence and increased life expectancy in cancer patients. Minimal invasive treatment using airway stents represents a meaningful and life-saving palliation. We present a new removable airway stent for improved individualised treatment. Methods: To our knowledge, the new airway stent is the world's first knitted and uncovered self-expanding metal stent, which can unravel and be completely removed. In an in vivo model using two anaesthetised and spontaneously breathing pigs, we deployed and subsequently removed the stents by unravelling the device. The procedures were executed by flexible bronchoscopy in an acute and a chronic setting – a ‘proof-of-principle’ study. Results: The new stent was easily and accurately deployed in the central airways, and it remained fixed in its original position. It was easy to unravel and completely remove from the airways without clinically significant complications. During the presence of the stent in the chronic study, granulation tissue was induced. This tissue disappeared spontaneously with the removal. Conclusions: The new removable stent functioned according to its purpose and unravelled easily, and it was completely removed without significant technical or medical complications. Induced granulation tissue disappeared spontaneously. Further studies on animals and humans are needed to define its optimal indications and future use.

  15. Stents for malignant ureteral obstruction

    Directory of Open Access Journals (Sweden)

    Kristina Pavlovic

    2016-07-01

    Full Text Available Malignant ureteral obstruction can result in renal dysfunction or urosepsis and can limit the physician's ability to treat the underlying cancer. There are multiple methods to deal with ureteral obstruction including regular polymeric double J stents (DJS, tandem DJS, nephrostomy tubes, and then more specialized products such as solid metal stents (e.g., Resonance Stent, Cook Medical and polyurethane stents reinforced with nickel-titanium (e.g., UVENTA stents, TaeWoong Medical. In patients who require long-term stenting, a nephrostomy tube could be transformed subcutaneously into an extra-anatomic stent that is then inserted into the bladder subcutaneously. We outline the most recent developments published since 2012 and report on identifiable risk factors that predict for failure of urinary drainage. These failures are typically a sign of cancer progression and the natural history of the disease rather than the individual type of drainage device. Factors that were identified to predict drainage failure included low serum albumin, bilateral hydronephrosis, elevated C-reactive protein, and the presence of pleural effusion. Head-to-head studies show that metal stents are superior to polymeric DJS in terms of maintaining patency. Discussions with the patient should take into consideration the frequency that exchanges will be needed, the need for externalized hardware (with nephrostomy tubes, or severe urinary symptoms in the case of internal DJS. This review will highlight the current state of diversions in the setting of malignant ureteral obstruction.

  16. Incidence of definite stent thrombosis or in-stent restenosis after drug-eluting stent implantation for treatment of coronary in-stent restenosis

    DEFF Research Database (Denmark)

    Jensen, Jesper Khedri; Jensen, Lisette Okkels; Terkelsen, Christian Juhl;

    2013-01-01

    There are limited data on the optimal management of in-stent restenosis after percutaneous coronary intervention (PCI) with bare metal stent (BMS) or drug-eluting stent (DES) implantations. We assessed the clinical presentation, the incidence, and prognosis of definite stent thrombosis...

  17. [Longitudinal stent deformation during bifurcation lesion treatment].

    Science.gov (United States)

    Mami, Z; Monsegu, J

    2014-12-01

    Longitudinal stent deformation is defined as a compression of stent length after its implantation. It's a rare complication but dangerous seen with several stents. We reported a case of longitudinal stent deformation during bifurcation lesion treatment with a Promus Element(®) and we perform a short review of this complication.

  18. Stent migration following endoscopic suture fixation of esophageal self-expandable metal stents: a systematic review and meta-analysis.

    Science.gov (United States)

    Law, Ryan; Prabhu, Anoop; Fujii-Lau, Larissa; Shannon, Carol; Singh, Siddharth

    2017-07-19

    Covered self-expandable metal stents (SEMS) are utilized for the management of benign and malignant esophageal conditions; however, covered SEMS are prone to migration. Endoscopic suture fixation may mitigate the migration risk of covered esophageal SEMS. Hence, we conducted a systematic review and meta-analysis to evaluate the effectiveness and safety of endoscopic suture fixation for covered esophageal SEMS. Following PRISMA guidelines, we performed a systematic review from 2011 to 2016 to identify studies (case control/case series) reporting the technical success and migration rate of covered esophageal SEMS following endoscopic suture fixation. We searched multiple electronic databases and conference proceedings. We calculated pooled rates (and 95% confidence intervals [CI]) of technical success and stent migration using a random effects model. We identified 14 studies (212 patients) describing covered esophageal SEMS placement with endoscopic suture fixation. When reported, SEMS indications included leak/fistula (n = 75), stricture (n = 65), perforation (n = 10), and achalasia (n = 4). The pooled technical success rate was 96.7% (95% CI 92.3-98.6), without heterogeneity (I (2) = 0%). We identified 29 SEMS migrations at rate of 15.9% (95% CI 11.4-21.6), without heterogeneity (I (2) = 0%). Publication bias was observed, and using the trim-and-fill method, a more conservative estimate for stent migration was 17.0%. Suture-related adverse events were estimated to occur in 3.7% (95% CI 1.6-8.2) of cases. Endoscopic suture fixation of covered esophageal SEMS appears to reduce stent migration when compared to published rates of non-anchored SEMS. However, SEMS migration still occurs in approximately 1 out of 6 cases despite excellent immediate technical success and low risk of suture-related adverse events.

  19. Endoscopic multiple metal stenting for the treatment of enteral leaks near the biliary orifice: A novel effective rescue procedure

    Institute of Scientific and Technical Information of China (English)

    Massimiliano Mutignani; Lorenzo Dioscoridi; Stefanos Dokas; Paolo Aseni; Pietro Carnevali; Edoardo Forti; Raffaele Manta; Mariano Sica; Alberto Tringali; Francesco Pugliese

    2016-01-01

    Between April 2013 and October 2015, 6 patients developed periampul ary duodenal or jejunal/biliary leaks after major abdominal surgery. In all patients, percutaneous drainage of the collection or re-operation with primary surgical repair was attempted at first but failed. A fully covered enteral metal stent was placed in all patients to seal the leak. Subsequently, we cannulated the common bile duct and, in some cases, and the main pancreatic duct inserting hydrophilic guidewires through the stent after dilating the stent mesh with a dilatation balloon or breaking the meshes with Argon Plasma Beam. Finally, we inserted a fully covered biliary metal stent to drain the bile into the lumen of the enteral stent. In cases of normal proximal upper gastrointestinal anatomy, a pancreatic plastic stent was also inserted. Oral food intake was initiated when the abdominal drain outflow stopped completely. Stent removal was scheduled four to eight weeks later after a CT scan to confirm the complete healing of the fistula and the absence of any perilesional residual fluid collection. The leak resolved in five patients. One patient died two days after the procedure due to severe, pre-existing, sepsis. The stents were removed endoscopically in four weeks in four patients. In one patient we experiencedstent migration causing small bowel obstruction. In this case, the stents were removed surgically. Four patients are still alive today. They are still under follow-up and doing well. Bilio-enteral fully covered metal stenting with or without pancreatic stenting was feasible, safe and effective in treating postoperative enteral leaks near the biliopancreatic orifice in our small series. This minimally invasive procedure can be implemented in selected patients as a rescue procedure to repair these challenging leaks.

  20. Successful management of hepatic artery pseudoaneurysm complicating chronic pancreatitis by stenting

    Institute of Scientific and Technical Information of China (English)

    Cynthia Sudar Singh; Kamini Giri; Renuka Gupta; Mohammed Aladdin; Harinder Sawhney

    2006-01-01

    A 41-year old alchoholic male with a history of chronic pancreatitis was admitted for nausea, vomiting and weight loss. Angiogram was performed and demonstrated an aneurysmal sac with a narrow neck originating from the inferior aspect of the distal portion of the proper hepatic artery. The origin of the pseudoaneurysm was covered with a 5 mm × 2.5 cm Viabahn cover stent (Gore). A repeat angiogram showed some leak and a second stent (6 mm × 2.3 cm)was deployed and overlapped with the first stent by 3 mm. Contrast was injected and a repeat angiogram demonstrated complete exclusion of the aneurysm. A repeat computerized axial tomography (CAT) scan of the abdomen after 24 h showed successful stenting. The patient had an uneventful post-operative course.

  1. Effect of rare earths surface treatment on tribological properties of carbon fibers reinforced PTFE composite under oil-lubricated condition

    Institute of Scientific and Technical Information of China (English)

    SHANGGUAN Qianqian; CHENG Xianhua

    2008-01-01

    The effect of rare earths (RE) surface treatment of carbon fibers (CF) on tribological properties of CF reinforced polytetrafluoroethylene (PTFE) composites under oil-lubricated condition was investigated. Experimental results revealed that RE treated CF reinforced PTFE (CF/PTFE) composite had the lowest friction coefficient and wear under various applied loads and sliding speeds compared with untreated and air-oxidated composites. X-ray photoelectron spectroscopy (XPS) study of carbon fiber surface showed that, after RE treatment, oxygen concentration increased obviously, and the amount of oxygen-containing groups on CF surfaces were largely increased. The increase in the amount of oxygen-containing groups enhanced interfacial adhesion between CF and PTFE matrix. With strong interfacial adhesion of the composite, stress could be effectively transmitted to carbon fibers;carbon fibers were strongly bonded with PTFE matrix, and large scale rubbing-off of PTFE be prevented, therefore, tribological properties of the composite was improved.

  2. Novel single-layer gas diffusion layer based on PTFE/carbon black composite for proton exchange membrane fuel cell

    Energy Technology Data Exchange (ETDEWEB)

    Chen-Yang, Y.W.; Hung, T.F.; Yang, F.L. [Department of Chemistry and Center for Nanotechnology, Chung Yuan Christian University, Chung-Li 32023 (China); Huang, J. [Yeu Ming Tai Chemical Industrial Co., Ltd, Taichung 40768 (China)

    2007-11-08

    A series of poly(tetrafluoroethylene)/carbon black composite-based single-layer gas diffusion layers (PTFE/CB-GDLs) for proton exchange membrane fuel cell (PEMFC) was successfully prepared from carbon black and un-sintered PTFE, which included powder resin and colloidal dispersion, by a simple inexpensive method. The scanning electron micrographs of PTFE/CB-GDLs indicated that the PTFE resins were homogeneously dispersed in the carbon black matrix and showed a microporous layer (MPL)-like structure. The as-prepared PTFE/CB-GDLs exhibited good mechanical property, high gas permeability, and sufficient water repellency. The best current density obtained from the PEMFC with the single-layer PTFE/CB-GDL was 1.27 and 0.42 A cm{sup -2} for H{sub 2}/O{sub 2} and H{sub 2}/air system, respectively. (author)

  3. Paraplegia after aortic and superior mesenteric artery stenting for occlusive disease.

    Science.gov (United States)

    Hans, Sachinder S; Ngo, William; McAllister, Michael

    2014-02-01

    Paraplegia after endovascular therapy for aortic and visceral artery occlusive disease is an extremely uncommon occurrence. Two cases of paraplegia after placement of an aortic covered stent for infrarenal aortic stenosis and a superior mesenteric artery stent for chronic visceral ischemia are presented. In both patients, embolization of the arterial supply to the spinal cord was the presumed cause. One patient had a slight recovery after intense physical therapy and rehabilitation. The second patient did not have any recovery from her paraplegia.

  4. Synergetic effects of radiolytically degraded PTFE microparticles and organoclay in PTFE-reinforced ethylene vinyl acetate composites

    Energy Technology Data Exchange (ETDEWEB)

    Dubey, K.A., E-mail: abhinav@barc.gov.in [Radiation Technology Development Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Majji, S. [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Sinha, S.K. [Institute of Chemical Technology, Matunga, Mumbai 400 019 (India); Bhardwaj, Y.K. [Radiation Technology Development Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Acharya, S. [Accelerator and Pulse Power Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India); Chaudhari, C.V.; Varshney, L. [Radiation Technology Development Division, Bhabha Atomic Research Centre, Trombay, Mumbai 400085 (India)

    2013-12-16

    This article reports exceptional synergistic effects observed in organic–inorganic dual filler containing ethylene vinyl acetate (EVA) composites. Polytetrafluoroethylene microparticles (PTFEMP) were produced by mechanically grinding radiolytically degraded PTFE; composites of EVA containing PTFEMP and organoclay were prepared in different proportions by melt compounding and their mechanical, melt flow, morphological and crystallographic characteristics were examined. Mechanical properties of ternary composites demonstrated high synergy between fillers, leading to manifold increase in the modulus of dual filler filled composites in comparison to single filler systems. Nielsen model fitted well with EVA/PTFEMP system; however it predicted remarkably low values for EVA/PTFEMP/organoclay system, confirming exceptional synergy between two fillers. Melt viscosity of EVA increased substantially on the addition of either of the fillers. X-ray diffraction studies revealed around 10% intergallery expansion in organoclay, in the composites having high loading of PTFEMP; though the crystallinity of EVA did not change. - Highlights: • Binary and ternary thermoplastic composites of EVA, PTFEMP and organoclay were synthesized. • Exceptional synergistic interactions between PTFEMP and organoclay were observed. • High synergy translated in extremely high modulus, without affecting crystallinity of EVA. • At high PTFEMP loading, shear induced intergallery expansion was observed. • The formulations can be used for designing low-weight high-modulus composites.

  5. Effect of Addition of Polytetrafluoroethylene (PTFE) and Silicon Carbide (SiC) on Properties of Electroless Nickel Alloy Coatings

    Institute of Scientific and Technical Information of China (English)

    WU Yu-cheng; HU Xiao-ye; WANG Wen-fang; HUANG Xin-min

    2004-01-01

    Electroless nickel (copper)-phosphorus-silicon carbide (SiC)-polytetrafluoroethylene (PTFE) composite coatings were prepared by adding SiC and PTFE into electroless nickel (copper)-phosphorus alloy baths. The effects of addition of SiC and PTFE on depositing rate, microhardness, wear resistance and anti-friction of the resulted composite coatings were studied. The results indicated that electroless nickel (copper)-phosphorus alloy coatings were greatly improved in depositing rate, microhardness, wear resistance and antifriction by co-deposited proper amount of SiC and PTFE.

  6. Present and future of endovascular SFA treatment: stents, stent-grafts, drug coated balloons and drug coated stents.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Verbist, J; Peeters, P

    2008-04-01

    The current evolution towards treating more complex femoropopliteal lesions as seen in the renewed TASC II recommendations clearly reflects the continuous evolutions in femoropopliteal stent design. Recent stent design improvements focus on decreasing stent fractures rates which can negatively impact patency rates. By rearranging strut alignment towards helical connecting bridges or full helical stent designs, stent designers have successfully improved the fracture resistance of their stents. The superior fracture resistance of the latest stent generation in combination with the production of long nitinol stents of up to 20 cm in length allow that more difficult and complex lesions can be treated endovascularly. The continuous perfection of nitinol stent platforms followed by the transfer of coronary technologies (e.g. active coatings) towards peripheral devices might broaden the indications for the minimal invasive strategy towards TransAtlantic Inter-Society Consensus (TASC) II C&D lesions.

  7. Metal or plastic stents for preoperative biliary drainage in resectable pancreatic cancer.

    Science.gov (United States)

    Tol, J A M G; van Hooft, J E; Timmer, R; Kubben, F J G M; van der Harst, E; de Hingh, I H J T; Vleggaar, F P; Molenaar, I Q; Keulemans, Y C A; Boerma, D; Bruno, M J; Schoon, E J; van der Gaag, N A; Besselink, M G H; Fockens, P; van Gulik, T M; Rauws, E A J; Busch, O R C; Gouma, D J

    2016-12-01

    In pancreatic cancer, preoperative biliary drainage (PBD) increases complications compared with surgery without PBD, demonstrated by a recent randomised controlled trial (RCT). This outcome might be related to the plastic endoprosthesis used. Metal stents may reduce the PBD-related complications risk. A prospective multicentre cohort study was performed including patients with obstructive jaundice due to pancreatic cancer, scheduled to undergo PBD before surgery. This cohort was added to the earlier RCT (ISRCTN31939699). The RCT protocol was adhered to, except PBD was performed with a fully covered self-expandable metal stent (FCSEMS). This FCSEMS cohort was compared with the RCT's plastic stent cohort. PBD-related complications were the primary outcome. Three-group comparison of overall complications including early surgery patients was performed. 53 patients underwent PBD with FCSEMS compared with 102 patients treated with plastic stents. Patients' characteristics did not differ. PBD-related complication rates were 24% in the FCSEMS group vs 46% in the plastic stent group (relative risk of plastic stent use 1.9, 95% CI 1.1 to 3.2, p=0.011). Stent-related complications (occlusion and exchange) were 6% vs 31%. Surgical complications did not differ, 40% vs 47%. Overall complication rates for the FCSEMS, plastic stent and early surgery groups were 51% vs 74% vs 39%. For PBD in pancreatic cancer, FCSEMS yield a better outcome compared with plastic stents. Although early surgery without PBD remains the treatment of choice, FCSEMS should be preferred over plastic stents whenever PBD is indicated. Dutch Trial Registry (NTR3142). Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. A retrievable rescue stent graft and radiofrequency positioning for rapid control of noncompressible hemorrhage.

    Science.gov (United States)

    Chun, Youngjae; Cho, Sung Kwon; Clark, William C; Wagner, William R; Gu, Xinzhu; Tevar, Amit D; McEnaney, Ryan M; Tillman, Bryan W

    2017-08-01

    Noncompressible hemorrhage of the torso remains a challenging surgical dilemma. Stent graft repair requires endovascular expertise, imaging, and inventory that are not available within the critical window of massive hemorrhage. We developed a retrievable stent graft for rapid hemorrhage. We further investigated a radiofrequency (RF) positioning approach as a possible alternative to the logistics of fluoroscopy. A retrievable stent graft was constructed with a novel "petal and stem" design from nitinol and covered with a sleeve of electrospun polyurethane. The stent graft was tested using an in vitro model of simulated hemorrhage. Next, the stent graft was examined in vivo using a porcine model of noncompressible hemorrhage. The stent was examined for hemorrhage control in a porcine model of either aortic or caval injury. An RF reader was assembled from an Arduino processor while RF tags were affixed to the ends of the stent graft. Detection accuracy of a handheld RF wand for an RF tag was quantified both in vitro and through tissue. The retrievable RESCUEstent graft was deployed within minutes and rapidly controlled traumatic hemorrhage angiographically in both aortic injury (n = 3) and caval injury (n = 2). Stent grafts were easily recaptured in both models in under 15 seconds. The LED light of a handheld RF detector illuminated when positioned directly over an RF tag. The RF detection approach revealed positioning accuracy to within 1 cm of the intended target, despite tissue interference. This study demonstrates the rapid deployment and retrieval of a RESCUE stent graft as well as the ability to tamponade injuries of the aorta and cava. In addition, this study demonstrates the feasibility of RF tags to guide stent placement through tissue. More rigorous models are needed to define the effectiveness of this approach in the setting of vascular injury and shock.

  9. Performance characteristics of modern self-expanding nitinol stents indicated for SFA

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, W.; Behrens, P. [Rostock Univ. (Germany). Inst. fuer Biomedizinische Technik; Wissgott, C.; Andresen, R. [Westkuestenklinikum Heide - Akademisches Lehrkrankenhaus der Universitaeten Kiel, Luebeck und Hamburg (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Schmitz, K.P. [Institut fuer ImplantatTechnologie und Biomaterialien e.V., Rostock-Warnemuende (Germany); Rostock Univ. (Germany). Inst. fuer Biomedizinische Technik

    2011-09-15

    Purpose: To evaluate performance characteristics of currently available superficial femoral artery (SFA) stents and stent delivery systems (SDS). Materials and Methods: Six 7 mm/80 mm stent systems were included: BIOTRONIK Astron Pulsar (4F), EDWARDS LifeStent Flexstar, ev3 PROTEGE Everflex, CORDIS Smart Control, BARD E-Luminexx, GUIDANT Absolute (all 6F). The SDS were evaluated for profile, flexibility in the stent region, trackability and pushability through a tortuous vessel model and release force during deployment. The stents were evaluated for flexibility, radial force during expansion and compression, and shortening. Results: The 4F system had a profile of 1.45 mm, and the 6F stent systems had a profile of 1.96 - 2.10 mm. The Astron Pulsar was most flexible (195 Nmm{sup 2}) compared to 334 - 972 Nmm{sup 2} for the 6F systems. The track force of the stiffest system (Flexstar, 0.314N) was higher than that of the Astron Pulsar (0.273N) but lower than that of the other systems (0.387 - 0.579N). The release force was 1.69N (Absolute), 2.05N (Astron Pulsar) up to 13.00N (Flexstar). The radial force for a 6 mm stent diameter during expansion ranged from 3.95N (Absolute) and 3.99N (Astron Pulsar) up to 7.22N (FlexStar) but was higher when compressed. Conclusion: The 4F system had the best flexibility and trackability. The release force was high in most systems with release handles. The radial force of all tested stents covers a broad range. These results could be helpful to find the best stent for different lesions. (orig.)

  10. Allium Stents: A Novel Solution for the Management of Upper and Lower Urinary Tract Strictures.

    Science.gov (United States)

    Bahouth, Zaher; Moskovitz, Boaz; Halachmi, Sarel; Nativ, Ofer

    2017-08-22

    proximal strictures). We have previously published data on 107 URSs inserted in patients with ureteral stricture due to several etiologies, including patients who failed previous treatment. All patients were asymptomatic for a long period of follow-up after stent removal, with only one case of re-stenosis. In this paper, we review the urological "covered" stents produced by Allium Medical with the relevant clinical data available at the present time.

  11. DJ stent - boon or curse?

    Directory of Open Access Journals (Sweden)

    AS Agrawal

    2014-04-01

    Full Text Available DJ stent is considered as a boon by the urologist but without proper knowledge it turns to be curse for the patient. We report a case of a 34 year old man who developed vesical calculus secondary to DJ stent in a short span of 6-8 months. He underwent cystolithotomy for removal of the vesical calculus along with the DJ stent. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-3, 55-59 DOI: http://dx.doi.org/10.3126/jcmsn.v9i3.10224  

  12. Evaluating Stent Optimisation Technique (StentBoost®) in a Dedicated Bifurcation Stent (the Tryton™)

    Energy Technology Data Exchange (ETDEWEB)

    Fysal, Zamil; Hyde, Thomas; Barnes, Edward; McCrea, William; Ramcharitar, Steve, E-mail: steve.ramcharitar@chem.ox.ac.uk

    2014-03-15

    Background/Purpose: To evaluate the use of StentBoost® in the Tryton™ dedicated SideBranch Stent. Methods and Results: The Tryton™ SideBranch Stent has been effectively used to manage complex bifurcations. However, the paucity of scaffolding in the proximal part of the stent makes it often difficult to visualise under standard radiographic imaging. We set out to evaluate whether by using an augmented radiographic imaging technique it was possible to aid visualisation of the stent. In particular the so call 'wedding ring' band which is crucial to the procedural success. We further evaluated whether it was possible to determine the apposition of the stent at the carina, its coverage and the ability to aid recrossing of the struts closest to the carina as well as the added radiation exposure. Conclusions: StentBoost® was found to be invaluable to the procedural success of the Tryton™ deployment without adding any extra cost to the procedure and with only a 3.7% increase in radiation to the patient. It allowed enhanced visualisation in all cases to aid apposition, recrossing and coverage.

  13. A biomimetic peptide fluorosurfactant polymer for endothelialization of ePTFE with limited platelet adhesion.

    Science.gov (United States)

    Larsen, Coby C; Kligman, Faina; Tang, Chad; Kottke-Marchant, Kandice; Marchant, Roger E

    2007-08-01

    Endothelialization of expanded polytetrafluoroethylene (ePTFE) has the potential to improve long-term patency for small-diameter vascular grafts. Successful endothelialization requires ePTFE surface modification to permit cell attachment to this otherwise non-adhesive substrate. We report here on a peptide fluorosurfactant polymer (FSP) biomimetic construct that promotes endothelial cell (EC)-selective attachment, growth, shear stability, and function on ePTFE. The peptide FSP consists of a flexible poly(vinyl amine) backbone with EC-selective peptide ligands for specific cell adhesion and pendant fluorocarbon branches for stable anchorage to underlying ePTFE. The EC-selective peptide (primary sequence: Cys-Arg-Arg-Glu-Thr-Ala-Trp-Ala-Cys, CRRETAWAC) has demonstrated high binding affinity for the alpha(5)beta(1) integrin found on ECs. Here, we demonstrate low affinity of CRRETAWAC for platelets and platelet integrins, thus providing it with EC-selectivity. This EC-selectivity could potentially facilitate rapid in vivo endothelialization and healing without thrombosis for small-diameter ePTFE vascular grafts.

  14. Management Of Encrusted Ureteral stents

    African Journals Online (AJOL)

    imac-3

    Objectives: To present our experience in managing encrusted ureteral stents and to review the .... A single anesthetic session was required in 18 patients (81.8%) and ... fluid intake, chemotherapy-induced hyperuricosuria, persistent or.

  15. Novel side branch ostial stent.

    Science.gov (United States)

    Chen, Shao-Liang; Lv, Shu-Zheng; Kwan, Tak W

    2009-04-01

    Bifurcation lesions are technically challenging and plagued by a high incidence of restenosis, especially at the side branch orifice, which results in a more frequent need for revascularization during the follow-up period. This report discusses two clinical experiences with a novel side branch ostial stent, the BIGUARD stent, designed for the treatment of bifurcation lesions; procedural success with no in-hospital complications was observed in types IVb and Ia lesions.

  16. Simulation of Particle Size Effect on Dynamic Properties and Fracture of PTFE-W-Al Composites

    Science.gov (United States)

    Herbold, E. B.; Cai, J.; Benson, D. J.; Nesterenko, V. F.

    2007-12-01

    Recent investigations of the dynamic compressive strength of cold isostatically pressed composites of polytetrafluoroethylene (PTFE), tungsten (W) and aluminum (Al) powders show significant differences depending on the size of metallic particles. The addition of W increases the density and changes the overall strength of the sample depending on the size of W particles. To investigate relatively large deformations, multi-material Eulerian and arbitrary Lagrangian-Eulerian methods, which have the ability to efficiently handle the formation of free surfaces, were used. The calculations indicate that the increased sample strength with fine metallic particles is due to the dynamic formation of force chains. This phenomenon occurs for samples with a higher porosity of the PTFE matrix compared to samples with larger particle size of W and a higher density PTFE matrix.

  17. Micro-Ball Lens Array Fabrication in Photoresist Using Ptfe Hydrophobic Effect

    CERN Document Server

    Shyu Ruey Fang; Tsai Wen Ren; Tsai Jhy Cherng

    2007-01-01

    This paper presents a simple method to fabricate micro-ball lens and its array. The key technology is to use the hydrophobic characteristics of polyterafluoroethylene (PTFE) substrate. High contact angle between melted photoresist pattern and PTFE can generate micro-ball lens and its array. PTFE thin film was spun onto a silicon wafer and dried in oven. Photoresist AZ4620 was used to pattern micro-columns with different diameters 60, 70 and 80 $\\mu$m. A thermal reflow process then was applied to melt these micro-column patterns resulted in micro-ball lens array. The achieved micro-ball lens array with diameter 98 $\\mu$m was fabricated using 80 $\\mu$m in diameter patterns. This method provides a simple fabrication process and low material cost.

  18. Study on Protective Clothing against SARS Using PTFE/Poly(ether-ester) Membrane

    Institute of Scientific and Technical Information of China (English)

    HAO Xin-min; ZHANG Jian-chun; GUO Yu-hai

    2004-01-01

    By means of texturing with organic conductive fiber, and then being treated with JAM-Y1 anti-bacteria agent, in the end, treated with the XL-550 waterproof agent, the PET fabric has permanent antistatic, anti-bacteria and waterproof and anti-oil properties. The PET fabric was laminated with PTFE membrane by paste dot coating, and then coated by Poly(ether-ester) solution in a direct process. The filter efficiency of NaCl aerosol, penetration property of poliomyelitis virus in liquid and animalcule in air of PET fabric laminated with PTFE membrane are measured. The properties show that the PET fabric laminated with PTFE membrane can separate SARS virus in air and liquid. The protective mechanism is also discussed in the article.

  19. Dynamic mechanical properties of PTFE-based composites filled with multi-component

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    To improve performance of PTFE-based damping material, composites with several fillers were prepared by compressing and sintering. The dynamic mechanical properties of the composites were investigated by means of viscoanalyser. Temperature-dependent loss factors, storage modulus and loss modulus were obtained.And SEM was employed to study the compatibility between PTFE and fillers. The results show that, when blending PPS and PEEK at proper content, the loss factor curve appears double peaks, which can widen the high-damping temperature region of the composites. Blending graphite or alumina can increase the storage modulus obviously, but decrease the value of loss factor. And because graphite or alumina combines with matrix poorly, glide would happen at interface when bearing external load. The interface friction can dissipate vibration energy, which increases the loss modulus of the composites. Blending PPS, PEEK and graphite or alumina at right content, PTFE-based composites can meet demands as damping material in practical engineering.

  20. Influence of porous PTFE/LDPE/PP composite electret in skin ultrastructure

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, J; Liang, Y Y; Tang, Y; Ye, X T; Yang, Y J; Song, M H [Department of Physics and Mathematics, College of Basic Medical Sciences, Second Military Medical University, Shanghai, 200433 (China); Cui, L L; Hou, X M [Department of Inorganic Chemistry, College of Pharmacy, Second Military Medical University, Shanghai, 200433 (China)], E-mail: jjiang0827@hotmail.com, E-mail: cuilili39@hotmail.com

    2008-12-01

    Corona charging and heat melting method were used to prepare porous PTFE electret and porous PTFE/LDPE/PP composite electret, respectively. After 0.5, 1, 1.5, 3 and 4 hour's action of fluorescein sodium (FINa) and -300V porous PTFE/LDPE/PP composite electret on the excised abdominal skin of rat, the skin structure was studied by means of scanning electron microscopy, transmission electron microscopy and confocal laser scanning microscopy, respectively, to probe the mechanism of electret on transdermal drug delivery. The results indicated that negative electret could increase the transdermal delivery of FINa due to its effect on changing the organized structure of stratum corneum, enlarging the hair follicles, which may be the mechanism of electret in enhancing transdermal drug delivery.

  1. Fabrication of micro-prominences on PTFE surface using proton beam writing

    Energy Technology Data Exchange (ETDEWEB)

    Kitamura, Akane, E-mail: ogawa.akane@jaea.go.jp [Department of Advanced Radiation Technology, Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency, 1233 Watanuki-Machi, Takasaki, Gunma 370-1292 (Japan); Satoh, Takahiro; Koka, Masashi [Department of Advanced Radiation Technology, Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency, 1233 Watanuki-Machi, Takasaki, Gunma 370-1292 (Japan); Kobayashi, Tomohiro [Advanced Science Institute, RIKEN, 2-1 Hirosawa, Wako-shi, Saitama 350-0198 (Japan); Kamiya, Tomihiro [Department of Advanced Radiation Technology, Takasaki Advanced Radiation Research Institute, Japan Atomic Energy Agency, 1233 Watanuki-Machi, Takasaki, Gunma 370-1292 (Japan)

    2013-07-01

    Polytetrafluoroethylene (PTFE) is a typical fluoropolymer and it has several desirable technological properties such as electrical insulation, solid lubrication etc. However, the conventional microstructuring methods have not been well applied to PTFE due to its chemical inertness. Some effective micromachining using synchrotron radiation or ion beam irradiation has been reported. In this study, we create micro-prominences by raising the original surface using proton beam writing (PBW) without chemical etching. A conical prominence was formed by spiral drawing from the center with a 3 MeV proton beam. The body was porous, and the bulk PTFE below the prominence changed to fragmented structures. With decreasing writing speed, the prominence became taller but the height peaked. The prominence gradually reduced in size after the speed reached the optimum value. We expect that these porous projections with high aspect ratio will be versatile in medical fields and microelectromechanical systems (MEMS) technology.

  2. Inappropriateness in biliary stenting

    Directory of Open Access Journals (Sweden)

    Giuseppe Chesi

    2013-10-01

    Full Text Available Starting from a real case of a 69-year old patient affected by cholangiocarcinoma, we intend to discuss the accuracy and appropriateness of the diagnostic and therapeutic procedures adopted. This case shows in particular that a more accurate preoperative staging could probably avoid the patient unnecessary laparotomy. According to the indications in the medical literature, this patient could possibly benefit from chemotherapy, but a chemoembolization of liver metastases was performed. However in the literature no available evidence suggests that this treatment would be beneficial in this kind of clinical picture. Eventually, when the disease was already at an advanced stage and worsened due to a necrosis of the left hepatic lobe and a cholangitic infection, a repositioning of the stent on the stent was performed, despite in the literature the life expectancy cut-off for this procedure is at least 6 months. We also discuss the communication between the physician, the patient and the family, which was probably based on overly optimistic and unrealistic expectations. This led to a number of surgical procedures, which were not certainly helpful and indeed were probably even harmful for this patient. In addition, these procedures caused unnecessary costs borne by the healthcare system. In conclusion, we advocate that discussion and self-assessment must be always promoted, so that the healthcare professionals can review the process and the outcome of their treatment as well as their behavior to understand if it could have been more appropriate to offer actual benefits to the patients in terms of better quality of life and longer life expectancy.

  3. Land Cover

    Data.gov (United States)

    Kansas Data Access and Support Center — The Land Cover database depicts 10 general land cover classes for the State of Kansas. The database was compiled from a digital classification of Landsat Thematic...

  4. Development of radioactive stent using HANARO research reactor

    Energy Technology Data Exchange (ETDEWEB)

    Park, Kyung Bae; Kim, J. R.; Han, H. S.; Shin, B. C.; Kim, Y. M.; Cho, U. K.; Han, K. H.; Park, W. W.; Chung, Y. J

    1997-10-01

    Radioactive cylindrical was prepared by neutron irradiation of pre-made non-radioactive `1`6`5 Ho-sleeve, which was made by casting polyurethane solution containing `1`6`5`Ho(NO{sub 3}){sub 3} in THF+DMF (10:1) solvent in cylindrical glass tube. Its length and diameter could be easily controlled by glass tube used as a mold. The radioactive stent assembly (`1`6`5Ho-SA) was prepared by covering the metallic stent with radioactive sleeve and then treated both ends with epoxy glue for prevention of peeling off the radioactive sleeve from stent (post-irradiation method). Other preparation method of radioactive stent is similar to that of the first one except using radioactive `1`6`6Ho(NO{sub 3}){sub 3} and glass tube fitted with metallic stent before casting (pre-irradiation method). Scanning electron microscopy and autoradiography exhibited that the distribution of `1`6`5Ho and `1`6`6Ho(NO{sub 3}) compounds in polyurethane matrix was nearly homogeneous. The present preparation methods of radioactive sleeve and stent are quite different from conventional method which metallic stent is coated or implanted with radionuclide. The ease with which the radioactive stent can be prepared and its homogeneous radiation emission make it an attractive radiation applicator for the treatment of esophagus cancer. As an animal studies, 6 pathologic specimens were obtained. An animal with 4 mCi of `1`6`6Ho-SA showed loss of epithelial tissue and inflammation at the submucosal layer 4 weeks after the procedure. Considerable improvement of the inflammatory reaction was observed 7 weeks post-therapy without complication. In case treated with 6 mCi of `1`6`6Ho-SA, tissue destruction and widening of the esophageal lumen were observed and the inflammatory reaction propagated into the muscle layer. In case with 9 mCi of `1`6`6Ho-SA, severe esophagitis with cellular proliferation were seen, which resulted in further narrowing of the lumen. (author). 58 refs., 5 tabs., 14 figs

  5. Forgotten Ureteral Stents: An Avoidable Morbidity.

    Science.gov (United States)

    Murtaza, Badar; Alvi, Sarwar

    2016-03-01

    To assess the clinical presentation of forgotten ureteral stents and highlight the etiological factors resulting in the retention of these stents. Observational study. Department of Urology, Armed Forces Institute of Urology, Rawalpindi, from January 2010 to June 2011. Thirty-eight patients, with forgotten ureteral stents, retained for more than 6 months duration, were enrolled. A detailed evaluation was performed, along with the questions regarding the patients' opinion about the ureteral stents. They were specially asked whether they knew about the stents or were they formally informed regarding the stents. Subsequently, the patients were managed according to their clinical condition. The male to female ratio was 2.1:1 aged 23 - 69 years, mean being 40.24 ±12.59 years. The time of presentation after the ureteral stenting was 7 - 180 months (mean = 28.89 ±33.435 years). Seven patients (18.4%) reported with chronic kidney disease, including ESRD in two cases. Recurrent UTI was seen in 28 cases (73.6%), calculus formed over the stents in 20 cases (52.6%), and stent fragmented in 5 patients (13.1%). Majority of patients, (n = 23, 60.5%), were not even aware of the placement of these stents while 8 (21.0%) knew but were reluctant about its removal. In 3 cases (7.8%), the relatives knew about the stent but never informed the patients. The stent had been removed in 2 cases (5.2%), but the other broken fragment was missed. One case (2.6%) each had a misconception about the permanent placement of the stents like cardiac stents and regarding degradation of the stents in situ. Forgotten ureteral stents produce clinical features ranging from recurrent UTI to ESRD. This preventable urological complication is primarily due to the unawareness or ignorance of the patients and their relatives regarding the stent.

  6. Molecular level analyses of mechanical properties of PTFE sterilized by Co-60 γ-ray irradiation for clinical use

    Science.gov (United States)

    Furuta, Masakazu; Matsugaki, Aira; Nakano, Takayoshi; Hirata, Isao; Kato, Koichi; Oda, Takashi; Sato, Mamoru; Okazaki, Masayuki

    2017-10-01

    Recently, Co-60 gamma-ray irradiation has become markedly popular for the sterilization of biomedical materials, including expanded PTFE. However, its effect on the properties of PTFE has not been thoroughly examined. In this study, changes in the properties of PTFE before and after irradiation were analyzed physicochemically and discussed crystallographically. The tensile breaking strengths of PTFE decreased markedly on irradiation at 1 kGy, and were maintained at almost one fourth of the original value (44.3±2.5 N/mm2) ranging from 5 to 100 kGy. XPS analysis indicated that the atomic concentrations of carbon (C) and fluorine (F) of PTFE were not different among samples irradiated at various dosages. Raman spectra of PTFE showed a slight increase of the absorption peak intensity at 735 cm-1 in an irradiation dosage-dependent manner. X-ray diffraction showed that the crystal size of PTFE (56.7±1.0 nm) became smaller after radiation at 100 kGy (48.5±0.6 nm). These results are consistent with the above results of Raman analysis. It is suggested that the observed changes in the mechanical properties of PTFE may be due to nano-scale C-C bond scission by gamma ray irradiation, and not due to the formation of micro-scale cracks.

  7. Coronary aneurysm and very late stent thrombosis formation associated with sirolimus-eluting stent implantation

    Institute of Scientific and Technical Information of China (English)

    XIE Hong-zhi; ZHANG Shu-yang; ZENG Yong; SHEN Zhu-jun; FANG Quan

    2009-01-01

    @@ Since drug-eluting stents (DES) can significantly reduce the risk of instant restenosis compared with bare-metal stents, they have been widely used in interventional therapy for coronary heart disease. With bare-metal stents being rapidly replaced by DES there is a great concern about the safety of DES due to stent thrombosis.~(1,2)

  8. Drug diffusion and biological responses of arteries using a drug-eluting stent with nonuniform coating

    Directory of Open Access Journals (Sweden)

    Saito N

    2016-03-01

    Full Text Available Noboru Saito, Yuhei Mori, Sayaka Uchiyama Terumo Corporation R&D Center, Inokuchi, Nakai-machi, Ashigarakami-gun, Kanagawa, Japan Abstract: The purpose of this study was to determine the effect of a nonuniform coating, abluminal-gradient coating (AGC, which leaves the abluminal surface of the curves and links parts of the stent free from the drug coating, on the diffusion direction of the drug and the biological responses of the artery to drug-eluting stent (DES by comparing the AGC-sirolimus stent and the conventional full-surface coating (CFC sirolimus stent. The study aimed to verify whether the AGC approach was appropriate for the development of a safer DES, minimizing the risks of stent thrombosis due to delayed endothelialization by the drug and distal embolization due to cracking of the coating layer on the hinge parts of the DES on stent expansion. In the in vitro local drug diffusion study, we used rhodamine B as a model drug, and rhodamine B released from the AGC stent diffused predominantly into the abluminal side of the alginate artery model. Conversely, rhodamine B released from the CFC stent quickly spread to the luminal side of the artery model, where endothelial cell regeneration is required. In the biological responses study, the luminal surface of the iliac artery implanted with the AGC-sirolimus stent in a rabbit iliac artery for 2 weeks was completely covered with endothelial-like cells. On the other hand, the luminal surface of the iliac artery implanted with the CFC-sirolimus stent for 2 weeks only showed partial coverage with endothelial-like cells. While thrombosis was observed in two of the three CFC-sirolimus stents, it was observed in only one of the three AGC-sirolimus stents. Taken together, these findings indicate that the designed nonuniform coating (AGC is an appropriate approach to ensure a safer DES. However, the number of studies is limited and a larger study should be conducted to reach a statistically

  9. Wettability properties of PTFE/ZnO nanorods thin film exhibiting UV-resilient superhydrophobicity

    Energy Technology Data Exchange (ETDEWEB)

    Bayat, A.; Ebrahimi, M. [Department of Physics, Sharif University of Technology, P.O. Box 11155-9161, Tehran (Iran, Islamic Republic of); Nourmohammadi, A. [Department of Physics, University of Nevada, Reno, NV 89557 (United States); Moshfegh, A.Z., E-mail: moshfegh@sharif.edu [Department of Physics, Sharif University of Technology, P.O. Box 11155-9161, Tehran (Iran, Islamic Republic of); Institute for Nanoscience and Nanotechnology, Sharif University of Technology, P.O. Box 14588-89694, Tehran (Iran, Islamic Republic of)

    2015-06-30

    Highlights: • Thin layer of Teflon was deposited on ZnO nanorods using RF sputtering technique. • Water contact angle was measured from 3° for ZnO to 160° for the PTFE/ZnO. • Very low contact angle hysteresis of ∼2° and sliding angle of ∼1° was measured. • Excellent stability under UV illumination was observed for the PTFE/ZnO sample. • We have proposed a model to describe wettability property supporting our data. - Abstract: In this research, initially anodization process was used to fabricate ZnO nanorods on Zn substrate and then RF sputtering technique was applied to grow a thin layer of polytetrafluoroethylene (PTFE, Teflon) on the coated ZnO nanorods for producing a superhydrophobic surface. According to scanning electron microscopy (SEM) observations, ZnO nanorods were formed with average diameter and length of about ∼180 nm and 14 μm, respectively. Superhydrophilic property of ZnO nanorods and superhydrophobic property of PTFE/ZnO nanorods was investigated by water contact angle (WCA) measurements. It was found that the contact angle varied with the PTFE deposition time. The highest contact angle measurement was obtained at 160° for the PTFE (60 min coating)/ZnO as optimum sample which indicates its superhydrophobic property. X-ray photoelectron spectroscopy (XPS) determined surface chemical composition and F/C ratio of about 1.27 for this sample. A change of water contact angle from 3° to 160° indicates transition from superhydrophilic to superhydrophobic state. Very low contact angle hysteresis (CAH) of ∼2° and sliding angle (SA) of ∼1° as well as unchanged contact angle under UV illumination was observed for the synthesized optimum PTFE/ZnO sample exhibits an excellent superhydrophobic property. Based on our data analysis, the ZnO nanorods and the PTFE/ZnO nanorods obey Wenzel and Cassie–Baxter model, respectively.

  10. Seroma after laparoscopic repair of hernia with PTFE patch: is it really a complication?

    Science.gov (United States)

    Susmallian, S; Gewurtz, G; Ezri, T; Charuzi, I

    2001-09-01

    We evaluated the true incidence of seroma formation after laparoscopic repair of incisional hernia with polytetrafluoroethylene (PTFE) patch. In a prospective study, 20 patients who underwent laparoscopic repair of incisional hernia with PTFE were evaluated clinically and with ultrasound examination for seroma formation up to the 90th postoperative day. Seroma was diagnosed clinically in only 35% of cases, while ultrasound examination revealed the presence of seroma in 100% of patients. Ultrasound examination is a reliable tool for diagnosis of early or delayed postoperative seroma formation following laparoscopic repair of incisional hernia with Gore-Tex Dualmesh.

  11. PTFE treatment by remote atmospheric Ar/O2 plasmas: a simple reaction scheme model proposal

    CERN Document Server

    Carbone, E A D; Keuning, W; van der Mullen, J J A M

    2013-01-01

    Polytetrafluoroethylene (PTFE) samples were treated by a remote atmospheric pressure microwave plasma torch and analyzed by water contact angle (WCA) and X-ray photoelectron spectroscopy (XPS). In the case of pure argon plasma a decrease of WCA is observed meanwhile an increase of hydrophobicity was observed when some oxygen was added to the discharge. The WCA results are correlated to XPS of reference samples and the change of WCA are attributed to changes in roughness of the samples. A simple kinetics scheme for the chemistry on the PTFE surface is proposed to explain the results.

  12. Drug-eluting bioabsorbable magnesium stent.

    Science.gov (United States)

    Di Mario, Carlo; Griffiths, Huw; Goktekin, Omer; Peeters, Nicolas; Verbist, Jan; Bosiers, Marc; Deloose, Koen; Heublein, Bernhard; Rohde, Roland; Kasese, Victor; Ilsley, Charles; Erbel, Raimund

    2004-12-01

    Current stent technology is based on the use of permanent implants that remain life long in the vessel wall, far beyond the time required for the prosthesis to accomplish its main goals of sealing dissection and preventing wall recoil. With the possibility to implant long vessel segments using antiproliferative drugs to prevent restenosis, the practice of transforming the coronary vessels into stiff tubes with a full metal jacket covering all side branches and being unable to adjust to the long-term wall changes, including wall remodeling with lumen ectasia becomes a serious concern. In this article, we describe the first biodegradable stent based on a magnesium alloy that allows controlled corrosion with release to the vessel wall and the blood stream of a natural body component such as magnesium with beneficial antithrombotic, antiarrhythmic, and antiproliferative properties. We also discuss the animal experiments and the initial clinical applications in 20 patients with implants below the knee, with final results soon to be released, and the plans for the first coronary study. The results of these last two studies will indicate whether the absence of a permanent implant and the antiproliferative properties shown in animals are sufficient to prevent the restenotic process in humans or whether the prosthesis must be modified by adding the biodegradable coating with conventional antiproliferative drugs.

  13. Very late coronary aneurysm formation with subsequent stent thrombosis secondary to drug-eluting stent

    Institute of Scientific and Technical Information of China (English)

    Ibrahim Akin,; Stephan Kische; Tim C Rehders; Henrik Schneider; G(o)kmen R Turan; Tilo Kleinfeldt; Jasmin Ortak; Christoph A. Nienaber; Hüseyin Ince

    2011-01-01

    Drug-eluting stents have changed the practice in interventional cardiology.With the widespread use of these stents important safety concerns regarding stent thrombosis and formation of coronary artery aneurysm have been expressed.While the majority of attention was focused on stent thrombosis,the formation of coronary aneurysm was only described in anecdotal reports.We report on a patient who suffered from very late stent thrombosis in association with coronary artery aneurysm formation secondary to drug-eluting stent but not to bare-metal stent.

  14. Tl response of KMgF{sub 3}: Lu + PTFE at ultraviolet radiation; Respuesta Tl de KMgF{sub 3}: Lu + PTFE a radiacion ultravioleta

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez, P.R. [Instituto Nacional de Investigaciones Nucleares, A.P. 18 -1027, 11801 Mexico D.F. (Mexico); Alarcon, N.G. [Facultad de Quimica, Universidad Autonoma del Estado de Mexico. Paseo Tollocan, Esq. con Jesus Carranza, 50180 Toluca, Estado de Mexico (Mexico); Furetta, C.; Azorin, J. [Universidad Autonoma Metropolitana- Iztapalapa, San Rafael Atlixco 186, 09340 Mexico. D.F. (Mexico)

    2003-07-01

    Ionizing radiation has different types of interaction with a crystalline solid. However, only few effects are interesting to optimize some thermoluminescent (Tl) properties of certain Tl materials. This paper presents results obtained by irradiating KMgF{sub 3}: Lu + Ptfe Tl dosimeters with ultraviolet (UV) radiation previously exposed to gamma radiation. These results showed that those dosimeters not exposed previously to gamma radiation did not presented any Tl signal. Meanwhile, those previously submitted to gamma irradiation showed that their sensitivity was increased as the gamma dose increased. The glow curve of sensitized KMgF{sub 3}: Lu + Ptfe exposed to UV radiation, presented the dosimetric pea at 212 C. This makes this material to be promissory for measuring UV radiation. (Author)

  15. Engineering Stent Based Delivery System for Esophageal Cancer Using Docetaxel.

    Science.gov (United States)

    Shaikh, Mohsin; Choudhury, Namita Roy; Knott, Robert; Garg, Sanjay

    2015-07-01

    Esophageal cancer patients are often diagnosed as "advanced" cases. These patients are subjected to palliative stenting using self-expanding metallic stents (SEMS) to maintain oral alimentation. Unfortunately, SEMS get reoccluded due to tumor growth, in and over the stent struts. To investigate potential solutions to this problem, docetaxel (DTX) delivery films were prepared using PurSil AL 20 (PUS), which can be used as a covering material for the SEMS. Drug-polymer miscibility and interactions were studied. Bilayer films were prepared by adhering the blank film to the DTX loaded film in order to maintain the unidirectional delivery to the esophagus. In vitro release and the local DTX delivery were studied using in vitro permeation experiments. It was found that DTX and PUS were physically and chemically compatible. The bilayer films exhibited sustained release (>30 days) and minimal DTX permeation through esophageal tissues in vitro. The rate-determining step for the DTX delivery was calculated. It was found that >0.9 fraction of rate control lies with the esophageal tissues, suggesting that DTX delivery can be sustained for longer periods compared to the in vitro release observed. Thus, the bilayer films can be developed as a localized sustained delivery system in combination with the stent.

  16. Mechanisms of Biliary Plastic Stent Occlusion and Efforts at Prevention

    Science.gov (United States)

    Kwon, Chang-Il; Lehman, Glen A.

    2016-01-01

    Biliary stenting via endoscopic retrograde cholangiopancreatography has greatly improved the quality of patient care over the last 30 years. Plastic stent occlusion limits the life span of such stents. Attempts to improve plastic stent patency duration have mostly failed. Metal stents (self-expandable metal stents [SEMSs]) have therefore replaced plastic stents, especially for malignant biliary strictures. SEMS are at least 10 times more expensive than plastic stents. In this focused review, we will discuss basic mechanisms of plastic stent occlusion, along with a systematic summary of previous efforts and related studies to improve stent patency and potential new techniques to overcome existing limitations. PMID:27000422

  17. [Utility of the WallFlexTM duodenal stent for unresectable advanced gastric cancer related to gastric outlet obstruction].

    Science.gov (United States)

    Aoki, Taro; Hyuga, Satoshi; Kato, Aya; Chono, Teruhiro; Watanabe, Risa; Komori, Takamichi; Matsumoto, Takashi; Takachi, Kou; Nishioka, Kiyonori; Uemura, Yoshio; Kobayashi, Kenji

    2012-11-01

    Duodenal stenting for malignant disease related to gastric outlet obstruction(GOO) has been covered by health insurance in Japan since April 2010. We inserted WallFlexTM duodenal stents(WDS) in 4 patients with GOO caused by unresectable gastric cancer. WDS insertion was successful in all 4 cases. Duodenal perforation occurred in 1 case. One case each of stent obstruction and stent migration occurred. All patients could eat a soft-food diet for 3-6 months (median, 5.3 months). Survival time ranged between 5 and 14 months (median, 6 months). Three patients underwent S-1 combination chemotherapy. Duodenal stenting is expected to be effective for advanced gastric cancer related to GOO.

  18. Preventive role of palladium-103 radioactive stent on in-stent restenosis in rabbit iliac arteries

    Institute of Scientific and Technical Information of China (English)

    LUO Quan-Yong; CHEN Li-Bo; YUAN Zhi-Bin; LU Han-Kui; ZHU Rui-Sen

    2005-01-01

    The abilility of γ-emitting palladium-103 stent implantation to inhibit in-stent restenosis in rabbit iliac arteries was investigated. Quantitative histomorphometry of the stented iliac segments 28 days after the implantation indicated that palladium-103 stents made a significant reduction in neointimal area and percent area stenosis compared with the nonradioactive stents. Lumen area in the palladium-103 stents treatment group was larger than the control group. However, the reduction of neointima formation by palladium-103 stents implantation was in a non-dose-dependent fashion. Low ionizing radiation doses via γ-emitting palladiurn-103 stent are effective in preventing neointimal hyperplasia in iliac arteries of rabbits. Palladium-103 stents can be employed as a possible novel means to prevent in-stent restenosis.

  19. The risk and prognostic impact of definite stent thrombosis or in-stent restenosis after coronary stent implantation

    DEFF Research Database (Denmark)

    Thayssen, Per; Jensen, Lisette Okkels; Lassen, Jens Flensted;

    2012-01-01

    of death (HR=2.71 [95% CI: 1.72-4.27]) compared to cases without stent thrombosis. In-stent restenosis had no substantial impact (HR=1.17 [95% CI: 0.79-1.75]). However, in-stent restenosis presenting as non-ST-segment elevation myocardial infarction (NSTEMI) was associated with a greater mortality risk...

  20. Interventional Exclusion of Iliac Artery Aneurysms Using the Flow-Diverting Multilayer Stent

    Energy Technology Data Exchange (ETDEWEB)

    Pieper, Claus Christian, E-mail: Claus.christian.pieper@ukb.uni-bonn.de; Meyer, Carsten, E-mail: Carsten.Meyer@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany); Rudolph, Jens, E-mail: jens.rudolph@ukb.uni-bonn.de; Verrel, Frauke, E-mail: frauke.verrel@ukb.uni-bonn.de [University of Bonn, Department of Surgery (Germany); Schild, Hans Heinz, E-mail: hans.schild@ukb.uni-bonn.de; Wilhelm, Kai E., E-mail: kai.wilhelm@ukb.uni-bonn.de [University of Bonn, Department of Radiology (Germany)

    2013-08-01

    PurposeThis study was designed to evaluate retrospectively the results of complex iliac artery aneurysm (IAA) exclusion using the Cardiatis-Multilayer-Stent.MethodsBetween October 2010 and August 2012, ten IAAs were treated in eight males (mean age 75 (59-91) years) using the Multilayer Stent. All IAA exceeded a diameter of 3 cm or were symptomatic. Follow-up (FU) examinations included CT or MR angiography, sonography, and clinical assessment up to 2 years.ResultsPrimary stent placement was technically successful in eight of ten cases. In two cases, severe stent retraction during deployment necessitated placement of an additional stent. Immediately after stent placement, a marked reduction of flow within the sac was observed in all cases (peri-interventional mortality 0 %). During FU, there were two thrombotic stent occlusions, making reintervention necessary (primary patency rate 80 %, secondary patency 100 %). Four IAA were completely occluded at FU, whereas the original vessel and covered branches (n = 8) were patent. In four IAA, there was still residual perfusion. In one patient, IAA diameter decreased slightly, while it remained constant in seven (mean imaging FU 195 (range 1-695) days). There were no adverse events on clinical FU (mean FU 467 (range 101-695) days).ConclusionsOther studies showed the Cardiatis-Multilayer-Stent to be a technically relatively simple treatment option for complex IAA with inadequate landing zones, especially in patients with multiple comorbidities to avoid ipsilateral IIA obstruction. However, in our series complication rate was high. Incomplete sac exclusion, stent-shortening, and thrombotic occlusion can complicate treatment, making meticulous patient selection necessary. Close imaging surveillance is mandatory especially in the early postinterventional period.

  1. Endovascular Management of Aorta-Iliac Stenosis and Occlusive Disease by Kissing-Stent Technique.

    Science.gov (United States)

    Liu, Meng; Zhang, Fuxian

    2016-01-01

    Kissing-stenting treatment has been used to treat patients with peripheral artery disease (PAD). However, the long term efficacy of the stenting therapy is not well defined in Chinese PAD patients. To investigate the question, sixty-three PAD patients (37 males and 26 females), aged 66 ± 7.3 years, were analysed in the study. They were featured as claudication (n = 45, 71.4%), rest pain (n = 18, 28.6%), or gangrene (n = 8, 12.7%). In total, 161 stents were applied in aorta-iliac lesions with 2.6 stents for each patient, including 55 self-expanding stents, 98 balloon expandable stents, and 8 covered stents. The success rate of implanting Kissing-stents was 100%. Catheter-directed thrombolysis (CDT) with urokinase was performed in 8 cases (12.7%). The severity of peripheral ischemia was significantly improved, as evidenced by 3.3-fold increase of ankle-brachial pressure index (ABI) after the surgery (P = 0.008). One, three, five, and seven years after surgery, the primary patency rate was 87.3%, 77.4%, 71.1%, and 65.0%, whereas the secondary patency rate was 95.2%, 92.5%, 89.5%, and 85.0%, respectively. No in-hospital mortality was recorded. In conclusion, Kissing-stenting technique for aorta-iliac lesions is safe and effective with lower complications. It is beneficial for aorta-iliac occlusions that are longer than 60 mm.

  2. Endovascular Management of Aorta-Iliac Stenosis and Occlusive Disease by Kissing-Stent Technique

    Directory of Open Access Journals (Sweden)

    Meng Liu

    2016-01-01

    Full Text Available Kissing-stenting treatment has been used to treat patients with peripheral artery disease (PAD. However, the long term efficacy of the stenting therapy is not well defined in Chinese PAD patients. To investigate the question, sixty-three PAD patients (37 males and 26 females, aged 66±7.3 years, were analysed in the study. They were featured as claudication (n=45, 71.4%, rest pain (n=18, 28.6%, or gangrene (n=8, 12.7%. In total, 161 stents were applied in aorta-iliac lesions with 2.6 stents for each patient, including 55 self-expanding stents, 98 balloon expandable stents, and 8 covered stents. The success rate of implanting Kissing-stents was 100%. Catheter-directed thrombolysis (CDT with urokinase was performed in 8 cases (12.7%. The severity of peripheral ischemia was significantly improved, as evidenced by 3.3-fold increase of ankle-brachial pressure index (ABI after the surgery (P=0.008. One, three, five, and seven years after surgery, the primary patency rate was 87.3%, 77.4%, 71.1%, and 65.0%, whereas the secondary patency rate was 95.2%, 92.5%, 89.5%, and 85.0%, respectively. No in-hospital mortality was recorded. In conclusion, Kissing-stenting technique for aorta-iliac lesions is safe and effective with lower complications. It is beneficial for aorta-iliac occlusions that are longer than 60 mm.

  3. Chemico-physical characterisation and in vivo biocompatibility assessment of DLC-coated coronary stents.

    Science.gov (United States)

    Castellino, Micaela; Stolojan, Vlad; Virga, Alessandro; Rovere, Massimo; Cabiale, Karine; Galloni, Marco R; Tagliaferro, Alberto

    2013-01-01

    The vast majority of stent thrombosis occurs in the acute and sub-acute phases and is more common in patients with acute coronary syndromes, due to the thrombotic milieu where stent struts are positioned. Stent thrombosis is likely due to incomplete tissue coverage of metallic stents as the contact between metallic stents and blood elements may lead to platelet adhesion and trigger vessel thrombosis. If a stent is covered after 7 days, the risk that it will be found uncovered at later stages is very low (<1%). In this article, we demonstrate that diamond-like carbon (DLC) coatings, deposited by physical vapour deposition, promote rapid endothelisation of coronary stent devices, with very low platelets activation, reducing thrombotic clots. We relate these behaviours to the surface and bulk material properties of the DLC films, subjected to a comprehensive chemico-physical characterisation using several techniques (X-ray photoelectron spectroscopy, atomic force microscopy, field-emission scanning electron microscope, transmission electron microscopy combined with electron energy loss spectroscopy, Raman and dispersive X-ray spectroscopy). In vivo studies, conducted on 24 pigs, have shown complete endothelisation after 7 days, with no fibrin mesh and with only rare monocytes scattered on the endothelial layer while 30 and 180 days tests have shown reduced inflammatory activation and a complete stabilisation of the vessel healing, with a minimal neointimal proliferation. The integral and permanent DLC film coating improves haemo- and bio-compatibility and leads to an excellent early vessel healing of the stent whilst the extremely thin strut thickness reduces the amount of late neointima and consequently the risk of late restenosis. These data should translate into a reduced acute and sub-acute stent thrombosis.

  4. Clinical outcomes of self-expandable metal stents in palliation of malignant anastomotic strictures caused by recurrent gastric cancer

    Institute of Scientific and Technical Information of China (English)

    Yu Kyung Cho; Sang Woo Kim; Kwan Woo Nam; Jae Hyuck Chang; Jae Myung Park; Jeong-Jo Jeong; In Seok Lee; Myung-Gyu Choi; In-Sik Chung

    2009-01-01

    AIM: To examine the technical feasibility and clinical outcomes of the endoscopic insertion of a selfexpandable metal stent (SEMS) for the palliation of a malignant anastomotic stricture caused by recurrent gastric cancer. METHODS: The medical records of patients, who had obstructive symptoms caused by a malignant anastomotic stricture after gastric surgery and underwent endoscopic insertion of a SEMS from January 2001 to December 2007 at Kangnam St Mary's Hospital, were reviewed retrospectively. RESULTS: Twenty patients (15 male, mean age 63 years) were included. The operations were a total gastrectomy with esophagojejunostomy ( n = 12), subtotal gastrectomy with Billroth-Ⅰ reconstruction ( n = 2) and subtotal gastrectomy with Billroth- Ⅱ reconstruction ( n = 8). The technical and clinical success rates were 100% and 70%, respectively. A small bowel or colon stricture was the reason for a lack of improvement in symptoms in 4 patients. Two of these patients showed improvement in symptoms after another stent was placed. Stent reobstruction caused by tumor ingrowth or overgrowth occurred in 3 patients (15%) within 1 mo after stenting. Stent migration occurred with a covered stent in 3 patients who underwent a subtotal gastrectomy with Billroth-Ⅱ reconstruction. Two cases of partial stent migration were easily treated with a second stent or stent repositioning. The median stent patency was 56 d (range, 5-439 d). The median survival was 83 d (range, 12-439 d). CONCLUSION: Endoscopic insertion of a SEMS provides safe and effective palliation of a recurrent anastomotic stricture caused by gastric cancer. A meticulous evaluation of the presence of other strictures before inserting the stent is essential for symptom improvement.

  5. Visualization of Stent Lumen in MR Imaging: Relationship with Stent Design and RF Direction

    Directory of Open Access Journals (Sweden)

    Ohno,Seiichiro

    2012-06-01

    Full Text Available Magnetic resonance imaging (MRI visualization of metallic stent lumens is possible if the stent structure counteracts eddy currents in the lumen induced by the radio frequency magnetic field, B1. To examine the effectiveness of various stent designs in counteracting eddy currents, we anchored eight copper stent models and 2 commercially available nickel-titanium alloy (Nitinol stents in a gel phantom, perpendicular or parallel to the direction of B1. A mesh stent lumen showed hypointensity irrespective of its alignment relative to B1. A solenoid stent lumen showed hypointensity with the stent axis parallel to B1, but it had the same signal intensity as outside the lumen when perpendicular to B1. A Moebius stent lumen showed no signal reduction, irrespective of alignment relative to B1. Lumens of the commercially available stents showed hypointensity regardless of alignment relative to B1. Computer simulation revealed that the signal intensities of the stents corresponded to magnetic flux densities of B1 in the stents, which are modified by the structure of the stent. While in vivo MRI viewing of a Moebius stent lumen is likely possible regardless of axis alignment, inherent structural weakness may be problematic. As a more practical choice, the solenoid stent is easier to manufacture and generates no hypointensive signal when the axis is parallel to B0.

  6. Refining stent technologies for femoral interventions.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Callaert, J; Maene, L; Keirse, K; Verbist, J; Peeters, P

    2012-08-01

    Stents were created as a mechanical scaffold to prevent vessel recoil and luminal renarrowing after percutaneous transluminal angioplasty (PTA). In femoropopliteal arteries, indication for stent implantation remains a topic much debated on, especially in long lesion configurations. Ever since the first stents were introduced on the market, in-stent restenosis (ISR) has been an important issue. The evolution in stent design has known a major progression in the last decades from the first generation of stents, plagued with high fracture rates and low primary patency rates, to the design of newer stents to tackle these outcomes. More flexible and longer stents decreased the high fracture rates and drug-eluting stents offered a solution to the restenosis rates by local drug application. The difficult recrossibility of the lesion because of the presence of a permanent vascular scaffold is an obstacle that the drug-coated balloon (DCB) overcomes. Future perspectives in the treatment of femoropopliteal lesions are found in the bioresorbable stent implantation. The bioresorbable stent combines the advantages of a drug-eluting scaffolding stent without the remainder of a foreign object in the long-term. Further investigations in this area will eventually evolve in the creation of a superior endovascular treatment modality with high long-term patency rates and minimal detriments.

  7. Migration of forgotten stent into renal pelvis.

    Science.gov (United States)

    Giridhar, Venkatesh; Natarajan, Kumaresan; Hegde, Padmaraj

    2011-04-01

    Stent migration is a well recognized complication of forgotten stents, but migration into the renal pelvis is rarely documented. We present a case of migration and coiling of a forgotten stent in the renal pelvis, and discuss briefly, the etiological factors for the phenomenon and associated problems in management.

  8. 21 CFR 884.3900 - Vaginal stent.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Vaginal stent. 884.3900 Section 884.3900 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES... stent. (a) Identification. A vaginal stent is a device used to enlarge the vagina by stretching, or...

  9. Incidence and predictors of coronary stent thrombosis

    DEFF Research Database (Denmark)

    D'Ascenzo, Fabrizio; Bollati, Mario; Clementi, Fabrizio

    2013-01-01

    Stent thrombosis remains among the most feared complications of percutaneous coronary intervention (PCI) with stenting. However, data on its incidence and predictors are sparse and conflicting. We thus aimed to perform a collaborative systematic review on incidence and predictors of stent...

  10. What to Expect After a Stent Procedure

    Science.gov (United States)

    ... time after the stent procedure. Your doctor will let you know when you can go back to your normal activities. Metal detectors used in airports and other screening areas don't affect stents. Your stent shouldn't cause metal ...

  11. Influence of Thickness on the Charge Storage Stability for Porous PTFE/PE/PP Film Electrets%厚度对多孔PTFE/PE/PP驻极体电荷储存稳定性的影响

    Institute of Scientific and Technical Information of China (English)

    江键; 宋茂海; 崔黎丽; 王小平

    2005-01-01

    研究由不同厚度多孔聚四氟乙烯(PTFE)组成的多孔PTFE/聚乙烯(PE)/聚丙烯(PP)驻极体的电荷储存稳定性.通过热融法和电晕充电技术将多孔PTFE,PE,PP复合膜制备成驻极体,并采用等温表面电位衰减测量、电荷TSD和扫描电子显微镜研究多孔PTFE/PE/PP驻极体的电荷储存稳定性.结果表明:较厚的多孔PTFE组成的多孔PTFE/PE/PP驻极体在低温区呈现出较好的电荷储存能力;多孔PTFE的孔洞越多,由其组成的多孔PTFE/PE/PP驻极体在高温区的电荷储存能力越强;在高湿环境下,多孔PTFE/PE/PP驻极体比多孔PTFE驻极体显示出更好的电荷储存稳定性.

  12. Spray-coating process in preparing PTFE-PPS composite super-hydrophobic coating

    Directory of Open Access Journals (Sweden)

    Rui Weng

    2014-03-01

    Full Text Available In order to improve the performance of a liquid-floated rotor micro-gyroscope, the resistance of the moving interface between the rotor and the floating liquid must be reduced. Hydrophobic treatment can reduce the frictional resistance between such interfaces, therefore we proposed a method to prepare a poly-tetrafluoroethylene (PTFE-poly-phenylene sulphide (PPS composite super-hydrophobic coating, based on a spraying process. This method can quickly prepare a continuous, uniform PTFE-PPS composite super-hydrophobic surface on a 2J85 material. This method can be divided into three steps, namely: pre-treatment; chemical etching; and spraying. The total time for this is around three hours. When the PTFE concentration is 4%, the average contact angle of the hydrophobic coating surface is 158°. If silicon dioxide nanoparticles are added, this can further improve the adhesion and mechanical strength of the super-hydrophobic composite coating. The maximum average contact angle can reach as high as 164° when the mass fraction of PTFE, PPS and silicon dioxide is 1:1:1.

  13. VUV light reflectivity measurements from PTFE in Liquid Xenon for the LZ Dark Matter experiment

    Science.gov (United States)

    Pushkin, Kirill; LZ Collaboration

    2016-03-01

    The LUX-Zeplin (LZ) collaboration is the next generation of the experiment to search for Dark Matter in the Universe with a dual-phase detector based on liquid xenon (LXe) with a target mass of 7 ton. LXe dual phase detectors are very sensitive probes to search for WIMP dark matter interactions. The LZ collaboration is conducting R&D to study VUV light reflectivity from PTFE (Teflon) in LXe. Teflon is used in dual phase detectors both as an electrical insulator and as reflector of VUV scintillation light (~175 nm) to improve photon detection with photomultiplier tubes (PMTs). However, experimental data for the reflectance of VUV light from PTFE in LXe is not sufficiently conclusive. We present a new technique of measuring the light reflectivity from PTFE by varying the fractional area of the PMT in the detector. PTFE reflectivity measurements were performed as a function of Teflon wall thickness in the range of 2 mm to 9.5 mm. The method, apparatus and experimental results will be presented.

  14. Does patency after a vein collar and PTFE-bypass depend on sex and age?

    DEFF Research Database (Denmark)

    Lundgren, F; Schroeder, Torben Veith

    2012-01-01

    Randomized studies evaluating the effect of a vein collar at the distal anastomosis of PTFE-grafts show conflicting results. The study of the Joint Vascular Research Group (JVRG) of UK found improved primary patency while the Scandinavian Miller Collar Study (SCAMICOS) found neither any effect...

  15. Experimental Study on Reaction Characteristics of PTFE/Ti/W Energetic Materials under Explosive Loading

    Directory of Open Access Journals (Sweden)

    Yan Li

    2016-11-01

    Full Text Available Metal/fluoropolymer composites represent a new category of energetic structural materials that release energy through exothermic chemical reactions initiated under shock loading conditions. This paper describes an experiment designed to study the reaction characteristics of energetic materials with low porosity under explosive loading. Three PTFE (polytetrafluoroethylene/Ti/W mixtures with different W contents are processed through pressing and sintering. An inert PTFE/W mixture without reactive Ti particles is also prepared to serve as a reference. Shock-induced chemical reactions are recorded by high-speed video through a narrow observation window. Related shock parameters are calculated based on experimental data, and differences in energy release are discussed. The results show that the reaction propagation of PTFE/Ti/W energetic materials with low porosity under explosive loading is not self-sustained. As propagation distance increases, the energy release gradually decreases. In addition, reaction failure distance in PTFE/Ti/W composites is inversely proportional to the W content. Porosity increased the failure distance due to higher shock temperature.

  16. Nafion/PTFE composite membranes for direct methanol fuel cell applications

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Hsiu-Li; Yu, T. Leon; Chen, Li-Chung [Department of Chemical Engineering and Materials Science, Yuan Ze University, Nei-Li, Taoyuan 32026 (Taiwan); Huang, Li-Ning; Shen, Kun-Sheng; Jung, Guo-Bin [Fuel Cell Center, Yuan Ze University, Nei-Li, Taoyuan 32026 (Taiwan)

    2005-10-04

    Using dynamic light scattering and scanning electron microscope (SEM), it is shown that a high-carbon-number alcohol/water, i.e., 2-propanol/water, mixed solvent is more effective than low-carbon-number alcohol/water, i.e., ethanol/water and methanol/water, mixed solvents in dispersing Nafion molecules. Thus, it is a better solvent for the preparation of Nafion/PTFE (poly(tetrafluoroethylene)) composite membranes. The performance of direct methanol fuel cells (DMFCs) with a Nafion/PTFE composite membrane, which was prepared in-house, a commercial Nafion-117 membrane, or a commercial Nafion-112 membrane were investigated by feeding various concentrations, i.e., 2-5M, of methanol to the anode. The Nafion/PTFE composite membrane gave a better DMFC performance than that obtained with Nafion-117 or Nafion-112 membranes. Using a DMFC model and varying the methanol concentration at the anode, cell voltage data were analyzed with respect to methanol concentration and cell current. The results indicate that inserting porous PTFE into Nafion polymer causes a reduction not only in methanol diffusion cross-over but also in the electro-osmosis of methanol cross-over in the membrane. (author)

  17. Polymer (PTFE) and shape memory alloy (NiTi) intercalated nano-biocomposites

    Science.gov (United States)

    Anjum, S. S.; Rao, J.; Nicholls, J. R.

    2012-09-01

    Engineering on a nano-scale has been undertaken to mimic a biomaterial by forming an intercalated nano-composite structure by PVD sputtering of a polymer with a nickel-titanium (NiTi) shape memory alloy (SMA). A PTFE polymer has been selected due to its elastic properties, low interactions with water, optimum surface energies, stability and chemical resistance. NiTi SMAs allow the coatings to be energy absorbent and thus suitable in load bearing situations. The coatings are aimed to constantly withstand variable adverse biological environments whilst maintaining their characteristics. The nano-intercalated structures have been characterised for their wettability, friction coefficients, chemical composition, and morphology. Intercalation of a polymer with energy-absorbing alloys uncovers a set of material systems that will offer characteristics such as self-healing of hierarchal tissue in the body. The reformation of PTFE following sputter deposition was confirmed by FTIR spectra. According to SEM analysis PTFE shows a promising surface interaction with NiTi, forming stable coatings. Surface interactions are evident by the hydrophobic behaviour of films as the composite's water contact angle is around 86° which lies in-between that of PTFE and NiTi. The nano composite films are lubricious and have a measured CoF below 0.2 which does not vary with layer thickness.

  18. Experimental Study on Reaction Characteristics of PTFE/Ti/W Energetic Materials under Explosive Loading.

    Science.gov (United States)

    Li, Yan; Jiang, Chunlan; Wang, Zaicheng; Luo, Puguang

    2016-11-18

    Metal/fluoropolymer composites represent a new category of energetic structural materials that release energy through exothermic chemical reactions initiated under shock loading conditions. This paper describes an experiment designed to study the reaction characteristics of energetic materials with low porosity under explosive loading. Three PTFE (polytetrafluoroethylene)/Ti/W mixtures with different W contents are processed through pressing and sintering. An inert PTFE/W mixture without reactive Ti particles is also prepared to serve as a reference. Shock-induced chemical reactions are recorded by high-speed video through a narrow observation window. Related shock parameters are calculated based on experimental data, and differences in energy release are discussed. The results show that the reaction propagation of PTFE/Ti/W energetic materials with low porosity under explosive loading is not self-sustained. As propagation distance increases, the energy release gradually decreases. In addition, reaction failure distance in PTFE/Ti/W composites is inversely proportional to the W content. Porosity increased the failure distance due to higher shock temperature.

  19. PTFE effect on the electrocatalysis of the oxygen reduction reaction in membraneless microbial fuel cells.

    Science.gov (United States)

    Guerrini, Edoardo; Grattieri, Matteo; Faggianelli, Alessio; Cristiani, Pierangela; Trasatti, Stefano

    2015-12-01

    Influence of PTFE in the external Gas Diffusion Layer (GDL) of open-air cathodes applied to membraneless microbial fuel cells (MFCs) is investigated in this work. Electrochemical measurements on cathodes with different PTFE contents (200%, 100%, 80% and 60%) were carried out to characterize cathodic oxygen reduction reaction, to study the reaction kinetics. It is demonstrated that ORR is not under diffusion-limiting conditions in the tested systems. Based on cyclic voltammetry, an increase of the cathodic electrochemical active area took place with the decrease of PTFE content. This was not directly related to MFC productivity, but to the cathode wettability and the biocathode development. Low electrodic interface resistances (from 1 to 1.5 Ω at the start, to near 0.1 Ω at day 61) indicated a negligible ohmic drop. A decrease of the Tafel slopes from 120 to 80 mV during productive periods of MFCs followed the biological activity in the whole MFC system. A high PTFE content in the cathode showed a detrimental effect on the MFC productivity, acting as an inhibitor of ORR electrocatalysis in the triple contact zone.

  20. Clinical outcomes of self-expandable stent placementfor benign esophageal diseases: A pooled analysis of theliterature

    Institute of Scientific and Technical Information of China (English)

    Emo E van Halsema; Jeanin E van Hooft

    2015-01-01

    AIM: To analyze the outcomes of self-expandable stentplacement for benign esophageal strictures and benignesophageal leaks in the literature.METHODS: The PubMed, Embase and Cochranedatabases were searched for relevant articles publishedbetween January 2000 and July 2014. Eight prospectivestudies were identified that analyzed the outcomesof stent placement for refractory benign esophagealstrictures. The outcomes of stent placement forbenign esophageal leaks, perforations and fistulaewere extracted from 20 retrospective studies thatwere published after the inclusion period of a recentsystematic review. Data were pooled and analyzedusing descriptive statistics.RESULTS: Fully covered self-expandable metal stents(FC SEMS) (n = 85), biodegradable (BD) stents (n =77) and self-expandable plastic stents (SEPS) (n = 70)were inserted in 232 patients with refractory benignesophageal strictures. The overall clinical success ratewas 24.2% and according to stent type 14.1% forFC SEMS, 32.9% for BD stents and 27.1% for SEPS.Stent migration occurred in 24.6% of cases. Theoverall complication rate was 31.0%, including major(17.7%) and minor (13.4%) complications. A total of643 patients were treated with self-expandable stentsmainly for postsurgical leaks (64.5%), iatrogenicperforations (19.6%), Boerhaave's syndrome (7.8%)and fistulae (3.7%). FC SEMS and partially coveredSEMS were used in the majority of patients. Successfulclosure of the defect was achieved in 76.8% ofpatients and according to etiology in 81.4% forpostsurgical leaks, 86.0% for perforations and 64.7%for fistulae. The pooled stent migration rate was16.5%. Stent-related complications occurred in 13.4%of patients, including major (7.8%) and minor (5.5%)complications.CONCLUSION: The outcomes of stent placementfor refractory benign esophageal strictures were poor.However, randomized trials are needed to put thisinto perspective. The evidence on successful

  1. Comparison between esophageal Wallstent and Ultraflex stents in the treatment of malignant stenoses of the esophagus and cardia.

    Science.gov (United States)

    Dorta, G; Binek, J; Blum, A L; Bühler, H; Felley, C P; Koelz, H R; Lammer, F; Lang, C; Meier, R; Meyenberger, C; Meyer-Wyss, B; Michetti, P; Protiva, P; Scheurer, U; Weber, B; Wiesel, P; Vogel, S

    1997-03-01

    Several published studies have examined various self-expanding metal esophageal stents for use in the palliative treatment of esophageal or cardiac neoplasia, but few have compared different self-expanding metal stents. The aim of this study was to evaluate non-covered Wallstent and Ultraflex prostheses in the treatment of malignancies in the esophagus and the cardiac region. In a retrospective study, the effectiveness of non-covered Wallstents (46 patients) and Ultraflex stents (36 patients) was compared in the treatment of malignancies in the esophageal and cardiac regions. Reintervention procedures were necessary in 16 of the 46 Wallstent patients (six patients during an early phase) and in 22 of the 36 Ultraflex patients (13 during an early phase) (overall P = 0.022; early P = 0.018). The major complication in the Wallstent group was tumor ingrowth (12 of 35 complications), while in the Ultraflex group, it was incomplete deployment (18 of 49 complications). Incomplete stent deployment occurred more often in patients treated with Ultraflex (P = 0.01), and food impaction was more often observed in the Wallstent group (P = 0.001). In addition, in patients with Ultraflex stents, more complex reinterventions were necessary than those required with Wallstents (four vs. 13 complex reinterventions, P = 0.0046). Wallstents tended to improve dysphagia better than Ultraflex stents. Compared to Ultraflex stents, Wallstents have several significant short-term and long-term advantages in the palliative treatment of malignancy of the esophagus and cardia.

  2. Acid Aging Effects on Surfaces of PTFE Gaskets Investigated by Fourier Transform Infrared Spectroscopy

    Directory of Open Access Journals (Sweden)

    L. Giorgini

    2016-09-01

    Full Text Available This paper investigates the effect of a prolonged acid and thermal attack, on the surface of PTFE by Fourier Transform Infrared Micro-Spectroscopy (FT-IR. The materials are commercialized by two alternative producers in form of Teflon tapes. These tapes are installed in process plants where tires moulds are cleaned inside a multistage ultrasonic process. In these cases, Teflon tapes, having a role of gaskets, show inexplicably phenomena of degradation in relatively short operation periods. Even considering that these gaskets are exposed to the combined effect of ultrasonic waves, temperature, humidity and acid attack, the PTFE properties of resistance nominally exclude the possibility of these severe erosion phenomena. An interesting explanation can be related to the potential presence in the cleaning solution, mainly based on sulfamic acid, of highly reactive chemical compounds, as chlorides and fluorides, originated by the disaggregation of elements from the tire composition and/or additives used as processing aids and/or by catalytic effect generated by fluorine produced by PTFE degradation. In general, up to 300 different chemical elements, both organic and inorganic, natural and synthetic, are merged in a tire. Since this composition is practically unknown, especially regarding additives and “unusual elements”, representing a secrecy of each tire manufactures, it is really complex to define the chemical composition of the cleaning solution with an appropriate precision. As a consequence, the gaskets have been treated with different mixtures of acids in the way to combine a larger range of possibilities. Thus, the FT-IR experimental characterization of PTFE surface properties followed an appropriate accelerated aging, aiming at actuating the specific mechanics of wearing as in industrial use. The different acid treatments adopted for accelerating the aging of gaskets have highlighted the different behaviour of the PTFE matrix, but

  3. Effect of oil and oil with graphite on tribological properties of glass filled PTFE polymer composites

    Indian Academy of Sciences (India)

    Y R Kharde; K V Saisrinadh

    2011-07-01

    Present work deals with the experimental investigation of tribological properties of GF-filled polymer composites considering three velocities, i.e. 0.5, 1 and 2.0 m/s and loads ranging from 15.7 N to 45.13 N keeping rest of the parameters constant. The test has been carried out for three materials, PTFE + 15% GF, PTFE + 25% GF and PTFE + 35% GF in wet (oil) and adding additive as graphite (5% wt) in oil. SAE 20W40 oil is used for the test. Friction and wear tests of PTFE composite against a counter surface of EN8 with surface finish of 0.56 m are carried out at ambient conditions using pin-on-disc tribometre (TR-20), Ducom make, Bangalore. The results are tabulated and graphs are plotted. It has been found that load and wet conditions have significant effect on coefficient of friction and specific wear rate of the materials. Where as sliding velocity also plays little role in wear mechanism of the material. It is concluded from the experimental study that the specific wear rate in wet condition as well as by adding additives in lubricating oil with 5% (by wt.) has been declined. Also the specific wear rate decreases with normal load and sliding velocity. Wear of PTFE + GF composite decreases with increase in glass percentage. Microscopic analysis of pin and disc surface is made with optical microscope. The mathematical models has been developed by using regression analysis and found to be valid for the above tested parameters.

  4. Structure-property effects on mechanical, friction and wear properties of electron modified PTFE filled EPDM composite

    Directory of Open Access Journals (Sweden)

    2009-01-01

    Full Text Available Tribological properties of Ethylene-Propylene-Diene-rubber (EPDM containing electron modified Polytetrafluoroethylene (PTFE have been investiagted with the help of pin on disk tribometer without lubrication for a testing time of 2 hrs in atmospheric conditions at a sliding speed and applied normal load of 0.05 m•s–1 and FN = 1 N, respectively. Radiation-induced chemical changes in electron modified PTFE powders were analyzed using Electron Spin Resonance (ESR and Fourier Transform Infrared (FTIR specroscopy to characterize the effects of compatibility and chemical coupling of modified PTFE powders with EPDM on mechanical, friction and wear properties. The composites showed different friction and wear behaviour due to unique morphology, dispersion behaviour and radiation functionalization of PTFE powders. In general, EPDM reinforced with electron modified PTFE powder demonstrated improvement both in mechanical and tribological properties. However, the enhanced compatibility of PTFE powder resulting from the specific chemical coupling of PTFE powder with EPDM has been found crucial for mechanical, friction and wear properties.

  5. Synthesis of per-fluorinated polymer-alloy based on PTFE by high temperature EB-irradiation

    Science.gov (United States)

    Oshima, Akihiro; Mutou, Fumihiro; Hyuga, Toshiyuki; Asano, Saneto; Ichizuri, Shogo; Li, Jingye; Miura, Takaharu; Washio, Masakazu

    2005-07-01

    In this study, synthesis of per-fluorinated polymer-alloy based on polytetrafluoroethylene (PTFE) has been demonstrated by high temperature irradiation techniques. The per-fluorinated polymer-blend thin films originated from polymer dispersion (PTFE, PTFE/PFA polymer-blend: FA and PTFE/FEP polymer-blend: FE) have been fabricated by the wire-bar coating equipment. The obtained films (thickness: 5-15 μm) were irradiated by EB at 335 °C ± 5 °C in nitrogen gas atmosphere. Characterization of irradiated polymer-blends has been performed by 19F solid-state NMR spectroscopy, thermal analysis and so on. By DSC analysis, the heat of crystallization (ΔHc) of both irradiated polymer-blends were decreased with increase in absorbed dose. Moreover, the melting and crystallization temperatures of both materials shift to lower temperatures, compared with crosslinked PTFE. The obtained materials showed the lower crystallinity. By 19F solid-state NMR spectroscopy, the new signals appeared at around -160 ppm and at -188 ppm. The signals are assigned to the fluorine signals of CF groups, which represent crosslinking sites with Y-type (>CF-) and Y‧-type (>Cdbnd CF-) in the polymer-blend chains. Thus, it is confirmed that the polymer-alloys with good performance based on PTFE are synthesized through the radiation crosslinking reaction between PTFE and PFA or FEP molecules.

  6. "Virtual" in-vivo bench test for bifurcation stenting with "StentBoost".

    Science.gov (United States)

    Agostoni, Pierfrancesco; Verheye, Stefan; Vermeersch, Paul; Cornelis, Kristoff; Van Langenhove, Glenn

    2009-04-01

    "StentBoost" is a new angiographic technique that allows improved angiographic visualization of stents deployed in coronary arteries, by enhancing the X-ray focus of the region where the stent is placed. Using this technique we were able to assess the deformation and the expansion of a stent deployed to treat a bifurcation lesion between the mid-left anterior descending (LAD) artery and a big second diagonal branch, during sequential inflations of: (1) the stent per se in the LAD, (2) the ostium of the diagonal branch through the stent struts, (3) the stent again with a non compliant balloon, and (4) both branches with the kissing balloon technique. "StentBoost" guided our clinical and angiographic decision-making process and allowed us to create a "virtual" bench test of the stent deployed at the level of the bifurcation treated.

  7. Comparison of Pulp Regeneration with Absorbable Gelatin Sponge Stent Combined MTA and Calcium Hydroxide Cover%可吸收明胶海绵支架联合三氧化矿物凝聚体与氢氧化钙覆盖诱导体内牙髓再生的疗效比较

    Institute of Scientific and Technical Information of China (English)

    张宇; 魏灼丽; 赵彪; 任延秀

    2016-01-01

    目的:比较可吸收明胶海绵支架联合三氧化矿物凝聚体( MTA)与氢氧化钙覆盖诱导体内牙髓再生的疗效。方法选取重庆三峡中心医院收治的122例(130颗患牙)不可复性牙髓炎患者,采用随机数字表法将其分为观察组61例(66颗患牙)和对照组61例(64颗患牙)。其中观察组采用可吸收明胶海绵支架联合MTA封闭治疗,对照组采用氢氧化钙覆盖治疗,经3个月随访,观察比较两组患者的治疗效果、牙龈活力变化情况。结果术后1周,观察组总的初步成功率为50.0%(33/66),明显高于对照组[12.5%(8/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎成功率均高于对照组,差异有统计学意义( P<0.01)。术后1个月,观察组总的阶段成功率为62.1%(41/66),明显高于对照组[18.8%(12/64)],差异有统计学意义(P<0.01);其中观察组急性牙髓炎、慢性闭锁性牙髓炎、慢性增生性牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。术后3个月,观察组总的最终成功率为66.7%(44/66),明显高于对照组[21.9%(14/64)],差异有统计学意义(P<0.01);且观察组各型牙髓炎成功率均高于对照组,差异有统计学意义(P<0.05)。结论可吸收明胶海绵支架联合MTA可有效诱导体内牙髓再生,对各型不可复性牙髓炎均有较好的效果,值得推广应用于临床。%Objective To compare the efficacy of pulp regeneration induced by absorbable gelatin sponge stent combined mineral trioxide aggregate(MTA) and calcium hydroxide cover.Methods Total of 122 patients (130 sick teeth) with irreducible pulpitis in Chongqing Three Gorges Central Hospital were chosen,and were randomly divided into observation group 61 cases (66 sick teeth) and control group 61 cases(64 skck

  8. Inductive antenna stent: design, fabrication and characterization

    Science.gov (United States)

    Rashidi Mohammadi, Abdolreza; Ali, Mohamed Sultan Mohamed; Lappin, Derry; Schlosser, Colin; Takahata, Kenichi

    2013-02-01

    This paper describes the design, fabrication, and electromechanical characteristics of inductive stents developed for intelligent stent applications. The stents, fabricated out of 316L stainless-steel tubes using laser machining, are patterned to have zigzag loops without bridge struts, and when expanded, become a helix-like structure. Highly conductive metals such as copper and gold are coated on the stents to improve their inductive/antenna function. The Q-factor of the stent is shown to increase by a factor of 7 at 150 MHz with copper coating. The expansion of the stent from 2 to 4 mm diameter results in a 3.2× increase in the inductance, obtaining ˜1 µH at a similar frequency. The stent passivated by Parylene-C film is used to characterize its resonance in different media including saline. The copper-coated inductive stent exhibits a 2.4× radial stiffness for 1 mm strain as well as a 16× bending compliance compared with a commercial stent, each of which is potentially beneficial in preventing/mitigating stent failures such as recoil as well as enabling easier navigation through intricate blood vessels. The mechanical stiffness may be tailored by adjusting stent-wire thickness while maintaining necessary coating thickness to achieve particular mechanical requirements and high inductive performance simultaneously.

  9. Local Delivery of Antiproliferative Agents via Stents

    Directory of Open Access Journals (Sweden)

    Hyuck Joon Kwon

    2014-03-01

    Full Text Available A stent is a medical device for serving as an internal scaffold to maintain or increase the lumen of a body conduit. Stent placement has become a primary treatment option in coronary artery disease for more than the last two decades. The stenting is also currently used for relieving the symptoms of narrowed lumen of nonvascular organs, such as esophagus, trachea and bronchi, small and large intestines, biliary, and urinary tract. Local delivery of active pharmaceutical agents via the stents can not only enhance healing of certain diseases, but it can also help decrease the potential risk of the stenting procedure to the surrounding tissue. In this review, we focus on reviewing a variety of drug-impregnated stents and local drug delivery systems using the stents.

  10. [Absorbable coronary stents. New promising technology].

    Science.gov (United States)

    Erbel, Raimund; Böse, Dirk; Haude, Michael; Kordish, Igor; Churzidze, Sofia; Malyar, Nasser; Konorza, Thomas; Sack, Stefan

    2007-06-01

    Coronary stent implantation started in Germany 20 years ago. In the beginning, the progress was very slow and accelerated 10 years later. Meanwhile, coronary stent implantation is a standard procedure in interventional cardiology. From the beginning of permanent stent implantation, research started to provide temporary stenting of coronary arteries, first with catheter-based systems, later with stent-alone technology. Stents were produced from polymers or metal. The first polymer stent implantation failed except the Igaki-Tamai stent in Japan. Newly developed absorbable polymer stents seem to be very promising, as intravascular ultrasound (IVUS) and optical coherence tomography have demonstrated. Temporary metal stents were developed based on iron and magnesium. Currently, the iron stent is tested in peripheral arteries. The absorbable magnesium stent (Biotronik, Berlin, Germany) was tested in peripheral arteries below the knee and meanwhile in the multicenter international PROGRESS-AMS (Clinical Performance and Angiographic Results of Coronary Stenting with Absorbable Metal Stents) study. The first magnesium stent implantation was performed on July 30, 2004 after extended experimental testing in Essen. The magnesium stent behaved like a bare-metal stent with low recoil of 5-7%. The stent struts were absorbed when tested with IVUS. Stent struts were not visible by fluoroscopy or computed tomography (CT) as well as magnetic resonance imaging (MRI). That means, that the magnesium stent is invisible and therefore CT and MRI can be used for imaging of interventions. Only using micro-CT the stent struts were visible. The absorption process could be demonstrated in a patient 18 days after implantation due to suspected acute coronary syndrome, which was excluded. IVUS showed a nice open lumen. Stent struts were no longer visible, but replaced by tissue indicating the previous stent location. Coronary angiography after 4 months showed an ischemia-driven target lesion

  11. Prevention of stent thrombosis: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Reejhsinghani R

    2015-01-01

    Full Text Available Risheen Reejhsinghani, Amir S LotfiDivision of Cardiology, Baystate Medical Center, Springfield, MA, USAAbstract: Stent thrombosis is an uncommon but serious complication which carries with it significant mortality and morbidity. This review analyzes the entity of stent thrombosis from a historical and clinical perspective, and chronicles the evolution of this condition through the various generations of stent development, from bare metal to first-generation, second-generation, and third-generation drug-eluting stents. It also delineates the specific risk factors associated with stent thrombosis and comprehensively examines the literature related to each of these risks. Finally, it highlights the preventative strategies that can be garnered from the existing data, and concludes that a multifactorial approach is necessary to combat the occurrence of stent thrombosis, with higher risk groups, such as patients with ST segment elevation myocardial infarction, meriting further research.Keywords: stent thrombosis, preventative strategies, post-procedural myocardial infarction

  12. PTFE surface etching in the post-discharge of a RF scanning plasma torch: evidence of ejected fluorinated species

    CERN Document Server

    Dufour, Thierry; Viville, Pascal; Duluard, Corinne Y; Desbief, Simon; Lazzaroni, Roberto; Reniers, François

    2016-01-01

    The texturization of poly(tetrafluoroethylene) (PTFE) surfaces is achieved at atmospheric pressure by using the post-discharge of a radio-frequency plasma torch supplied in helium and oxygen gases. The surface properties are characterized by contact angle measurement, X-ray photoelectron spectroscopy and atomic force microscopy. We show that the plasma treatment increases the surface hydrophobicity (with water contact angles increasing from 115 to 155{\\deg}) only by modifying the PTFE surface morphology and not the stoichiometry. Measurements of sample mass losses correlated to the ejection of CF$_2$ fragments from the PTFE surface evidenced an etching mechanism at atmospheric pressure.

  13. Stenting for restenotic lesions with the BARD XT stent.

    Science.gov (United States)

    Rahel, Braim M; Suttorp, Maarten J; Te Riele, Hans A; Bal, Egbert T; Ernst, Sjef M; Mast, E Gijs; Ten Berg, Jurriën M; Kelder, Johannes C; Plokker, H W Thijs

    2003-06-01

    Conventional PTCA for the treatment of restenotic lesions is associated with a high rate of recurrence (30-50%). Primary stenting decreases the restenosis rate at long-term follow-up. One-hundred consecutive patients with restenosis received a Bard XT stent. Follow-up angiography was performed after 6 months. Angiograms were compared by means of computed quantitative analysis. The mean pretreatment reference diameter was 2.88 +/- 0.51 mm. The mean minimal luminal diameter (MLD) increased from 1.09 +/- 0.57 mm to 2.70 +/- 0.44 mm. The percent diameter stenosis decreased from 66 +/- 13% to 15 +/- 10%. The procedural success rate was 99%. At 6 month follow-up repeat angiography was performed in 86 patients. The mean MLD was 1.74 +/- 0.67 mm with a mean diameter stenosis of 41 +/- 20%. Residual anginal complaints were reported in 29% of patients. In-stent restenosis (defined as diameter stenosis of more than 50%) occurred in 18% of the patients. Placement of the Bard XT stent in restenotic lesions is feasible, has an excellent short term outcome and yields a favorable result at 6 month follow-up angiography.

  14. Forgotten ureteral stents: who's at risk?

    Science.gov (United States)

    Divakaruni, Naveen; Palmer, Cristina J; Tek, Peter; Bjurlin, Marc A; Gage, Mistry K; Robinson, Jed; Lombardo, Lindsay; Wille, Mark A; Hollowell, Courtney M P

    2013-08-01

    The sequelae from forgotten stents carry significant morbidity and costs. In this study, we attempt to identify potential risk factors that may make patients less likely to follow up for stent removal so that more effective prevention efforts may be directed at these persons. A single-institution retrospective analysis of 187 consecutive patients who had stents placed between January 2010 and December 2010 was performed. Chart review was conducted to see if patients had undergone stent removal beyond the intended maximal stent life (MSL). Patients who were lost to follow-up were contacted to determine if stents were overdue. Logistic regression was performed to determine risk factors. Of the 187 patients who had stents placed, 147 had the stent removed before MSL and 28 had stents removed after the MSL. Twelve patients could not be contacted and were excluded from the analysis. Within our cohort of 175 patients, 48% were males, 73% were minorities (33% Latino, 30% Black, 8% Asian, and 2% Native American), 39% did not speak English, 79% were unemployed, 73% were uninsured, and 35% were married. Among the patients with forgotten stents, 68% were male, 64% were minorities (32% Latino, 29% Black, 4% Native American, and 0% Asian), 82% were unemployed, 39% did not speak English, 93% were uninsured, and 43% were married. Multivariate regression analysis demonstrated that uninsured patients (odds ratio [OR], 6.3; 95% confidence interval [CI], 1.4-28.2; P value 0.01) and males (OR, 2.8; CI, 1.2-6.8; P=0.02) had statistically significant associations with forgotten stents. Men were 2.8 times more likely to have forgotten stents than females. Patients without health insurance were six times more likely to have forgotten stents than patients with insurance. As efforts are made to prevent forgotten stents, increased attention should be given to these higher-risk patient populations.

  15. Endourological Management of Forgotten Encrusted Ureteral Stents

    Directory of Open Access Journals (Sweden)

    Kusuma V. R. Murthy

    2010-08-01

    Full Text Available PURPOSE: To present our experience and discuss the various endourological approaches for treating forgotten encrusted ureteral stents associated with stone formation. MATERIALS AND METHODS: From July 2006 to December 2008, 14 patients (11 men and 3 women with encrusted ureteral stents were analyzed. The average indwelling time of the stent was 4.9 years (range 1 to 12. Plain-film radiography was used to evaluate encrustation, stone burden, and fragmentation of the stents. Intravenous urogram and a Tc99m diethylene triamine penta acetic-acid renogram was used to assess renal function. RESULTS: In seven patients, the entire stent was encrusted, in three patients the encrustation was confined to the ureteral and lower coil part of the stent, two patients had encrustation of the lower coil, and minimal encrustation was observed in two patients. Percutaneous nephrolithotomy was performed in 5 cases and retrograde ureteroscopy with intra-corporeal lithotripsy in 9 patients. Cystolithotripsy was used to manage the distal coil of the encrusted stent in eight patients. Simple cystoscopic removal of the stents with minimal encrustation was carried-out in two cases. Looposcopy and removal of the stent was performed in one patient with an ileal conduit and retained stent. Only one patient required open surgical removal of the stent. Thirteen out of 14 patients were rendered stone and stent free in one session. All except two stents were removed intact and stone analysis of encrustation and calcification revealed calcium oxalate and calcium phosphate in the majority of the cases. CONCLUSION: Endourological management of forgotten encrusted stents is highly successful and often avoids the need for open surgical techniques.

  16. Emergency stenting to control massive bleeding of injured iliac artery following lumbar disk surgery

    Energy Technology Data Exchange (ETDEWEB)

    Bierdrager, Edwin; Rooij, Willem Jan van; Sluzewski, Menno [Department of Radiology, St. Elisabeth Ziekenhuis, Tilburg (Netherlands)

    2004-05-01

    The purpose of this study was to demonstrate the use of endovascular stenting to repair an iliac artery injury following lumbar discectomy, thus obviating the need for major surgery. A 57-year-old woman developed a distended abdomen and signs of hypovolemic shock immediately following discectomy at the L4-L5 level. Ultrasound showed a large amount of abdominal fluid. Angiography revealed a laceration of the right iliac artery bifurcation with extravasation of contrast material. After occlusion of the internal iliac artery with fibered coils to prevent retrograde flow to the iliac bifurcation, a self-expanding covered stent was inserted to seal the iliac laceration. The leakage of blood stopped immediately. The clinical condition of the patient gradually improved and she was discharged home 5 weeks later. Sealing of arterial laceration as a complication of lumbar disc surgery with a covered stent is a simple and effective alternative to major pelvic surgery. (orig.)

  17. Drug eluting biliary stents to decrease stent failure rates: Areview of the literature

    Institute of Scientific and Technical Information of China (English)

    2016-01-01

    Biliary stenting is clinically effective in relieving bothmalignant and non-malignant obstructions. However, thereare high failure rates associated with tumor ingrowth andepithelial overgrowth as well as internally from biofilmdevelopment and subsequent clogging. Within the lastdecade, the use of prophylactic drug eluting stents as ameans to reduce stent failure has been investigated. Inthis review we provide an overview of the current researchon drug eluting biliary stents. While there is limited humantrial data regarding the clinical benefit of drug elutingbiliary stents in preventing stent obstruction, recentresearch suggests promise regarding their safety andpotential efficacy.

  18. Efficacy of Self-Expandable Metallic Stent Inserted for Refractory Hemorrhage of Duodenal Cancer

    Directory of Open Access Journals (Sweden)

    Takashi Orii

    2016-05-01

    Full Text Available Because of advances in the technology of gastrointestinal endoscopy and improvements in the quality of stents, it has become routine to place a stent as palliative therapy for malignant gastrointestinal obstruction. On the other hand, stent placement for malignant gastrointestinal hemorrhage has scarcely been reported, although it may be performed for hemorrhage of the esophageal varicose vein. We recently experienced a patient with refractory hemorrhage from an unresectable duodenal cancer who underwent placement of a self-expandable metallic stent (SEMS and thereafter had no recurrence of the hemorrhage. A 46-year-old man underwent laparotomy to radically resect a cancer in the third portion of the duodenum, which invaded widely to the superior mesenteric vein and its branches and was considered unresectable. After stomach-partitioning gastrojejunostomy was performed, chemotherapy was initiated according to the regimen of chemotherapy of far advanced gastric cancer. One year and 4 months after induction of chemotherapy, gastrointestinal hemorrhage occurred. Upper gastrointestinal endoscopy revealed the hemorrhage oozing from the duodenal cancer, and endoscopic hemostasis, such as injection of hypertonic saline epinephrine and argon plasma coagulation, was unsuccessful. Twenty days after emergence of the hemorrhage, an endoscopic covered SEMS was placed with confirmation by fluoroscopy. Immediately after placement of the stent, the tarry stool stopped and the anemia ceased to progress. The recurrence of the hemorrhage has not been confirmed without migration of the stent. SEMS is an effective hemostatic procedure for malignant refractory hemorrhage.

  19. Clinicians' contributions to the development of coronary artery stents: a qualitative study of transformative device innovation.

    Directory of Open Access Journals (Sweden)

    Aaron S Kesselheim

    Full Text Available BACKGROUND: Medical device innovation remains poorly understood, and policymakers disagree over how to incentivize early development. We sought to elucidate the components of transformative health care innovation by conducting an in-depth case study of development of a key medical device: coronary artery stents. METHODS AND FINDINGS: We conducted semi-structured interviews with the innovators whose work contributed to the development of coronary artery stents who we identified based on a review of the regulatory, patent, and medical literature. Semi-structured interviews with each participant covered the interviewee's personal involvement in coronary artery stent development, the roles of institutions and other individuals in the development process, the interplay of funding and intellectual property in the interviewee's contribution, and finally reflections on lessons arising from the experience. Transcripts were analyzed using standard coding techniques and the constant comparative method of qualitative data analysis. CONCLUSIONS: We found that the first coronary artery stents emerged from three teams: Julio Palmaz and Richard Schatz, Cesare Gianturco and Gary Roubin, and Ulrich Sigwart. First, these individual physician-inventors saw the need for coronary artery stents in their clinical practice. In response, they developed prototypes with the support of academic medical centers leading to early validation studies. Larger companies entered afterwards with engineering support. Patents became paramount once the technology diffused. The case of coronary stents suggests that innovation policy should focus on supporting early physician-inventors at academic centers.

  20. Atomic layer deposition enhanced grafting of phosphorylcholine on stainless steel for intravascular stents.

    Science.gov (United States)

    Zhong, Qi; Yan, Jin; Qian, Xu; Zhang, Tao; Zhang, Zhuo; Li, Aidong

    2014-09-01

    In-stent restenosis (ISR) and re-endothelialization delay are two major issues of intravascular stent in terms of clinical safety and effects. Construction of mimetic cell membrane surface on stents using phosphorylcholine have been regarded as one of the most powerful strategies to resolve these two issues and improve the performance of stents. In this study, atomic layer deposition (ALD) technology, which is widely used in semiconductor industry, was utilized to fabricate ultra-thin layer (10nm) of alumina (Al2O3) on 316L stainless steel (SS), then the alumina covered surface was modified with 3-aminopropyltriethoxysilane (APS) and 2-methacryloyloxyethyl phosphorylcholine (MPC) sequentially in order to produce phosphorylcholine mimetic cell membrane surface. The pristine and modified surfaces were characterized using X-ray photoelectron spectroscopy, atomic force microscope and water contact angle measurement. Furthermore, the abilities of protein adsorption, platelet adhesion and cell proliferation on the surfaces were investigated. It was found that alumina layer can significantly enhance the surface grafting of APS and MPC on SS; and in turn efficiently inhibit protein adsorption and platelet adhesion, and promote the attachment and proliferation of human umbilical vein endothelial cells (HUVEC) on the surfaces. In association with the fact that the deposition of alumina layer is also beneficial to the improvement of adhesion and integrity of drug-carrying polymer coating on drug eluting stents, we expect that ALD technology can largely assist in the modifications on inert metallic surfaces and benefit implantable medical devices, especially intravascular stents.

  1. Clinical experience in coronary stenting with the Vivant Z Stent.

    Science.gov (United States)

    Chee, K H; Siaw, F S; Chan, C G; Chong, W P; Imran, Z A; Haizal, H K; Azman, W; Tan, K H

    2005-06-01

    This single centre study was designed to demonstrate feasibility, safety and efficacy of the Vivant Z stent (PFM AG, Cologne, Germany). Patients with de novo lesion were recruited. Coronary angioplasty was performed with either direct stenting or after balloon predilatation. Repeated angiogram was performed 6 months later or earlier if clinically indicated. Between January to June 2003, a total of 50 patients were recruited (mean age 55.8 +/- 9 years). A total of 52 lesions were stented successfully. Mean reference diameter was 2.77 mm (+/-0.59 SD, range 2.05-4.39 mm) with mean target lesion stenosis of 65.5% (+/-11.6 SD, range 50.1-93.3%). Forty-six lesions (88.5%) were American College of Cardiologist/American Heart Association class B/C types. Direct stenting was performed in 18 (34.6%) lesions. Mean stent diameter was 3.18 mm (+/-0.41 SD, range 2.5-4 mm), and mean stent length was 14.86 mm (+/-2.72 SD, range 9-18 mm). The procedure was complicated in only one case which involved the loss of side branch with no clinical sequelae. All treated lesions achieved Thrombolysis In Myocardial Infarction 3 flow. Mean residual diameter stenosis was 12.2% (+/-7.55 SD, range 0-22.6%) with acute gain of 1.72 mm (+/-0.50 SD, range 0.5-2.8). At 6 months, there was no major adverse cardiovascular event. Repeated angiography after 6 months showed a restenosis rate of 17% (defined as >50% diameter restenosis). Mean late loss was 0.96 mm (+/-0.48 SD) with loss index of 0.61 (+/-0.38 SD). The restenosis rate of those lesions less than 3.0 mm in diameter was 22.2% compared with 6.25% in those lesions more than 3.0 mm in diameter. The Vivant Z stent was shown to be safe and efficacious with low restenosis rate in de novo coronary artery lesion.

  2. A method to determine the kink resistance of stents and stent delivery systems according to international standards

    OpenAIRE

    Brandt-Wunderlich Christoph; Schwerdt Christopher; Behrens Peter; Grabow Niels; Schmitz Klaus-Peter; Schmidt Wolfram

    2016-01-01

    The kink behavior of vascular stents is of particular interest for clinicians, stent manufacturers and regulatory as a kinked stent generates a lumen loss in the stented vessel and can lead to in-stent restenosis. In this study methods to determine the kink resistance of stents and stent delivery systems according to the ISO 25539-2 and FDA guidance no. 1545 were presented. The methods are applicable for balloon expandable stents as well as for self-expanding stents and determine the lumen lo...

  3. A method to determine the kink resistance of stents and stent delivery systems according to international standards

    Directory of Open Access Journals (Sweden)

    Brandt-Wunderlich Christoph

    2016-09-01

    Full Text Available The kink behavior of vascular stents is of particular interest for clinicians, stent manufacturers and regulatory as a kinked stent generates a lumen loss in the stented vessel and can lead to in-stent restenosis. In this study methods to determine the kink resistance of stents and stent delivery systems according to the ISO 25539-2 and FDA guidance no. 1545 were presented. The methods are applicable for balloon expandable stents as well as for self-expanding stents and determine the lumen loss and residual diameter change dependent on the specific bending radius.

  4. EFFECTS OF TRITIUM EXPOSURE ON UHMW-PE, PTFE, AND VESPEL

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E; Kirk Shanahan, K

    2006-05-31

    Samples of three polymers, Ultra-High Molecular Weight Polyethylene (UHMW-PE), polytetrafluoroethylene (PTFE, also known as Teflon{reg_sign}), and Vespel{reg_sign} polyimide were exposed to 1 atmosphere of tritium gas at ambient temperature for varying times up to 2.3 years in closed containers. Sample mass and size measurements (to calculate density), spectra-colorimetry, dynamic mechanical analysis (DMA), and Fourier-transform infrared spectroscopy (FT-IR) were employed to characterize the effects of tritium exposure on these samples. Changes of the tritium exposure gas itself were characterized at the end of exposure by measuring total pressure and by mass spectroscopic analysis of the gas composition. None of the polymers exhibited significant changes of density. The color of initially white UHMW-PE and PTFE dramatically darkened to the eye and the color also significantly changed as measured by colorimetry. The bulk of UHMW-PE darkened just like the external surfaces, however the fracture surface of PTFE appeared white compared to the PTFE external surfaces. The white interior could have been formed while the sample was breaking or could reflect the extra tritium dose at the surface directly from the gas. The dynamic mechanical response of UHMW-PE was typical of radiation effects on polymers- an initial stiffening (increased storage modulus) and reduction of viscous behavior after three months exposure, followed by lowering of the storage modulus after one year exposure and longer. The storage modulus of PTFE increased through about nine months tritium exposure, then the samples became too weak to handle or test using DMA. Characterization of Vespel{reg_sign} using DMA was problematic--sample-to-sample variations were significant and no systematic change with tritium exposure could be discerned. Isotopic exchange and incorporation of tritium into UHMW-PE (exchanging for protium) and into PTFE (exchanging for fluorine) was observed by FT-IR using an attenuated

  5. EFFECTS OF TRITIUM EXPOSURE ON UHMW-PE, PTFE, AND VESPEL

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E; Kirk Shanahan, K

    2006-05-31

    Samples of three polymers, Ultra-High Molecular Weight Polyethylene (UHMW-PE), polytetrafluoroethylene (PTFE, also known as Teflon{reg_sign}), and Vespel{reg_sign} polyimide were exposed to 1 atmosphere of tritium gas at ambient temperature for varying times up to 2.3 years in closed containers. Sample mass and size measurements (to calculate density), spectra-colorimetry, dynamic mechanical analysis (DMA), and Fourier-transform infrared spectroscopy (FT-IR) were employed to characterize the effects of tritium exposure on these samples. Changes of the tritium exposure gas itself were characterized at the end of exposure by measuring total pressure and by mass spectroscopic analysis of the gas composition. None of the polymers exhibited significant changes of density. The color of initially white UHMW-PE and PTFE dramatically darkened to the eye and the color also significantly changed as measured by colorimetry. The bulk of UHMW-PE darkened just like the external surfaces, however the fracture surface of PTFE appeared white compared to the PTFE external surfaces. The white interior could have been formed while the sample was breaking or could reflect the extra tritium dose at the surface directly from the gas. The dynamic mechanical response of UHMW-PE was typical of radiation effects on polymers- an initial stiffening (increased storage modulus) and reduction of viscous behavior after three months exposure, followed by lowering of the storage modulus after one year exposure and longer. The storage modulus of PTFE increased through about nine months tritium exposure, then the samples became too weak to handle or test using DMA. Characterization of Vespel{reg_sign} using DMA was problematic--sample-to-sample variations were significant and no systematic change with tritium exposure could be discerned. Isotopic exchange and incorporation of tritium into UHMW-PE (exchanging for protium) and into PTFE (exchanging for fluorine) was observed by FT-IR using an attenuated

  6. Stent malapposition, as a potential mechanism of very late stent thrombosis after bare-metal stent implantation: A case report

    Energy Technology Data Exchange (ETDEWEB)

    Higuma, Takumi, E-mail: higuma@cc.hirosaki-u.ac.jp; Abe, Naoki; Hanada, Kenji; Yokoyama, Hiroaki; Tomita, Hirofumi; Okumura, Ken

    2014-04-15

    A 90-year-old man was admitted to our hospital with acute ST-segment elevation myocardial infarction. He had a history of post-infarction angina pectoris 79 months ago and had a bare-metal stent (BMS) implanted in the proximal left anterior descending artery at our hospital. Emergent coronary angiography demonstrated thrombotic occlusion in the previously stented segment. After catheter thrombectomy, antegrade flow was restored, but 90% stenosis with haziness persisted in the proximal and distal portions of the previously stented segment. Intravascular ultrasound imaging showed interstrut cavities or stent malapposition at the proximal and distal sites of stented segment. In close proximity to the sites, residual thrombi were also observed. Optical coherence tomography (OCT) demonstrated neither lipid-laden neointimal tissue nor rupture but clearly demonstrated residual thrombus adjacent to the malapposed region in addition to the stent malapposition. PCI with balloon was successfully performed and stent apposition was confirmed by OCT. Stent malapposition is an unusual mechanism of very late stent thrombosis after BMS implantation. OCT can clearly reveal the etiology of stent thrombosis.

  7. An in Vitro Twist Fatigue Test of Fabric Stent-Grafts Supported by Z-Stents vs. Ringed Stents

    Directory of Open Access Journals (Sweden)

    Jing Lin

    2016-02-01

    Full Text Available Whereas buckling can cause type III endoleaks, long-term twisting of a stent-graft was investigated here as a mechanism leading to type V endoleak or endotension. Two experimental device designs supported with Z-stents having strut angles of 35° or 45° were compared to a ringed control under accelerated twisting. Damage to each device was assessed and compared after different durations of twisting, with focus on damage that may allow leakage. Stent-grafts with 35° Z-stents had the most severe distortion and damage to the graft fabric. The 45° Z-stents caused less fabric damage. However, consistent stretching was still seen around the holes for sutures, which attach the stents to the graft fabric. Larger holes may become channels for fluid percolation through the wall. The ringed stent-graft had the least damage observed. Stent apexes with sharp angles appear to be responsible for major damage to the fabrics. Device manufacturers should consider stent apex angle when designing stent-grafts, and ensure their devices are resistant to twisting.

  8. Benthic Cover

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Benthic cover (habitat) maps are derived from aerial imagery, underwater photos, acoustic surveys, and data gathered from sediment samples. Shallow to moderate-depth...

  9. Self-expanding metal stents in malignant esophageal obstruction: a comparison between two stent types.

    Science.gov (United States)

    Schmassmann, A; Meyenberger, C; Knuchel, J; Binek, J; Lammer, F; Kleiner, B; Hürlimann, S; Inauen, W; Hammer, B; Scheurer, U; Halter, F

    1997-03-01

    Self-expanding metal stents are a promising alternative in the palliation of malignant esophageal obstruction, but the relative value of different stent types is not well established. During a 3-year enrollment period in four different centers, 82 consecutive patients with malignant dysphagia without tumor recurrence after surgery or esophagorespiratory fistulas received either an uncovered Wallstent (44 patients) or a knitted nitinol stent (38 patients). Age (median: 79 yr), sex (F:M = 33:67), dysphagia score (median: 3), Karnofsky score (median: 53), body mass index (median: 19), type of pretreatment, tumor stage, stricture length (median: 5.4 cm), and stricture location were comparable in both stent groups. After stent placement, median dysphagia score improved markedly in both groups by two points. Procedure-related mortality (16 vs 0%; p < 0.01), early complication rate (32 vs 8%; p < 0.01), and severe persistent pain after stent placement (23 vs 0%; p < 0.002) were higher in the Wallstent compared with the knitted nitinol stent group. In contrast, stent dysfunction (7 vs 32%; p < 0.005), reintervention rate (9 vs 34%; p < 0.005), and costs were lower in the Wallstent compared with the nitinol stent group. In malignant esophageal obstruction, both stents markedly improved dysphagia. Uncovered Wallstents seem to cause more early severe complications than knitted nitinol stents. In contrast, stent dysfunction, reintervention rate, and costs appear to be higher in the nitinol stent group.

  10. A new SWL titanium stent (Zebra Stent): resistance to shockwave exposure.

    Science.gov (United States)

    Buchholz, Noor N P; Cannaby, Clive; Fong, Ruby; Gray, Andrew; Andrews, Henry O; Birch, Malcolm J

    2005-06-01

    Recently, a new-concept lumen-less Teflon-coated double-J wire stent (Zebra stent) has been introduced to facilitate residual stone clearance, in particular after SWL. Its metal core expresses highly mismatched acoustic impedance. It was the aim of this study to exclude damage to the stent through shockwaves. Also, its Teflon coating should to some degree prevent encrustation, and stents removed from stone formers were examined for encrustation. Series of 2000 shockwaves of an average and a maximum energy were applied to defined areas of Zebra stents in a waterbath on a Siemens Multiline Lithotriptor. Stents were then examined for core and sheath damage by digital photography, scanning electron microscopy, and microradiography. In addition, two Zebra stents and one conventional double-J stent from two stone formers were assessed in the same way for damage and encrustation. There was no damage whatsoever to either of the stents. Whereas there was considerable encrustation on the conventional double-J stent, there was none on the Zebra stents after 4 and 5 weeks in situ. Zebra stents resist shockwaves to a maximum number and energy sufficiently to be applied safely under SWL. Whether they resist encrustation to a higher degree in the short term than conventional stents remains to be established.

  11. MR Angiography of Peripheral Arterial Stents: In Vitro Evaluation of 22 Different Stent Types

    Directory of Open Access Journals (Sweden)

    Matthias C. Burg

    2011-01-01

    Full Text Available Purpose. To evaluate stent lumen visibility of a large sample of different peripheral arterial (iliac, renal, carotid stents using magnetic resonance angiography in vitro. Materials and Methods. 21 different stents and one stentgraft (10 nitinol, 7 316L, 2 tantalum, 1 cobalt superalloy, 1 PET + cobalt superalloy, and 1 platinum alloy were examined in a vessel phantom (vessel diameters ranging from 5 to 13 mm filled with a solution of Gd-DTPA. Stents were imaged at 1.5 Tesla using a T1-weighted 3D spoiled gradient-echo sequence. Image analysis was performed measuring three categories: Signal intensity in the stent lumen, lumen visibility of the stented lumen, and homogeneity of the stented lumen. The results were classified using a 3-point scale (good, intermediate, and poor results. Results. 7 stents showed good MR lumen visibility (4x nitinol, 2x tantalum, and 1x cobalt superalloy. 9 stents showed intermediate results (5x nitinol, 2x 316L, 1x PET + cobalt superalloy, and 1x platinum alloy and 6 stents showed poor results (1x nitinol, and 5x 316L. Conclusion. Stent lumen visibility varies depending on the stent material and type. Some products show good lumen visibility which may allow the detection of stenoses inside the lumen, while other products cause artifacts which prevent reliable evaluation of the stent lumen with this technique.

  12. Thermoluminescent response of CaSO{sub 4}: Dy + PTFE to beta particles; Respuesta termoluminiscente de CaSO{sub 4}: Dy + PTFE a particulas beta

    Energy Technology Data Exchange (ETDEWEB)

    Aguirre C, A.; Azorin N, J. [Colegio de Bachilleres No. 13, Xochimilco-Tepepan, 16000 Mexico D.F. (Mexico)

    2000-07-01

    In this work the results of studying the thermoluminescent properties of CaSO{sub 4}: Dy + PTFE are presented when it is irradiated with beta particles. The conclusion was the obtention of the Tl response curve in function of dose is that to desexcite the dosemeters at temperature 300 C during 30 minutes and after that were irradiated at different times in groups and to do the reading of dosemeter, it can be observed that a greater irradiation time major is the Tl response and this depends of the material has been used. (Author)

  13. Temporary metallic stent placement in the treatment of refractory benign esophageal strictures: results and factors associated with outcome in 55 patients

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin Hyoung; Kim, Kyung Rae; Shin, Ji Hoon; Lim, Jin-Oh [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Song, Ho-Young [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea)]|[University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology, Seoul (Korea); Choi, Eugene K. [Weill Medical College of Cornell University, New York, NY (United States)

    2009-02-15

    The purpose of this study was to evaluate the effectiveness of temporary metallic stenting in 55 patients with treatment-resistant benign esophageal strictures and to identify factors associated with clinical outcomes. Under fluoroscopic guidance, covered retrievable stents were placed in 55 patients with benign esophageal strictures and were removed with retrieval hook 1 week to 6 months after placement. Stent placement was successful in all patients, and the mean dysphagia score was reduced from 2.8 to 1.3 (p<0.001). The most common complications were tissue hyperproliferation (31%), severe pain (24%), and stent migration (25%). During follow-up (mean: 38 months), recurrence of the stricture necessitating balloon dilation was seen in 38 (69%) of 55 patients. Maintained patency rates after temporary stenting at 1, 3, and 6 months and 1, 2, and 4 years were 58%, 43%, 38%, 33%, 26%, and 21%, respectively. In multivariate analysis, length (p=0.003) of the stricture was the only significant factor associated with maintained patency after temporary stenting. In conclusion, temporary metallic stenting for refractory benign esophageal strictures may be effective during the period of stent placement, but is disadvantaged by the high recurrence rates after stent removal, particularly in patients with a long length of stricture (>7cm). (orig.)

  14. Esophageal Stent for Refractory Variceal Bleeding: A Systemic Review and Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Xiao-Dong Shao

    2016-01-01

    Full Text Available Background. Preliminary studies suggest that covered self-expandable metal stents may be helpful in controlling esophageal variceal bleeding. Aims. To evaluate the effectiveness and safety of esophageal stent in refractory variceal bleeding in a systematic review and meta-analysis. Methods. A comprehensive literature search was conducted on PubMed, EMBASE, and Cochrane Library covering the period from January 1970 to December 2015. Data were selected and abstracted from eligible studies and were pooled using a random-effects model. Heterogeneity was assessed using I2 test. Results. Five studies involving 80 patients were included in the analysis. The age of patients ranged from 18 to 91 years. The mean duration of follow-up was 46.8 d (range, 30–60 d. The success rate of stent deployment was 96.7% (95% CI: 91.6%–99.5% and complete response to esophageal stenting was in 93.9% (95% CI: 82.2%–99.6%. The incidence of rebleeding was 13.2% (95% CI: 1.8%–32.8% and the overall mortality was 34.5% (95% CI: 24.8%–44.8%. Most of patients (87.4% died from hepatic or multiple organ failure, and only 12.6% of patients died from uncontrolled bleeding. There was no stent-related complication reported and the incidence of stent migration was 21.6% (95% CI: 4.7%–46.1%. Conclusion. Esophageal stent may be considered in patients with variceal bleeding refractory to conventional therapy.

  15. Oral mycophenolate mofetil prevents in-stent intimal hyperplasia without edge effect.

    Science.gov (United States)

    Ilkay, Erdogan; Tirikli, Latif; Ozercan, Ibrahim; Yavuzkir, Mustafa; Karaca, Ilgin; Rahman, Ali; Arslan, Nadi

    2006-01-01

    Neointimal hyperplasia is in the forefront in in-stent restenosis. Prevention of in-stent restenosis is possible by reducing and inhibiting the hyperplasia of smooth muscle cells. The authors planned this study to test the hypothesis that when administered orally, mycophenolate mofetil (MMF) could inhibit in-stent neointimal hyperplasia. The study included 14 New Zealand rabbits. The rabbits were allocated to 2 different groups: Group 1 included 7 rabbits that were given MMF, 40 mg/kg/day by oral route. Group 2 included 7 rabbits that were not given MMF after the stenting. Sampling materials were taken before and after stenting by incising the artery so as to cover a 5-mm area. The samples taken from the edge of the stent in Group 1 showed focal neointimal cell proliferation, but it was less than that from the control group. Neointimal thickness was 0.048 +/-0.009 mm and neointimal area was 0.0925 +/-0.019 mm(2). Apparent neointimal cell proliferation and thickening of the intimal layer were observed in Group 2. Neointimal thickness at the stent edge was 0.147 +/-0.051 mm and the neointimal area was 0.154 +/-0.023 mm(2). The differences between groups in terms of neointimal thickness and neointimal area were statistically significant (p=0.001 for thickness and p=0.001 for area). In-stent artery samples of Group 1 showed that some subjects had no neointimal cell proliferation, while others had very limited focal intimal thickening. Neointimal thickening was 0.071 +/-0.003 mm and neointimal area was 0.073 +/-0.003 mm(2). In Group 2 apparent, and mostly focal, neointimal cell proliferation and formation of intimal layer were observed in the stent. Neointimal thickening was 0.154 +/-0.069 mm and neointimal area was 0.279 +/-0.059 mm(2). The comparison between groups showed significant differences (p=0.011 for thickness and p=0.001 for area). It was established in the third month that endothelialization was completed in both groups. Oral MMF decreased in-stent intimal

  16. Ternary Pd2/PtFe networks supported by 3D graphene for efficient and durable electrooxidation of formic acid.

    Science.gov (United States)

    Hu, Chuangang; Zhao, Yang; Cheng, Huhu; Hu, Yue; Shi, Gaoquan; Dai, Liming; Qu, Liangti

    2012-12-18

    A newly-designed network of ternary Pd(2)/PtFe nanowires on a three-dimensional graphene framework has been fabricated via a dual solvothermal approach, which presents superior electrocatalytic activity towards the oxidation of formic acid.

  17. Orientation and structure of thin films of α, ω- dihexyl sexithiophene deposited onto PTFE oriented by friction

    Science.gov (United States)

    Lang, P.; Nogues, C.; Verneyre, S.; Demanze, F.; Srivastava, P.; Garnier, F.; Wittmann, J. C.; Lotz, B.; Straupé, C.

    1998-06-01

    We analyze the influence of hexyl chains in terminal positions of a sexithiophene (DHS) on the orientation and structure of the evaporated film onto a thin layer of PTFE oriented by friction. When the substrate is cooled, the alkyl chains disorganize the film whereas at room temperature, the chains improve the orientation and epitaxial organization of molecular film towards the PTFE. Nous analysons l'influence de chaînes hexyles en positions terminales d'un sexithiophène (DHS) sur l'orientation et la structure du film déposé par évaporation sur une couche mince de PTFE orienté par friction. Alors qu'à basse température du substrat, les chaînes alkyles désorganisent le film, à température ambiante au contraire, elles améliorent l'orientation et l'organisation epitaxiale du film par rapport au PTFE

  18. Flow disturbances in stent-related coronary evaginations

    DEFF Research Database (Denmark)

    Radu, Maria D; Pfenniger, Aloïs; Räber, Lorenz

    2014-01-01

    Aims: Angiographic ectasias and aneurysms in stented segments have been associated with late stent thrombosis. Using optical coherence tomography (OCT), some stented segments show coronary evaginations reminiscent of ectasias. The purpose of this study was to explore, using computational fluid...

  19. Acute stent thrombosis after bifurcation stenting with the crush technique visualized with 64-slice computed tomography

    DEFF Research Database (Denmark)

    Kristensen, T.S.; Engstrom, T.; Kofoed, Klaus Fuglsang

    2008-01-01

    Acute stent thrombosis remains a potential complication after stent implantation. With the introduction of electrocardiographic gated multidetector row computed tomography (MDCT), a new nonnvasive imaging modality has become available that may contribute to the detection of complications after...

  20. Evaluation of a novel stent technology: the Genous EPC capturing stent

    NARCIS (Netherlands)

    M. Klomp

    2012-01-01

    Tegenwoordig gebruiken ziekenhuizen een nieuwe stent bij dotterbehandelingen van kransslagadervernauwingen. Deze Genous-stent heeft een laag met antistoffen waardoor het behandelde bloedvat snel bedekt raakt met lichaamseigen cellen. Zo wordt tegengegaan dat er opnieuw een vernauwing optreedt of dat

  1. Emergency endovascular repair of iliac artery rupture caused by post-stenting angioplasty with an endograft

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yu-bin; WU Dan-ming; XU Ke; WANG Cheng-gang; YI Wei; JIA Qi; SUN Yu-xin

    2007-01-01

    @@ Iliac artery rupture is a rare complication of poststenting angioplasty and can lead to massive lifethreatening haemorrhage. Conventional surgery can not repair the damaged vessel easily and may cause substantial blood loss and high operative morbidity and mortality. We report our experience with a selfexpanding covered endoprosthesis for endovascular repair of the rupture of an iliac artery caused by stenting angioplasty.

  2. Self-assembled monolayers on gold for the fabrication of radioactive stents

    NARCIS (Netherlands)

    Bommel, van Kjeld J.C.; Friggeri, Arianna; Mateman, Dorine; Geurts, Frank A.J.; Leerdam, Kees G.C.; Verboom, Willem; Veggel, van Frank C.J.M.; Reinhoudt, David N.

    2001-01-01

    An innovative and easily applicable method for the fabrication of radioactive stents, to be used for the treatment of restenosis, is presented. By incorporating the b-emitting radioisotopes 186Re, 188Re, 90Y, or 32P into sulfur-containing adsorbates, it becomes possible to cover a gold surface with

  3. Emergency coronary artery stenting for coronary dissection complicating diagnostic cardiac catheterisation.

    OpenAIRE

    Knight, C; Stables, R; Sigwart, U

    1995-01-01

    Dissection of a coronary artery is a recognised and significant complication of diagnostic coronary angiography that often requires emergency coronary artery bypass grafting. A coronary stent was used to treat this complication. This technique has potential advantages in terms of speed of reperfusion and availability in centres performing diagnostic angiography without surgical cover on site.

  4. The effect of RGD fluorosurfactant polymer modification of ePTFE on endothelial cell adhesion, growth, and function

    OpenAIRE

    Larsen, Coby C.; Kligman, Faina; KOTTKE-MARCHANT, KANDICE; Marchant, Roger E.

    2006-01-01

    We have synthesized and characterized a novel peptide fluorosurfactant polymer (PFSP) modification that facilitates the adhesion and growth of endothelial cells on ePTFE vascular graft material. This PFSP consists of a poly(vinyl amine) (PVAm) backbone with integrin binding Arg-Gly-Asp (RGD) peptides and perfluorocarbon pendant branches for adsorption and stable adhesion to underlying ePTFE. Aqueous PFSP solution was used to modify the surface of fluorocarbon substrates. Following subconfluen...

  5. Influence of strut cross-section of stents on local hemodynamics in stented arteries

    Science.gov (United States)

    Jiang, Yongfei; Zhang, Jun; Zhao, Wanhua

    2016-05-01

    Stenting is a very effective treatment for stenotic vascular diseases, but vascular geometries altered by stent implantation may lead to flow disturbances which play an important role in the initiation and progression of restenosis, especially in the near wall in stented arterial regions. So stent designs have become one of the indispensable factors needed to be considered for reducing the flow disturbances. In this paper, the structural designs of strut cross-section are considered as an aspect of stent designs to be studied in details. Six virtual stents with different strut cross-section are designed for deployments in the same ideal arterial model. Computational fluid dynamics (CFD) methods are performed to study how the shape and the aspect ratio (AR) of strut cross-section modified the local hemodynamics in the stented segments. The results indicate that stents with different strut cross-sections have different influence on the hemodynamics. Stents with streamlined cross-sectional struts for circular arc or elliptical arc can significantly enhance wall shear stress (WSS) in the stented segments, and reduce the flow disturbances around stent struts. The performances of stents with streamlined cross-sectional struts are better than that of stents with non-streamlined cross-sectional struts for rectangle. The results also show that stents with a larger AR cross-section are more conductive to improve the blood flow. The present study provides an understanding of the flow physics in the vicinity of stent struts and indicates that the shape and AR of strut cross-section ought to be considered as important factors to minimize flow disturbance in stent designs.

  6. Carotid artery stent continued expansion days after deployment, without post stent deployment angioplasty

    Directory of Open Access Journals (Sweden)

    Umair Qazi

    2015-10-01

    Full Text Available This is a carotid artery stent (CAS case report, which avoids post-stent deployment angioplasty (Post-SDA, with duplex confirmed continued stent expansion at 1, 3 and 30-day post deployment. This report confirms that self-expanding nitinol stents in the carotid artery may not require Post-SDA. We believe CAS can be performed without Post-SDA, which helps reduce the occurrence of intraoperative hemodynamic depression.

  7. Safety, efficacy and costs associated with direct coronary stenting compared with stenting after predilatation

    Science.gov (United States)

    IJsselmuiden, A.; Serruys, P.W.; Tangelder, G.J.; Slagboom, T.; van der Wieken, R.; Kiemeneij, F.; Laarman, G.J.

    2004-01-01

    Objectives Comparison of the in-hospital success rates, procedural costs and short-term clinical outcomes of direct stenting versus stenting after balloon predilatation. Methods Altogether, 400 patients with angina pectoris and/or myocardial ischaemia due to coronary stenoses in a single native vessel were randomised to either direct stenting or stenting after predilatation. Baseline characteristics were evenly distributed between the two groups. Results Procedural success rates were similar (96.0% direct stenting group vs. 94.5% predilatation) as well as final successful stent implantation (98.3 vs. 97.8%), while the primary success rate of direct stenting alone was 88.3%, p=0.01. In multivariate analysis, angiographic lesion calcification was an independent predictor of unsuccessful direct stenting (odds ratio 7.1, 95% confidence interval 2.8-18.2, p0.15 μg/l, used as a measure of distal embolisation, were similar in both groups (17.8 vs. 17.1%). Rates of major adverse cardiac events at 30 days were 4.5% in the direct stenting group versus 5.5% in the predilated group (ns). Direct stenting was associated with savings in fluoroscopy time, and angiographic contrast agent use, and a reduction in utilisation of angioplasty balloons (0.4 vs. 1.17 balloons per patient, p<0.001). Mean per patient procedural costs associated with direct stenting versus predilatation were €2545±914 versus €2763±842 (p=0.01), despite the implantation of more stents in the directly stented group. Conclusion Compared with a strategy of stenting preceded by balloon predilatation, direct stenting was equally safe and effective, with similar in-hospital and 30-day clinical outcomes, and modest procedural cost-savings. A calcified lesion predicted unsuccessful direct stenting. PMID:25696356

  8. Measurement of the absolute reflectance of polytetrafluoroethylene (PTFE) immersed in liquid xenon

    Science.gov (United States)

    Neves, F.; Lindote, A.; Morozov, A.; Solovov, V.; Silva, C.; Bras, P.; Rodrigues, J. P.; Lopes, M. I.

    2017-01-01

    The performance of a detector using liquid xenon (LXe) as a scintillator is strongly dependent on the collection efficiency for xenon scintillation light, which in turn is critically dependent on the reflectance of the surfaces that surround the active volume. To improve the light collection in such detectors the active volume is usually surrounded by polytetrafluoroethylene (PTFE) reflector panels, used due to its very high reflectance—even at the short wavelength of scintillation light of LXe (peaked at 178 nm). In this work, which contributed to the overall R&D effort towards the LUX-ZEPLIN (LZ) experiment, we present experimental results for the absolute reflectance measurements of three different PTFE samples (including the material used in the LUX detector) immersed in LXe for its scintillation light. The obtained results show that very high bi-hemispherical reflectance values (>= 97%) can be achieved, enabling very low energy thresholds in liquid xenon scintillator-based detectors.

  9. Extreme ultraviolet (EUV) surface modification of polytetrafluoroethylene (PTFE) for control of biocompatibility

    Energy Technology Data Exchange (ETDEWEB)

    Ahad, Inam Ul, E-mail: inam-ul.ahad@wat.edu.pl [Institute of Optoelectronics, Military University of Technology, 00-908 Warsaw (Poland); Advanced Processing Technology Research Centre, School of Mechanical and Manufacturing Engineering, Faculty of Engineering & Computing, Dublin City University, Dublin 9 (Ireland); Butruk, Beata [Department of Biotechnology and Bioprocess Engineering, Warsaw University of Technology, Ul. Waryńskiego 1, 00-645 Warsaw (Poland); Ayele, Mesfin; Budner, Bogusław; Bartnik, Andrzej; Fiedorowicz, Henryk [Institute of Optoelectronics, Military University of Technology, 00-908 Warsaw (Poland); Ciach, Tomasz [Department of Biotechnology and Bioprocess Engineering, Warsaw University of Technology, Ul. Waryńskiego 1, 00-645 Warsaw (Poland); Brabazon, Dermot [Advanced Processing Technology Research Centre, School of Mechanical and Manufacturing Engineering, Faculty of Engineering & Computing, Dublin City University, Dublin 9 (Ireland)

    2015-12-01

    Extreme ultraviolet (EUV) surface modification of polytetrafluoroethylene (PTFE) was performed in order to enhance the degree of biocompatibility. Polymer samples were irradiated by different number of EUV shots using a laser–plasma based EUV source in the presence of nitrogen gas. The physical and chemical properties of EUV modified PTFE samples were studied using Atomic Force Microscopy, X-ray photoelectron spectroscopy and water contact angle (WCA) methods. Pronounced wall type micro and nano-structures appeared on the EUV treated polymer surfaces resulting in increased surface roughness and hydrophobicity. Stronger cell adhesion and good cell morphology were observed on EUV modified surfaces by in-vitro cell culture studies performed using L929 fibroblasts.

  10. Chemically robust carbon nanotube – PTFE superhydrophobic thin films with enhanced ability of wear resistance

    Directory of Open Access Journals (Sweden)

    Kewei Wang

    2017-06-01

    Full Text Available A chemically robust superhydrophobic nanocomposite thin film with enhanced wear resistance is prepared from a composite comprising polytetrafluoroethylene (PTFE and carbon nanotubes. The superhydrophobic thin films with hierarchical structure are fabricated by spraying an environmentally friendly aqueous dispersion containing carbon nanotubes and PTFE resin on silicon wafer. Thin films with a contact angle of 154.1°±2° and a sliding angle less than 2° remain superhydrophobic after abrading over 500 times under a pressure of 50 g/cm2. The thin film is also extremely stable even under much stress conditions. To further the understanding of the enhancement of wear resistance, we investigated the formation of microsized structure and their effects. The growth of microbumps is caused by attracting solution droplet to the hydrophilic islands on hydrophobic surface.

  11. Impact of lubrication on the tribological behaviour of PTFE composites for guide rings application

    Indian Academy of Sciences (India)

    M TRABELSI; M KHARRAT; M DAMMAK

    2016-09-01

    In this study, the friction and wear behaviours of polytetrafluoroethylene (PTFE)-based composites were comparatively evaluated under dry sliding and oil-lubricated conditions. Two PTFE composites filled with bronze and bronze $+$ molybdenum disulfide (MoS$_2$) were considered. These composites were used as guide rings for hydraulic actuating cylinder. Friction and wear tests of the composite specimens sliding against high chromium steel ball were conducted using reciprocating linear tribometer. The wear mechanisms of the composites under the two different sliding conditions were analysed and discussed based on scanning electron microscopic (SEM) examinationsof the worn surface and optical micrographs of the steel counterface. Under the oil-lubricated condition, the friction and wear behaviours of the composites were considerably improved if compared to that under the dry sliding. The oil adsorbed layer limited the transfer of the composite to the steel counterface and avoided the oxidation of the MoS$_2$ during the sliding test.

  12. Constitutive modeling of the dynamic-tensile-extrusion test of PTFE

    Science.gov (United States)

    Resnyansky, A. D.; Brown, E. N.; Trujillo, C. P.; Gray, G. T.

    2017-01-01

    Use of polymers in defense, aerospace and industrial applications under extreme loading conditions makes prediction of the behavior of these materials very important. Crucial to this is knowledge of the physical damage response in association with phase transformations during loading and the ability to predict this via multi-phase simulation accounting for thermodynamical non-equilibrium and strain rate sensitivity. The current work analyzes Dynamic-Tensile-Extrusion (Dyn-Ten-Ext) experiments on polytetrafluoroethylene (PTFE). In particular, the phase transition during loading and subsequent tension are analyzed using a two-phase rate sensitive material model implemented in the CTH hydrocode. The calculations are compared with experimental high-speed photography. Deformation patterns and their link with changing loading modes are analyzed numerically and correlated to the test observations. It is concluded that the phase transformation is not as critical to the response of PTFE under Dyn-Ten-Ext loading as it is during the Taylor rod impact testing.

  13. Femtosecond laser ablated durable superhydrophobic PTFE sheet for oil/water separation

    Science.gov (United States)

    Li, Wentao; Yang, Qing; Chen, Feng; Yong, Jiale; Fang, Yao; Huo, Jinglan

    2017-02-01

    Femtosecond laser microfabrication has been attracting increasing interest of researchers in recent years, and been applied on interface science to control the wettability of solid surfaces. Herein, we fabricate a kind of rough microstructures on polytetrafluoroethylene (PTFE) sheet by femtosecond laser. The femtosecond laser ablated surfaces show durable superhydrophobicity and ultralow water adhesion even after storing in a harsh environment for a long time, including strong acid, strong alkali, and high temperature. A penetrating microholes array was further generated on the rough superhydrophobic PTFE sheet by a subsequent mechanical drilling process. The as-prepared material was successfully applied in the field of oil/water separation due to the inverse superhydrophobicity and superoleophilicity.

  14. Electroless Ni-P-PTFE-Al2O3 Dispersion Nanocomposite Coating for Corrosion and Wear Resistance

    Science.gov (United States)

    Sharma, Ankita; Singh, A. K.

    2014-01-01

    With the aim to produce a coating having good corrosion and wear resistance alongside hardness but lesser friction coefficient, Ni-P-PTFE-Al2O3 (NiPPA) dispersion coating was developed. This was achieved by introducing nanosized polytetrafluoroethylene (PTFE) and alumina (Al2O3) in the Ni-P matrix deposited on mild steel substrate. The coating was characterized using scanning electron microscopy, energy dispersive analysis of x-ray, and x-ray diffractrometry. Microhardness and wear resistance of the coating was measured using Vicker's hardness tester and Pin-on-Disc method, respectively. The corrosion behavior was measured using electrochemical polarization and immersion tests with and without exposure in 3.5% NaCl solution. It is observed that codeposition of Al2O3 and PTFE particles with Ni-P coating results in comparatively smooth surface with nodular grains. The NiPPA coating was observed to have moderate hardness between electroless Ni-P-PTFE and Ni-P-Al2O3 coating and good wear resistance with lubricating effect. Addition of both PTFE and Al2O3 is observed to enhance corrosion resistance of the Ni-P coating. However, improvement in corrosion resistance is more due to addition of Al2O3 than PTFE. Continuous exposure for 10-20 days in corrosive solution is found to deteriorate corrosion protection properties of the coating.

  15. Process to Improve the Adherences of Copper to a PTFE Plate

    Directory of Open Access Journals (Sweden)

    Abel Pérez

    2016-01-01

    Full Text Available A simple low plasma power and roughness free process for improving the adherence of Cu to PTFE is presented. The results show that low pressure and Ar flow combination are the drivers of this improved adherence. Copper Peel Strength Tensile values up to 60 kg/m are obtained which are comparable to those shown in commercial composite dielectrics for high-frequency applications Printed Circuit Boards.

  16. EFFECTS OF TRITIUM ON UHMW-PE, PTFE, AND VESPEL POLYIMIDE

    Energy Technology Data Exchange (ETDEWEB)

    Clark, E; Kirk Shanahan, K

    2006-11-01

    Samples of ultrahigh molecular weight polyethylene (UHMW-PE), polytetrafluoroethylene (PTFE), and the polyimide Vespel{reg_sign} were exposed to tritium gas in closed containers initially at 101 kPa (1 atmosphere) pressure and ambient temperature for various times up to 2.3 years. Tritium exposure effects on the samples were characterized by dynamic mechanical analysis (DMA) and radiolysis products were characterized by measuring the total final pressure and composition in the exposure containers at the end of exposure period.

  17. EXPERIMENTAL ANALYSIS TO IDENTIFY THE DEFORMATION MECHANISMS DURING SINTERING OF COLD COMPACTED POLYTETRAFLUOROETHYLENE (PTFE) POWDERS

    OpenAIRE

    Canto, Rodrigo,; Schmitt, Nicolas; Carvalho, Jonas; Billardon, René R.

    2009-01-01

    Soumis; International audience; Thermal dilatometry analyses were performed on specimens made of pure or filled PTFE powders. The specimens were obtained by isostatic pressing or by uniaxial compaction up to different values of the residual void ratio. The large deformations that were recorded during different heating-cooling treatments strongly depend on the mode and level of compaction, as well as on the presence or the absence of fillers. Besides, these deformations are strongly anisotropi...

  18. SELECTIVE HYDROGENATION OF CINNAMALDEHYDE WITH Pt AND Pt-Fe CATALYSTS: EFFECTS OF THE SUPPORT

    Directory of Open Access Journals (Sweden)

    A.B. da Silva

    1998-06-01

    Full Text Available Low-temperature reduced TiO2-supported Pt and Pt-Fe catalysts are much more active and selective for the liquid–phase hydrogenation of cinnamaldehyde to unsaturated cinnamyl alcohol than the corresponding carbon-supported catalysts. High-temperature reduced catalysts, where the SMSI effect should be present, are almost inactive for this reaction. There is at present no definitive explanation for this effect but an electronic metal-support interaction is most probably involved.

  19. Laser ablation of polytetrafluoroethylene (PTFE) coatings applied on EN AW-5251 substrates; Ablacion laser de recubrimientos de politetrafluoretileno (PTFE) aplicados sobre sustratos EN AW-5251

    Energy Technology Data Exchange (ETDEWEB)

    Guerrero Vaca, G. R.; Sevilla Hurtado, L.; Soriano Reyes, C.

    2014-07-01

    Currently the most common used methods for removing PTFE rich coatings on metal substrates are: grinding, pyrolysis, chemical processes or a combination of these. While effective, all present serious difficulties. In this paper the use of laser ablation to remove PTFE rich coatings, which have previously been applied to sheets of aluminum magnesium alloy EN AW-5251 H34, is proposed. For this purpose the values of the yield strength, tensile strength, percent elongation, impact energy retained and hardness are analyzed. Equally, the grain size distribution at the microstructural level, the ASTM average grain size and distribution of constituent particles have been evaluated. Measurements were performed to three successive stages of application and laser coating removal. Moreover, the previous set of properties have been determined for the same substrates and stages but using pyrolysis to remove the coating. Comparison of the results shows that the removal by laser ablation does not cause any reduction in the properties of the substrates and may become an industrial alternative to traditional disposal procedures. (Author)

  20. Review of stents for the carotid artery.

    Science.gov (United States)

    Bosiers, M; Deloose, K; Verbist, J; Peeters, P

    2006-04-01

    The individual characteristics of a stent may make it an attractive choice in some circumstances, but render it a less desirable option in others. The applicability depends primarily on the arterial anatomy and the specific details of the lesion being treated. A careful assessment by the interventionalist is required to select the proper type of stent that is of appropriate size. Certainly, personal preferences and familiarity with a specific device may legitimately influence the decision to choose one stent over another. Finally, stent design can play a role in the selection procedure. Although carotid stents are often functionally equivalent in the clinical setting and have been used successfully to treat a wide variety of lesions, a basic knowledge of stent geometry can contribute to make up your mind in certain carotid cases.

  1. Rapid virtual stenting for intracranial aneurysms

    Science.gov (United States)

    Zhao, Liang; Chen, Danyang; Chen, Zihe; Wang, Xiangyu; Paliwal, Nikhil; Xiang, Jianping; Meng, Hui; Corso, Jason J.; Xu, Jinhui

    2016-03-01

    The rupture of Intracranial Aneurysms is the most severe form of stroke with high rates of mortality and disability. One of its primary treatments is to use stent or Flow Diverter to divert the blood flow away from the IA in a minimal invasive manner. To optimize such treatments, it is desirable to provide an automatic tool for virtual stenting before its actual implantation. In this paper, we propose a novel method, called ball-sweeping, for rapid virtual stenting. Our method sweeps a maximum inscribed sphere through the aneurysmal region of the vessel and directly generates a stent surface touching the vessel wall without needing to iteratively grow a deformable stent surface. Our resulting stent mesh has guaranteed smoothness and variable pore density to achieve an enhanced occlusion performance. Comparing to existing methods, our technique is computationally much more efficient.

  2. Esophageal stent migration leads to intestinal obstruction

    Directory of Open Access Journals (Sweden)

    Oguzhan Karatepe

    2009-07-01

    Full Text Available Background: Self-expanding metallic stents are the devices of choice in the treatment of malign or benign strictures of esophagus. Stent migration is a well-known complication of this procedure. Aims: We report a case of intestinal obstruction caused by esophageal stent migration, in which surgical intervention was used. Methods: A 65-year-old woman, who had a medical history of gastric cancer operation and esophageal stent application admitted to our emergeny department with a 48-hour history of abdominal pain, nausea and vomiting. An emergeny laparotomy was performed and the migrated stent leading to intestinal obstruction was removed. Results: The patient recovered without incident and was discharged on postoperative day 3. Conclusion: This case illustrates that esophageal stent migration has to be considered as a potential life-threatening complication.

  3. Hypersensitivity to drug-eluting stent and stent thrombosis: Kounis or not Kounis syndrome?

    Institute of Scientific and Technical Information of China (English)

    TAN Wei; CHENG Kang-lin; CHEN Qiu-xiong

    2009-01-01

    @@ With the utilization of coronary-stents, coronary remodeling and restenosis were reduced compared with balloon angioplasty alone.~1 However, the risk of restenosis is still in the range of 15% to 20%. Drug-eluting stents (DES), which could release antiproliferative pharmacological agents after deployment. were designed to inhibit the response to injury reaction after bare-metal stent (BMS) implantation.

  4. Mechanical behavior of peripheral stents and stent-vessel interaction: A computational study

    Science.gov (United States)

    Dottori, Serena; Flamini, Vittoria; Vairo, Giuseppe

    2016-05-01

    In this paper stents employed to treat peripheral artery disease are analyzed through a three-dimensional finite-element approach, based on a large-strain and large-displacement formulation. Aiming to evaluate the influence of some stent design parameters on stent mechanics and on the biomechanical interaction between stent and arterial wall, quasi-static and dynamic numerical analyses are carried out by referring to computational models of commercially and noncommercially available versions of both braided self-expandable stents and balloon-expandable stents. Addressing isolated device models, opening mechanisms and flexibility of both opened and closed stent configurations are numerically experienced. Moreover, stent deployment into a stenotic peripheral artery and possible postdilatation angioplasty (the latter for the self-expandable device only) are simulated by considering different idealized vessel geometries and accounting for the presence of a stenotic plaque. Proposed results highlight important differences in the mechanical response of the two types of stents, as well as a significant influence of the vessel shape on the stress distributions arising upon the artery-plaque system. Finally, computational results are used to assess both the stent mechanical performance and the effectiveness of the stenting treatment, allowing also to identify possible critical conditions affecting the risk of stent fracture, tissue damage, and/or pathological tissue response.

  5. Advances in drug eluting stents – focus on the Endeavor® zotarolimus stent

    Directory of Open Access Journals (Sweden)

    Jonathan Bridges

    2008-12-01

    Full Text Available Jonathan Bridges, Donald CutlipBeth Israel Deaconess Medical Center, Boston, Massachusetts, USAAbstract: Coronary artery disease remains one of the leading causes of death in the United States. Over the last 30 years, the development of coronary artery angioplasty and stenting has drastically reduced mortality during acute coronary syndromes while also reducing symptoms of chronic coronary artery disease. Unfortunately, the placement of stents in a coronary artery can be complicated by in-stent thrombosis or restenosis. In 2003–2004, a new generation of stents was introduced to the market with the goal of reducing the rate of restenosis. These stents, called drug eluting stents (DES, are coated with a pharmacological agent designed to reduce the neointimal hyperplasia associated with restenosis. Within a year, approximately 80% of all percutaneous coronary interventions performed within the US involved placement of a DES. In 2006, a controversy arose about the possibility of a statistically significant increased risk of acute stent thrombosis associated with DES especially when used for an “off label” indication. This risk was attributed to delayed endothelization. This controversy has led to a reduction in the use of DES along with longer use of dual platelet inhibition with aspirin and clopidogrel. Recently Medtronic introduced a new DES to the market called the Endeavor® stent – a zotarolimus eluting stent.Keywords: Endeavor® stent, zotarolimus stent, drug eluting stent

  6. Comparative tensile strength study of the adhesion improvement of PTFE by UV photon assisted surface processing

    Science.gov (United States)

    Hopp, B.; Geretovszky, Zs.; Bertóti, I.; Boyd, I. W.

    2002-01-01

    Poly(tetrafluoroethylene) (PTFE) is notable for its non-adhesive and non-reactive properties. A number of technologies can potentially benefit from the application of PTFE, but these characteristics restrict the ability to structuring its surface. In this paper, we present results on two ultraviolet photon assisted treatments of PTFE. The originally poor adhesion was significantly improved by both 172 nm excimer lamp and 193 nm excimer laser assisted surface treatments. While Xe2∗ lamp irradiation, applied in a modest vacuum environment, was sufficient by itself to improve adhesion, the ArF laser process was only effective when the irradiated interface was in contact with 1,2-diaminoethane photoreagent. It was found that the tensile strength of an epoxy resin glued interface created on treated surfaces depended strongly on the applied number of laser pulses and lamp irradiation time. Laser treatment caused fast tensile strength increase during the first 50-500 pulses, while after this it saturates slowly at about 5.5 MPa in the 500-2500 pulse domain. The excimer lamp irradiation resulted in a maximum tensile strength of approximately 10 MPa after 2 min irradiation time which reduced to about 65% of the peak value at longer times.

  7. Layer-by-layer assembly of thin organic films on PTFE activated by cold atmospheric plasma

    Directory of Open Access Journals (Sweden)

    Tóth András

    2014-12-01

    Full Text Available An air diffuse coplanar surface barrier discharge is used to activate the surface of polytetrafluoroethylene (PTFE samples, which are subsequently coated with polyvinylpyrrolidone (PVP and tannic acid (TAN single, bi- and multilayers, respectively, using the dip-coating method. The surfaces are characterized by X-ray Photoelectron Spectroscopy (XPS, Attenuated Total Reflection – Fourier Transform Infrared Spectroscopy (ATR-FTIR and Atomic Force Microscopy (AFM. The XPS measurements show that with plasma treatment the F/C atomic ratio in the PTFE surface decreases, due to the diminution of the concentration of CF2 moieties, and also oxygen incorporation through formation of new C–O, C=O and O=C–O bonds can be observed. In the case of coated samples, the new bonds indicated by XPS show the bonding between the organic layer and the surface, and thus the stability of layers, while the gradual decrease of the concentration of F atoms with the number of deposited layers proves the creation of PVP/TAN bi- and multi-layers. According to the ATR-FTIR spectra, in the case of PVP/TAN multilayer hydrogen bonding develops between the PVP and TAN, which assures the stability of the multilayer. The AFM lateral friction measurements show that the macromolecular layers homogeneously coat the plasma treated PTFE surface.

  8. Investigations into the Degradation of PTFE Surface Properties by Accelerated Aging Tests

    Directory of Open Access Journals (Sweden)

    C. Fragassa

    2016-06-01

    Full Text Available This paper describes an accelerate aging procedure used for investigating the surface alteration of PTFE gaskets commercialized by two alternative producers. These gaskets are installed in modern process plants where tires moulds are cleaned inside a multistage ultrasonic process. The surface of gaskets degrades inexplicably under ordinary operative conditions after a relatively short period. Even if these gaskets are exposed to a combination of ultrasonic waves, temperature, humidity and acid attack, the PTFE properties of resistance nominally exclude the possibility of severe erosion phenomena as highlighted during the real utilization. A possible explanation could be represented by the presence of unexpected chemical compounds emerging from the disaggregation of highly reacting elements from the tire composition. In particular, it is believed that the unpredicted combination of fluorides and chlorides could explain the violent chemical attack highlighted on steel tanks and on their gaskets. But no evidence exists. Thus, the experimental characterization of PTFE properties has to follow an appropriate accelerated aging, aiming at actuating the specific mechanics of wearing as in industrial use.

  9. Physico-chemical and antimicrobial properties of co-sputtered Ag-Au/PTFE nanocomposite coatings

    Energy Technology Data Exchange (ETDEWEB)

    Zaporojtchenko, V [Chair for Multicomponent Materials, Technische Fakultaet der CAU, Kaiserstrasse 2, D-24143 Kiel (Germany); Podschun, R [Institute for Infection Medicine, University Hospital SH, Campus Kiel (Germany); Schuermann, U [Chair for Multicomponent Materials, Technische Fakultaet der CAU, Kaiserstrasse 2, D-24143 Kiel (Germany); Kulkarni, A [Chair for Multicomponent Materials, Technische Fakultaet der CAU, Kaiserstrasse 2, D-24143 Kiel (Germany); Faupel, F [Chair for Multicomponent Materials, Technische Fakultaet der CAU, Kaiserstrasse 2, D-24143 Kiel (Germany)

    2006-10-14

    In this work, we used co-sputtering of noble metals together with polytetrafluorethylene (PTFE) as a method for producing antibacterial metal/polymer nanocomposite coatings, where the precious metals are only incorporated in a thin surface layer. Moreover, they are finely dispersed as nanoparticles, thus saving additional material and providing a very large effective surface for metal ion release. Nanocomposite films with thickness between 100 and 300 nm were prepared with a wide range of metal filling between 10 and 40%. The antimicrobial effect of the nanocomposite coatings was evaluated by means of two different assays. The bactericidal activity due to silver release from the surface was determined by a modification of conventional disc diffusion methods. Inhibition of bacterial growth on the coated surface was investigated through a modified proliferation assay. Staphylococcus aureus and S. epidermidis were used as test bacteria, as these species commonly cause infections associated with medical polymer devices. The antibacterial efficiency of the coatings against different bacteria was demonstrated at extremely small noble metal consumption: Au: {approx}1 mg m{sup -2} and Ag: {approx}0.1 g m{sup -2}. The maximum ability for having an antibacterial effect was shown by the Ag-Au/PTFE nanocomposite, followed by the Ag/PTFE nanocomposite.

  10. Wear Resistance and Structure of Electrodeposited RE-Ni-W-P-SiC-PTFE Composite Materials

    Institute of Scientific and Technical Information of China (English)

    GuoZhongcheng; ZhuXiaoyun; YangXianwan

    2004-01-01

    Effects of heat treatment temperature and time on hardness and wear resistance of RE-Ni-W-P-SiC-PTFE and RE-Ni-W-P-SiC composite coatings were studied. The results indicated that the hardness of the composite coatings as-deposited was lower and the mass loss (i.e. rate of abrasion) was higher, while the hardness increased and the rate of abrasion decreased with the increase of heat treatment temperature. The rate of abrasion was the lowest and hardness was the highest at 400℃ . The hardness decreased and the rate of abrasion increased with the temperature increasing continuously. Both the hardness and wear resistance also increased with the prolongation of heat treatment time, reaching their peak values when the heat treatment time was 2 h. The experimental results also showed that the hardness of the coatings decreased with PTFE quantity enhancing, but the wear rate diminished correspondingly. X-ray diffraction analysis indicated that the structure of RE-Ni-W-P-SiC-PTFE composite coating as-deposited is amorphous, and it partly became crystal when heat treatment temperature was over 3000℃.

  11. Modelling of the mechanical behaviour of two pure PTFE powders during their compaction at room temperature

    Science.gov (United States)

    Frédy, Carole; Canto, Rodrigo B.; Schmitt, Nicolas; Roux, Stéphane; Billardon, René

    2013-06-01

    Since PolyTetraFluoroEthylene (PTFE) is not melt processible because of its very high melt viscosity, parts made of this material are generally manufactured by cold compaction of powder material followed by sintering of the green compact. The aim of this study is to identify 3-D constitutive equations suitable for the finite element analysis of PTFE powder compaction. To exhibit the influence of their geometrical aspect on their mechanical behaviour, two pure PTFE resins were tested, viz. a free flowing pelletized resin and a granular fine cut resin. To study the behaviour of these powders during their compaction along different loading paths, a novel triaxial device has been designed and installed on a six-actuator triaxial testing machine. The results obtained for hydrostatic loading were favourably compared with results obtained by isostatic pressing. Various complex loading paths were also investigated. Full 3D elasto-viscoplastic non-associated constitutive equations, viz. a non-linear Drucker-Prager/cap type model, could be identified.

  12. Characterization of particulates accompanying laser ablation of pressed polytetrafluorethylene (PTFE) targets

    Science.gov (United States)

    Heitz, J.; Dickinson, J. T.

    We present observations of sub-micron- to micron-sized particles generated by high fluence ( 2 J/cm2) 248-nm laser ablation of pressed polytetrafluorethylene (PTFE) targets in air at atmospheric pressure. The original target material was hydrostatically compressed 7 μm PTFE powder, sintered at 275 °C. Collected ejecta due to laser irradiation consists of four basic particle morphologies ranging from small particles 50-200 nm in diameter to larger particles 10 μm in diameter. Many particles formed in air carry electric charge. Using charged electrodes we are able to collect charged particles to determine relative numbers of +/- charge. We observe roughly equal numbers of positively and negatively charged particles except for the largest particles which were predominantly negative. For a range of particle sizes we are able to measure the sign and magnitude of this charge with a Millikan-oil-drop technique and determine surface charge densities. The implications of these observations with respect to pulsed laser deposition of PTFE thin films and coatings are discussed.

  13. Role of PTFE Patch Saphenoplasty in Reducing Neovascularization and Recurrence in Varicose Veins.

    Science.gov (United States)

    Vashist, M G; Singhal, Nitin; Verma, Manish; Sen, Jyotsana

    2015-12-01

    Varicose veins have a high recurrence rate following surgery. Besides poor surgical technique, majority of these recurrences are attributable to neovascularization after both primary and repeat surgery. Authors have studied the effectiveness of a polytetrafluoroethylene (PTFE) patch interposition between the ligated vein stump and the overlying soft tissue at saphenofemoral junction in decreasing recurrence of varicose veins after initial surgery. Study was conducted on 50 patients of varicose veins with saphenofemoral junction incompetence. Patients were randomly divided into two groups, group A and group B alternately. In group A, standard surgical procedure was done followed by PTFE patch application. In group B, same surgical procedure was applied as in group A, with the exception of PTFE patch application. Patients in both groups were given similar postoperative care. A full venous duplex ultrasound assessment was performed in all the patients postoperatively. Neovascularization was observed in five patients (20 %) of group B, while it was not seen in any of the patients in group A at 1-year follow-up. This difference in neovascularization across the two groups was found to be statistically significant with a p value of 0.0251. Hence, authors concluded that patch saphenoplasty helps in reducing recurrence in varicose veins by decreasing neovascularization at saphenofemoral junction.

  14. Stent implantation influence wall shear stress evolution

    Science.gov (United States)

    Bernad, S. I.; Totorean, A. F.; Bosioc, A. I.; Petre, I.; Bernad, E. S.

    2016-06-01

    Local hemodynamic factors are known affect the natural history of the restenosis critically after coronary stenting of atherosclerosis. Stent-induced flows disturbance magnitude dependent directly on the strut design. The impact of flow alterations around struts vary as the strut geometrical parameters change. Our results provide data regarding the hemodynamic parameters for the blood flow in both stenosed and stented coronary artery under physiological conditions, namely wall shear stress and pressure drop.

  15. Assessment of Coronary Stents by 64-slice Computed Tomography:In-stent Lumen Visibility and Patency

    Institute of Scientific and Technical Information of China (English)

    Ling-yan Kong; Zheng-yu Jin; Shu-yang Zhang; Zhu-hua Zhang; Yi-ning Wang; Lan Song; Xiao-na Zhang; Yun-qing Zhang

    2009-01-01

    Objective To assess lumen visibility of coronary stents by 64-slice computed tomography(CT)coronary angiography,and determine the value of 64-slice CT in non-invasive detecting of in-stent restenosis after coronary artery stent implantation.Methods Totally,60 patients(54 males,aged 57.0±12.7 years)and 105 stents were investigated by 64-slice CT at a mean interval of 20.0±16.6 months after coronary stents implantation.Axial multi-planar reconstruction images of the stents and curved-planar reconstruction images through the median of the stents were reconstructed for evaluating stent image quality on a 5-point scale(1=excellent,5=nonassessable),and stent lumen diameter was detected.Conventional coronary angiography was performed in 18 patients,and 32 stents were evaluated.Results Image quality was good to excellent on average(score 1.71±0.76).Stent image quality score was correlated to heart rate(r=0.281,P<0.01)and stent diameter(r=0.480,P<0.001).All the stents were assessable in lumen visibility with an average visible lumen diameter percentage of 60.7% ±13.6% .Visible lumen diameter percentage was correlated to heart rate(r=-0.193,P<0.05),stent diameter (r=0.403,P<0.001),and stent image quality score(r=-0.500,P<0.001).Visible lumen diameter percentage also varied depending on the stent type.In comparison with the conventional coronary angiography,4 of 6 in-stent stenoses were correctly detected.The sensitivity and specificity for the detection of in-stent stenosis were 66.7% and 84.6% ,respectively.Conclusions Using a 64-slice CT,the stent lumen is partly visible in most of the stents.And 64-slice CT may be useful in the assessment of stent patency.

  16. Novel stents for the prevention of restenosis.

    Science.gov (United States)

    McKenna, C J; Holmes, D R; Schwartz, R S

    1997-10-01

    Since the introduction of Interventional Cardiology in 1976, there has been rapid expansion both in its clinical application and the tools of the trade. This growth was accelerated with the introduction of the intra-coronary stent in 1987. The demonstration that stents may reduce the incidence of restenosis after percutaneous coronary revascularization has further stimulated the search for the perfect endovascular prosthesis. By creating a hybrid stent, incorporating natural coatings and local drug delivery in the design, it is hoped that the complications associated with stent thrombosis and restenosis can be eradicated. (Trends Cardiovasc Med 1997;7:245-249). © 1997, Elsevier Science Inc.

  17. Stent Fracture: Case Report and Literature Review

    OpenAIRE

    Lousinha, A; Fiarresga, A; Cardona, L.; Lopes, JP; Lopes, A.; Cacela, D; L. Sousa; Patrício, L; Bernardes, L; Cruz Ferreira, R

    2011-01-01

    Apresentamos o caso de um doente, previamente submetido a angioplastia coronária com um stent revestido com fármaco, com enfarte agudo do miocárdio (EAM) provocado por trombose tardia do stent, tendo sido detectada fractura do mesmo. Este caso vem reforçar o reconhecimento crescente da fractura como potencial mecanismo para a trombose tardia de stent, na era dos stents revestidos com fármaco. A propósito deste caso clínico, apresentamos uma revisão da liter...

  18. Stenting:84 Cases of Clinical Application

    Institute of Scientific and Technical Information of China (English)

    GUANG Yongsong

    2002-01-01

    Objective To evaluate clinical application of therapeutic stenting. Methods 84 cases were managed with stents clinically, 136 procedures of intervention in all. The cases were suffering from portal hypertension of cirrhosis, stricture of inferior vana cava, superior vana cava syndrome, post- operative esophageal stricture, narrowig of femoral, common carotid, renal, superior mesentery arteries and biliary tract, etc. Results Therapeutic stenting achieves clinical effects completely different from conventional intemal medicine and surgery. Conclusion Therapeutic stenting is clinically unique, dramatically effective, with minor risks and worthy promoting.

  19. Nitinol stent design - understanding axial buckling.

    Science.gov (United States)

    McGrath, D J; O'Brien, B; Bruzzi, M; McHugh, P E

    2014-12-01

    Nitinol׳s superelastic properties permit self-expanding stents to be crimped without plastic deformation, but its nonlinear properties can contribute towards stent buckling. This study investigates the axial buckling of a prototype tracheobronchial nitinol stent design during crimping, with the objective of eliminating buckling from the design. To capture the stent buckling mechanism a computational model of a radial force test is simulated, where small geometric defects are introduced to remove symmetry and allow buckling to occur. With the buckling mechanism ascertained, a sensitivity study is carried out to examine the effect that the transitional plateau region of the nitinol loading curve has on stent stability. Results of this analysis are then used to redesign the stent and remove buckling. It is found that the transitional plateau region can have a significant effect on the stability of a stent during crimping, and by reducing the amount of transitional material within the stent hinges during loading the stability of a nitinol stent can be increased.

  20. Oxygen Compatibility of Brass-Filled PTFE Compared to Commonly Used Fluorinated Polymers for Oxygen Systems

    Science.gov (United States)

    Herald, Stephen D.; Frisby, Paul M.; Davis, Samuel Eddie

    2009-01-01

    Safe and reliable seal materials for high-pressure oxygen systems sometimes appear to be extinct species when sought out by oxygen systems designers. Materials that seal well are easy to find, but these materials are typically incompatible with oxygen, especially in cryogenic liquid form. This incompatibility can result in seals that leak, or much worse, seals that easily ignite and burn during use. Materials that are compatible with oxygen are easy to find, such as the long list of compatible metals, but these metallic materials are limiting as seal materials. A material that seals well and is oxygen compatible has been the big game in the designer's safari. Scientists at the Materials Combustion Research Facility (MCRF), part of NASA/Marshall Space Flight Center (MSFC), are constantly searching for better materials and processes to improve the safety of oxygen systems. One focus of this effort is improving the characteristics of polymers used in the presence of an oxygen enriched environment. Very few systems can be built which contain no polymeric materials; therefore, materials which have good impact resistance, low heat of combustion, high auto-ignition temperature and that maintain good mechanical properties are essential. The scientists and engineers at the Materials Combustion Research Facility, in cooperation with seal suppliers, are currently testing a new formulation of polytetrafluoroethylene (PTFE) with Brass filler. This Brass-filled PTFE is showing great promise as a seal and seat material for high pressure oxygen systems. Early research has demonstrated very encouraging results, which could rank this material as one of the best fluorinated polymers ever tested. This paper will compare the data obtained for Brass-filled PTFE with other fluorinated polymers, such as TFE-Teflon (PTFE) , Kel-F 81, Viton A, Viton A-500, Fluorel , and Algoflon . A similar metal filled fluorinated polymer, Salox-M , was tested in comparison to Brass-filled PTFE to

  1. Aorta Segmentation for Stent Simulation

    CERN Document Server

    Egger, Jan; Setser, Randolph; Renapuraar, Rahul; Biermann, Christina; O'Donnell, Thomas

    2011-01-01

    Simulation of arterial stenting procedures prior to intervention allows for appropriate device selection as well as highlights potential complications. To this end, we present a framework for facilitating virtual aortic stenting from a contrast computer tomography (CT) scan. More specifically, we present a method for both lumen and outer wall segmentation that may be employed in determining both the appropriateness of intervention as well as the selection and localization of the device. The more challenging recovery of the outer wall is based on a novel minimal closure tracking algorithm. Our aortic segmentation method has been validated on over 3000 multiplanar reformatting (MPR) planes from 50 CT angiography data sets yielding a Dice Similarity Coefficient (DSC) of 90.67%.

  2. Intravascular Stenting in Microvascular Anastomoses

    DEFF Research Database (Denmark)

    Assersen, Kristine; Sørensen, Jens

    2015-01-01

    Background The effect of intravascular stenting (IVaS) on microvascular anastomoses has given adverse results. For experienced microsurgeons the benefit of IVaS is doubtful. We have investigated the potential benefit of the IVaS technique for two groups of inexperienced microsurgeons with different...... surgical levels of experience (medical students and young residents). Experienced microsurgeons acted as a control group. Materials and Methods In an experimental crossover study, 139 microsurgical anastomoses were performed on the femoral artery in 70 rats by 10 surgeons. On one side of the rat, the IVaS...... spent on the anastomosis. Results No significant difference in patency rates was seen between the stenting and conventional technique in all three groups. The experienced microsurgeons had 100% patency rate with both techniques. The medical students had 20/28 in the IVaS and 19/28 conventional group...

  3. Stents in patients with esophageal cancer before chemoradiotherapy: high risk of complications and no impact on the nutritional status.

    Science.gov (United States)

    Mão-de-Ferro, S; Serrano, M; Ferreira, S; Rosa, I; Lage, P; Alexandre, D P; Freire, J; Mirones, L; Casaca, R; Bettencourt, A; Pereira, A D

    2016-03-01

    Preoperative chemoradiotherapy is the standard of care for locally advanced esophageal cancer, causing persistent deterioration in the nutritional status. We performed a prospective study to evaluate the safety and efficacy of esophageal double-covered self-expandable metal stents in patients with esophageal cancer before chemoradiotherapy. The nutritional status and dysphagia were prospectively recorded. Eleven patients were included: eight were moderate and three were severely malnourished. After stent placement, dysphagia improved in all patients. With regard to complications, one patient developed an esophageal perforation that required urgent esophagectomy. Four patients presented stent migration. Three of these patients required enteral nutrition and none was submitted to surgery because of poor nutritional status. Of the other six patients, only four were operated upon. Stent placement presented a high complication rate and did not prevent weight loss or malnutrition. Other alternatives, including naso-gastric tube placement or endoscopic percutaneous gastrostomy or jejunostomy, should be considered.

  4. Late stent malapposition and marked positive vessel remodeling after sirolimus-eluting coronary stent implantation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Feng; QIAN Ju-ying; GE Jun-bo

    2006-01-01

    @@ It has been reported that positive remodeling, regression of neointimal hyperplasia, and late malapposition are associated with brachytherapy, one of the approaches to prevent first-time and recurrent in-stent restenosis.1,2 Recently, some drug-eluting stents have been demonstrated to dramatically reduce restenosis rates.3,4 Despite these promising results, these drug-eluting stents may have the same potential risks as brachytherapy, with some similarities between the 2 technologies in anti- proliferative effects on vascular smooth muscle cells and endothelial cells. We reported a case of late stent malapposition and marked positive vessel remodeling after sirolimus-eluting coronary stent implantation.

  5. Delayed cerebral infarction due to stent folding deformation following carotid artery stenting

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Kwon Duk; Lee, Kyung Yul; Suh, Sang Hyun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Kim, Byung Moon [Dept. of Radiology, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    We report a case of delayed cerebral infarction due to stent longitudinal folding deformation following carotid artery stenting using a self-expandable stent with an open-cell design. The stented segment of the left common carotid artery was divided into two different lumens by this folding deformation, and the separated lumens became restricted with in-stent thrombosis. Although no established method of managing this rare complication exists, a conservative approach was taken with administration of anticoagulant and dual antiplatelet therapy. No neurological symptoms were observed during several months of clinical follow-up after discharge.

  6. Peri-stent contrast staining, major evaginations and severe malapposition after biolimus-eluting stent implantation

    DEFF Research Database (Denmark)

    Antonsen, Lisbeth; Thayssen, Per; Jensen, Lisette Okkels

    2014-01-01

    Peri-stent contrast staining and late acquired malapposition represent pathological vessel wall healing patterns following percutaneous coronary intervention with stent implantation. Earlier studies have described these abnormal vessel wall responses commonly present after implantation of first......-generation drug-eluting stents. These coronary vascular changes can cause flow disturbance and thereby dispose for later thrombotic events. This case report, based on coronary optical frequency domain imaging, describes peri-stent contrast staining, major evaginations and severe malapposition occurring 18months...... after third-generation biolimus-eluting stent implantation....

  7. Stent graft repair of subclavian and axillary vascular injuries: The Groote Schuur experience.

    Science.gov (United States)

    Naidoo, N G; Navsaria, P; Beningfield, S J; Natha, B; Cloete, N; Gill, H

    2015-10-08

    Trauma-related subclavian and axillary vascular injuries (SAVIs) are generally associated with high morbidity and mortality rates in the surgical literature. There is an emerging trend towards increasing use of stent grafts (covered stents) for repair, with evidence limited to small case series and case reports. To report on the clinical and device-related outcomes of stent graft repair of trauma-related SAVIs at a single institution. A retrospective chart review of all patients with trauma-related SAVIs requiring stent graft repair was performed. Outcome measures included technical success, mortality, amputation rate, device-related complications (early and late), and reintervention rates (early and late). A total of 31 patients was identified between June 2008 and October 2013 (30 males, 1 female). Mean age was 27.9 years (range 19-51). All 31 patients sustained a penetrating injury (93.5% stab, 6.5% gunshot injuries). There were 21 subclavian and 10 axillary artery injuries. Five patients (16%) were HIV-positive. Nine patients (29%) were shocked on presentation. Early results (30 days): There were no periprocedural deaths. Primary technical success was 83.9% (26/31). Five patients required adjunctive interventional or operative procedures. There were no early procedure-related complications, reinterventions or open conversions in this study. Overall, suboptimal results were seen in five patients (one type I endoleak and four type II endoleaks). Follow-up results (>30 days): Nineteen patients (61.3%) were available for follow-up. Mean duration of follow-up was 55.7 weeks (range 4 - 240). Overall stent graft patency was 89.5% (17/19). Four patients (21.1%) had an occluded stent graft. Stent graft salvage was possible in two patients. Three type II endoleaks were seen on follow-up. Late reinterventions were performed in five patients (26.3%). Conversion to an open procedure was not required in any patient. There was one late death and one major amputation of a

  8. Forgotten biliary stents: ignorance is not bliss.

    Science.gov (United States)

    Kumar, Saket; Chandra, Abhijit; Kulkarni, Rugved; Maurya, Ajeet Pratap; Gupta, Vishal

    2017-06-22

    Endoscopic biliary stenting is a common procedure in routine gastroenterology practice. Plastic stents are the most common type of stents used and are indicated mainly for short-term biliary drainage. Prolonged indwelling plastic stents can result in disastrous complications. We conducted a retrospective analysis of patients who presented with complications of forgotten biliary stents in a tertiary care hospital during January 2010 to October 2016. All patients were managed either by endoscopic or surgical means. Details of these patients were obtained from departmental patient database, endoscopy records, and surgical register. A total of 21 cases of retained biliary stents were managed in the study period and their outcome was analyzed. The median age was 47 years (range 17-70 years) and 17 (80.9%) patients were female. Primary indication of biliary stenting was stone disease in 76.2% (n = 16), while benign biliary stricture accounted for 19% of cases (n = 4). Mean duration at presentation to hospital after ERCP stenting was 3.53 years (range 1-14 years), with cholangitis being the most common presentation (66.67%). Definitive endoscopic treatment for forgotten stent and its associated complication was possible only in five patients (23.8%); in remaining 16 (76.2%) cases, surgical exploration was required. Despite life-threatening complications and major surgical interventions, no mortality was recorded. Instances of forgotten biliary stents presenting with serious complications are not uncommon in Indian setup. Patients either ignore advice for timely stent removal or are unaware of the presence of endoprosthesis or need for removal. Adequate patient counseling, information, and proper documentation are essential to avoid this condition.

  9. Iliocaval Confluence Stenting for Chronic Venous Obstructions

    Energy Technology Data Exchange (ETDEWEB)

    Graaf, Rick de, E-mail: r.de.graaf@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Wolf, Mark de, E-mail: markthewolf@gmail.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Sailer, Anna M., E-mail: anni.sailer@mumc.nl [Maastricht University Medical Centre (MUMC), Department of Radiology (Netherlands); Laanen, Jorinde van, E-mail: jorinde.van.laanen@mumc.nl; Wittens, Cees, E-mail: c.wittens@me.com [Maastricht University Medical Centre (MUMC), Department of Surgery (Netherlands); Jalaie, Houman, E-mail: hjalaie@ukaachen.de [University Hospital Aachen, Department of Surgery (Germany)

    2015-10-15

    PurposeDifferent techniques have been described for stenting of venous obstructions. We report our experience with two different confluence stenting techniques to treat chronic bi-iliocaval obstructions.Materials and MethodsBetween 11/2009 and 08/2014 we treated 40 patients for chronic total bi-iliocaval obstructions. Pre-operative magnetic resonance venography showed bilateral extensive post-thrombotic scarring in common and external iliac veins as well as obstruction of the inferior vena cava (IVC). Stenting of the IVC was performed with large self-expandable stents down to the level of the iliocaval confluence. To bridge the confluence, either self-expandable stents were placed inside the IVC stent (24 patients, SECS group) or high radial force balloon-expandable stents were placed at the same level (16 patients, BECS group). In both cases, bilateral iliac extensions were performed using nitinol stents.ResultsRecanalization was achieved for all patients. In 15 (38 %) patients, a hybrid procedure with endophlebectomy and arteriovenous fistula creation needed to be performed because of significant involvement of inflow vessels below the inguinal ligament. Mean follow-up was 443 ± 438 days (range 7–1683 days). For all patients, primary, assisted-primary, and secondary patency rate at 36 months were 70, 73, and 78 %, respectively. Twelve-month patency rates in the SECS group were 85, 85, and 95 % for primary, assisted-primary, and secondary patency. In the BECS group, primary patency was 100 % during a mean follow-up period of 134 ± 118 (range 29–337) days.ConclusionStenting of chronic bi-iliocaval obstruction shows relatively high patency rates at medium follow-up. Short-term patency seems to favor confluence stenting with balloon-expandable stents.

  10. 电子支气管镜下覆膜气道支架置入术治疗肿瘤性食管气管瘘的护理%Nursing of electronic bronchoscope covered airway stent placement for the treatment of malignant esophageal fistula

    Institute of Scientific and Technical Information of China (English)

    杨柳

    2012-01-01

    目的:探讨在电子支气管镜下进行覆膜气道支架置入术对治疗肿瘤性食管气管瘘患者的手术前、手术中及手术后的方法,以提高肿瘤性食管气管瘘的患者的生活质量及延长生存时间,减少术后的并发症.方法:通过积极的术前护理,局部麻醉,术中配合,及术中心电、血压、指脉氧监测,注重术后护理和并发症的预防.结果:32例肿瘤性食管气管瘘患者均放置成功,覆膜气道支架置入术后,呛咳及肺部感染情况明显好转,生活质量明显提高,术后呼吸困难改善,未发生大咯血及支架移位等严重并发症.结论:积极的术前准备和心理护理,术中的严密监护和积极配合,减少并发症的发生是电子支气管镜下覆膜气道支架置入术成功的关键.%Objective: To investigate the metheds of preoperative, intraoperative, and postoperative care in the treatment of neoplastic esophagotracheal fistula surgery by the airway membrana tectoria cochleae stents, in order to improve the quality of life and prolong survival time of patients with neoplastic esophagotracheal fistula,reduce postoperative complication. Methods: We investigated the effect of nursing through positive preoperative nursing,local anesthesia,operative cooperation,monitoring with the intraoperative electrocardiogram,blood pressure,oxygen saturation,positive post -operative nursing,and the prevention of complications. Results: All 32 cases of neoplastic esophagotracheal fistula patients were successfully placed airway stents. after these operation, we found excellent nursing could markedly reduce cough and lung infections,significantly improve the quality of life,improve the postoperative respiratory difficulties , eliminate the occurrence of massive hemoptysis and stent migration. Conclusion: Through positive preoperative preparation and psychological nursing, intensive intraoperative care and actively operative cooperation,and the prevention of

  11. Evaluation of the Anti-migration Effect of Barbed Prostatic Stents: In Vitro Study in Urethra-mimicking Bovine Pericardium Phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Na, Han Kyu, E-mail: hankyu1324@empas.com; Song, Ho-Young, E-mail: hysong@amc.seoul.kr; Kim, Jin Hyoung, E-mail: m1fenew@hanmail.net [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of); Nam, Deok Ho, E-mail: namjindan@paran.com [Kyung Hee University Hospital at Gangdong, School of Medicine, Kyung Hee University, Department of Radiology (Korea, Republic of); Park, Jung-Hoon, E-mail: jhparkz@amc.seoul.kr [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Asan Medical Center (Korea, Republic of); Jeong, In Gab, E-mail: uroman2000@yahoo.co.kr; Kim, Choung-Soo, E-mail: cskim@amc.seoul.kr [University of Ulsan College of Medicine, Department of Urology, Asan Medical Center (Korea, Republic of)

    2013-02-15

    This study was designed to compare the migration rates of covered stents with eight, four, and zero barbs in urethra-mimicking bovine pericardium models. Three types of polytetrafluoroethylene-covered retrievable self-expandable prostatic stents, with eight, four, and zero barbs, were tested in bovine pericardium models, consisting of normal saline-filled acrylic containers with tubes at both ends and a replica of the human urethra. The barbs were 2 mm in length and projected 60 Degree-Sign toward the urinary bladder. The anti-migration force (AMF) and resistance force against stent removal (RFSR) were measured by an automatic push-pull gauge system at a fixed rate (2 mm/s). Significant differences in AMF among the three stent types were detected (P < 0.001). Median AMF was far greater for eight-barbed than for four-barbed stents (11.96 vs. 7.55 N, P = 0.003). For stent removal, the difference between 4- and 8-barbed stents were not significant in median static (5.54 vs. 6.08 N, P = 0.15) or sliding (prostatic urethra, 5.32 vs. 5.59 N, P = 0.65; membranous urethra, 7.78 vs. 8.57 N, P = 0.364) RFSR. No perforations or scratched traces were observed during removal of these stents. The inclusion of eight barbs projecting 60 Degree-Sign toward the urinary bladder were not only effective against stent migration in this model but suggests that these stents may be suitable for the treatment of prostatic urethral strictures without severely irritating the tissue. However, whether these results translate into living urethral tissue is unclear, necessitating further studies.

  12. PTFE纤维制备技术的研究进展%Research progress in PTFE fiber manufacturing technology

    Institute of Scientific and Technical Information of China (English)

    张天; 胡祖明; 于俊荣; 陈蕾; 诸静; 王亓超

    2012-01-01

    介绍了聚四氟乙烯(PTFE)纤维的结构和物理化学性能;详述了PTFE纤维制备技术,如载体纺丝(湿法纺丝、干法纺丝)、糊料挤出纺丝、熔体纺丝、切割膜裂法等纺丝工艺,比较了各种纺丝工艺的优缺点,载体纺丝法制备PTFE纤维技术较为成熟,可制备线密度较小的纤维;叙述了PTFE纤维在过滤材料、医学材料、密封填料和纺织工业等方面的应用;指出我国PTFE纤维发展的关键是改进及开发新的制备技术,提高PTFE纤维的质量及产量.%The structure and physical and chemical properties of polytetrafluoroethylene (PTFE) fiber were introduced. Hie manufacturing techniques for PTFE fiber were described in details, including carrier spinning (wet spinning and dry spinning), paste extrusion spinning, melt spinning, fissure spinning. The advantages and disadvantages of these spinning techniques were compared. Carrier spinning process was a mature technique for PTFE fiber,especially for low-linear density fiber. The application of PTFE fiber was described in the fields of filtration material, medical material, sealing packing and textile industry. It was pointed out that the key to China PTFE fiber development should be the innovation and development of novel manufacturing techniques and the improvement of PTFE fiber quality and output.

  13. Investigating the feasibility of using a grit blasting process to coat nitinol stents with hydroxyapatite.

    Science.gov (United States)

    Keady, F; Murphy, B P

    2013-01-01

    This study investigates the feasibility of utilising a grit blasting process to coat three nitinol substrates (a planer 2D surface, a circular wire and a cardiovascular stent geometry) with a hydroxyapatite coating. Surface characteristics of the coating on the three substrates were determined and additionally the durability of the coating post fatigue testing was analysed. The coating process resulted in a consistent covering of the substrate that resulted in an extremely hydrophilic stent surface. The surface roughness was dependant on grit blasting particle size. A general trend of smaller particle size resulted in a lower surface roughness, while particle size did not have an effect on the hydroxyapatite coating thickness. Fatigue integrity tests that simulated 16 months implantation demonstrated minimal damage to the coating. In conclusion we demonstrated the initial feasibility of using a grit blasting method to produce a consistent, hydrophilic, and durable HAp stent coating that has the capability of incorporating a drug eluting function.

  14. INTRAVASCULAR ULTRASOUND EVALUATING CORONARY STENTS FOR PATIENTS WITH CORONARY ARTERY DISEASE: COMPARED OLD WITH NEW MULTILINK STENTS

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Objective.It was suggested that coronary stent design and coating may affect stent performance and hence induce varying degrees of thrombogenesis and neointimal hyperplasia.The purpose of this study is to compare the 6 month follow up results between old and new Multilink stents with the method of intravascular ultrasound (IVUS) imaging.Methods.We have performed old (n=40) and new (n=35) Multilink stent implantations on 75 patients with coronary artery disease.Coronary angiography was performed before,immediately after,and 6 months after the in stent procedure respectively.Six month follow up IVUS imaging was performed and analyzed off line.Results.Minimal lumen cross sectional area (CSA) of new Multilink stents was significantly larger than that of old Multilink stents (P=0.0053).Mean stent lumen area of new Multilink stents was significantly larger than that of old Multilink stents (P=0.040).Similarly,minimal lumen diameter (MLD) of new Multilink stents was larger than that of old Multilink stents (P= 0.011).Old Multilink stents had a higher percentage of plaque area than new Multilink stents.Conclusion.The new Multilink stent is obviously superior to old Multilink stents,in particular,in the stent MLD and lumen CSA- - major determinants of the restenosis.

  15. Compliance Study of Endovascular Stent Grafts Incorporated with Polyester and Polyurethane Graft Materials in both Stented and Unstented Zones

    Directory of Open Access Journals (Sweden)

    Ying Guan

    2016-08-01

    Full Text Available Compliance mismatch between stent graft and host artery may induce complications and blood flow disorders. However, few studies have been reported on stent graft compliance. This study aims to explore the deformation and compliance of stent graft in stented and unstented zones under three pressure ranges. Compliance of two stent grafts incorporated with polyurethane graft (nitinol-PU and polyester graft (nitinol-PET materials respectively were tested; the stents used in the two stent grafts were identical. For the circumferential deformation of the stent grafts under each pressure range, the nitinol-PET stent graft was uniform in both zones. The nitinol-PU stent graft was circumferentially uniform in the stented zone, however, it was nonuniform in the unstented zone. The compliance of the PU graft material was 15 times higher than that of the PET graft. No significant difference in compliance was observed between stented and unstented zones of the nitinol-PET stent graft regardless of the applied pressure range. However, for the nitinol-PU stent graft, compliance of the unstented PU region was approximately twice that of the stented region; thus, compliance along the length of the nitinol-PU stent graft was not constant and different from that of the nitinol-PET stent graft.

  16. Coronary artery stent geometry and in-stent contrast attenuation with 64-slice computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Schepis, Tiziano; Koepfli, Pascal; Gaemperli, Oliver; Eberli, Franz R.; Luescher, Thomas F. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Leschka, Sebastian; Desbiolles, Lotus; Husmann, Lars; Wildermuth, Simon; Marincek, Borut; Alkadhi, Hatem [University Hospital Zurich, Institute of Diagnostic Radiology, Zurich (Switzerland); Kaufmann, Philipp A. [University Hospital Zurich, Cardiovascular Center, Zurich (Switzerland); Zurich Center for Integrative Human Physiology, Zurich (Switzerland)

    2007-06-15

    We aimed at assessing stent geometry and in-stent contrast attenuation with 64-slice CT in patients with various coronary stents. Twenty-nine patients (mean age 60 {+-} 11 years; 24 men) with 50 stents underwent CT within 2 weeks after stent placement. Mean in-stent luminal diameter and reference vessel diameter proximal and distal to the stent were assessed with CT, and compared to quantitative coronary angiography (QCA). Stent length was also compared to the manufacturer's values. Images were reconstructed using a medium-smooth (B30f) and sharp (B46f) kernel. All 50 stents could be visualized with CT. Mean in-stent luminal diameter was systematically underestimated with CT compared to QCA (1.60 {+-} 0.39 mm versus 2.49 {+-} 0.45 mm; P < 0.0001), resulting in a modest correlation of QCA versus CT (r = 0.49; P < 0.0001). Stent length as given by the manufacturer was 18.2 {+-} 6.2 mm, correlating well with CT (18.5 {+-} 5.7 mm; r = 0.95; P < 0.0001) and QCA (17.4 {+-} 5.6 mm; r = 0.87; P < 0.0001). Proximal and distal reference vessel diameters were similar with CT and QCA (P = 0.06 and P = 0.03). B46f kernel images showed higher image noise (P < 0.05) and lower in-stent CT attenuation values (P < 0.001) than images reconstructed with the B30f kernel. 64-slice CT allows measurement of coronary artery in-stent density, and significantly underestimates the true in-stent diameter compared to QCA. (orig.)

  17. The conical stent in coronary artery improves hemodynamics compared with the traditional cylindrical stent.

    Science.gov (United States)

    Yu, Yi; Zhou, Yujie; Ma, Qian; Jia, Shuo; Wu, Sijing; Sun, Yan; Liu, Xiaoli; Zhao, Yingxin; Liu, Yuyang; Shi, Dongmei

    2017-01-15

    This study sought to explore the efficacy of the conical stent implantation in the coronary artery by comparing the effects of cylindrical and conical stents on wall shear stress (WSS) and velocity of flow and fractional flow reserve (FFR). The traditional cylindrical stent currently used in the percutaneous coronary intervention (PCI) has a consistent diameter, which does not match the physiological change of the coronary artery. On the contrary, as a new patent, the conical stent with tapering lumen is consistent with the physiological change of vascular diameter. However, the effect of the conical stent implantation on the coronary hemodynamics remains unclear. The coronary artery, artery stenosis and two stent models were established by Solidworks software. All models were imported into the computational fluid dynamics (CFD) software ANSYS ICEM-CFD to establish the fluid model. After the boundary conditions were set, CFD analysis was proceeded to compare the effects of two stent implantation on the change of WSS, velocity of flow and FFR. Hemodynamic indexes including FFR, blood flow velocity distribution (BVD) and WSS were improved by either the cylindrical or the conical stent implantation. However, after the conical stent implantation, the change of FFR seemed to be slower and more homogenous; the blood flow velocity was more appropriate without any obvious blood stagnation and direction changes; the WSS after the conical stent implantation was uniform from the proximal to distal side of the stent. Compared with the cylindrical stent, the conical stent implantation in the coronary artery can make the changes of vascular hemodynamic more closer to the physiological condition, which can reduce the incidence of intra-stent restenosis and thrombosis, thus making it more suitable for PCI therapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Crush stenting in treating coronary bifurcate lesions: paclitaxel eluting stents versus sirolimus eluting stents

    Institute of Scientific and Technical Information of China (English)

    CHEN Shao-liang; SUN Xue-wen; HU Da-yi; Tak W. Kwan; ZHANG Jun-jie; YE Fei; CHEN Yun-dai; ZHU Zhong-sheng; LIN Song; TIAN Nai-liang; LIU Zhi-zhong; FANG Wei-yi

    2008-01-01

    Background Because no data regarding the comparison of crush stenting with pactitaxel(PES)or sirolimus eluting stents(SES)for coronary bifurcate lesions have been reported,we compared the clinical outcomes of these two types of stents.Methods Two hundred and thirty patients with 242 bifurcate lesions were enrolled in a prospective,nonrandomized trial.Primary endpoints included myocardial infarction,cardiac death and target vessel revascularization at 8 months.Results All patients were followed up clinically and 82%angiographically at 8 months.Final kissing balloon inflation was performed in 72%in the PES and 75%in the SES groups(P>0.05).Compared to the SES group,PES group had a higher late loss and incidence of restenosis(P=0.04)in the prebifurcation vessel segment.The postbifurcation vessel segment in the PES group had a greater late loss((0.7+0.6)mm vs(0.3±0.4)mm,P<0.001)and higher restenosis in the side branch(25.5%vs 15.6%,P=0.04)when compared to the SES group.There was significant difference of insegment restenosis in the entire main vessel between PES and SES groups (P=0.004).Target lesion revascularization was more frequently seen in the PES group as compared to the SES group(P=0.01).There was significant difference in the accumulative MACE between these two groups(P=0.01).The survival rate free from target lesion revascularization was significantly higher in the SES group when compared to the PES group(P<0.001).Conclusion SES is superior to PES in reducing restenosis and target lesion revascularization by 8-month follow-up after crush stenting for bifurcate lesions.

  19. 黏接压力对PTFE/Kevlar双层织物摩擦磨损性能的影响%Effects of Bonding Pressure on Friction and Wear Properties of PTFE/Kevlar Double Fabric

    Institute of Scientific and Technical Information of China (English)

    刘宇飞; 尹忠慰; 蒋丹; 李虎林; 霍亚军

    2015-01-01

    通过PTFE(聚四氟乙烯)/Kevlar双层织物与GCr15钢制金属盘的黏接试验,研究黏接面经过喷砂处理后,黏接压力对PTFE/Kevlar双层织物摩擦磨损性能的影响.结果表明:黏接压力为0.30 MPa时,PTFE/Kevlar双层织物的摩擦因数和磨损率最低,润滑性能和耐磨性能最好;同时,与黏接压力为0.10及0.20 MPa时相比,黏接压力为0.30及0.40 MPa时,PTFE/Kevlar双层织物的摩擦因数与磨损率的一致性较好,故适当提高黏接压力有利于提高PTFE/Kevlar双层织物摩擦磨损性能的稳定性.

  20. Double layered self-expanding metal stents for malignant esophageal obstruction, especially across the gastroesophageal junction

    Institute of Scientific and Technical Information of China (English)

    Min Dae Kim; Su Bum Park; Dae Hwan Kang; Jae Hyung Lee; Cheol Woong Choi; Hyung Wook Kim; Chung Uk Chung

    2012-01-01

    AIM:TO evaluate the clinical outcomes of double-layered self-expanding metal stents (SEMS) for treatment of malignant esophageal obstruction according to whether SEMS crosses the gastroesophageal junction (GEJ).METHODS:Forty eight patients who underwent the SEMS insertion for malignant esophageal obstruction were enrolled.Patients were classified as GEJ group (SEMS across GEHm 18 patients) and non-GEJ group (SEMS above GEJ,30 patients) according to SEMS position.Double layered (outer uncovered and inner covered stent) esophageal stents were placed.RESULTS:The SEMS insertion and the clinical improvement were achieved in all patients in both groups.Stent malfunction occurred in seven patients in the GEJ group and nine patients in the non-GEJ group.Tumor overgrowth occurred in five and eight patients,respectively,food impaction occurred in one patient in each group,and stent migration occurred in one and no patient,respectively.There were no significant differences between the two groups.Reflux esophagitis occurred more frequently in the GEJ group (eight vs five patients,P =0.036) and was controlled by proton pump inhibitor.Aspiration pneumonia occurred in zero and five patients,respectively,and tracheoesophageal fistula occurred in zero and two patients,respectively.CONCLUSION:Double-layered SEMS are a feasible and effective treatment when placed across the GEJ for malignant esophageal obstruction.Double-layered SEMS provide acceptable complications,especially migration,although reflux esophagitis is more common in the GEJ group.

  1. ALD mediated heparin grafting on nitinol for self-expanded carotid stents.

    Science.gov (United States)

    Wang, Fei; Zhang, Yan; Chen, Xiumian; Leng, Bing; Guo, Xin; Zhang, Tao

    2016-07-01

    Carotid-artery atherosclerosis is a common cause of ischemic stroke. Carotid-artery stenting (CAS) is one of the most effective treatments. However, In-stent restenosis (ISR) and re-endothelialization delay are two major issues of intravascular stent which affect clinical safety and reduce effects. In this study, atomic layer deposition (ALD) technology was applied to deposit a layer (10nm) of Al2O3 on Nitinol surface as an intermediate functional layer. The alumina covered surface was then modified with a coupling agent 3-aminopropyltriethoxysilane (APS) and heparin sequentially in order to improve the hemocompatibility of Nitinol stents. The successful graft of APS and heparin onto Nitinol was proven by X-ray photoelectron spectroscopy. Furthermore, the predicted improvement in the biocompatibilities of modified Nitinol was confirmed by water contact angle measurement, protein adsorption, platelet adhesion, and plasma recalcification time determination. The results of hemolysis assay, cell proliferation and cytotoxicity tests revealed that the grafting of heparin on NiTi kept the original positive performance of nitinol material. The results indicate that ALD technology is of great potential for the manufacture of medical devices, especially for surface modifications and functionalization. ALD technology can help with modifications of inert metallic surfaces and therefore benefit implantable medical devices, especially intravascular stents.

  2. Structural Evaluation of Radially Expandable Cardiovascular Stents Encased in a Polyurethane Film

    Science.gov (United States)

    Trigwell, Steve; De, Samiran; Sharma, Rajesh; Mazumder, Malay K.; Mehta, Jawahar L.

    2004-01-01

    A method of encasing cardiovascular stents with an expandable polyurethane coating has been developed to provide a smooth homogeneous inner wall allowing for a confluent growth of endothelial cells. In this design, the metal wire stent structure is completely covered by the polyurethane film minimizing biocorrosion of the metal (stainless steel or nitinol), and providing a homogeneous surface for surface treatment and incorporation of various eluting drugs to prevent platelet aggregation while supporting endothelialization. The polyurethane surface was treated with a helium plasma for sterilization and promotes growth of cells. The paper details the performance of the coated film to expand with the metal stent up to 225 % during deployment. We present stress/strain behavior of polyurethane films, and subsequent plasma treatment of the surface and the adhesion of the coating to the stent structure upon expansion. A film of less than 25 tm was found to be sufficient for corrosion resistance and flexibility without producing any excess stress on the stent structure. Straining the film to 225 % and plasma modification did not affect the mechanical and surface properties while allowing for improved biocompatibility as determined by the critical surface tension, surface chemistry, and roughness.

  3. Dosimetry of beta particles using Li:Mg, Cu, P + Ptfe; Dosimetria de particulas beta usando Li: Mg, Cu, P + Ptfe

    Energy Technology Data Exchange (ETDEWEB)

    Olvera, L.; Azorin, J.; Rivera, T. [Depto. de Fisica, UAM-I, 09340 Mexico D.F. (Mexico)

    2003-07-01

    This paper presents the experimental results of determining the thermoluminescence (Tl) response of LiF: Mg, Cu, P + Ptfe pellets excited with {sup 90}Sr/{sup 90}Y beta radiation. The glow curve exhibited three peaks which appear at 121 C, 178 C and 217 C . Its relative sensitivity is 49 with respect to that of the TLD-100 dosemeter taken as a reference. The minimal dose that could be measured was 750 mGy. The Tl response as a function of dose was linear in the range of 0.7 mGy to 22.5 mGy. The study of the repeatability of the information contained in the pellets showed a standard deviation of 2 %. (Author)

  4. Microfabrication and nanotechnology in stent design.

    Science.gov (United States)

    Martinez, Adam W; Chaikof, Elliot L

    2011-01-01

    Intravascular stents were first introduced in the 1980s as an adjunct to primary angioplasty for management of early complications, including arterial dissection, or treatment of an inadequate technical outcome due to early elastic recoil of the atherosclerotic lesion. Despite the beneficial effects of stenting, persistent high rates of restenosis motivated the design of drug-eluting stents for delivery of agents to limit the proliferative and other inflammatory responses within the vascular wall that contribute to the development of a restenotic lesion. These strategies have yielded a significant reduction in the incidence of restenosis, but challenges remain, including incomplete repair of the endothelium at the site of vascular wall injury that may be associated with a late risk of thrombosis. A failure of vessel wall healing has been attributed primarily to the use of polymeric stent coatings, but the effects of the eluted drug and other material properties or design features of the stent cannot be excluded. Improvements in stent microfabrication, as well as the introduction of alternative materials may help to address those limitations that inhibit stent performance. This review describes the application of novel microfabrication processes and the evolution of new nanotechnologies that hold significant promise in eliminating existing shortcomings of current stent platforms.

  5. Stent placement for esophageal strictures : an update

    NARCIS (Netherlands)

    Hirdes, Meike Madeleine Catharine; Vleggaar, Frank Paul; Siersema, Peter Derk

    2011-01-01

    The use of stents for esophageal strictures has evolved rapidly over the past 10 years, from rigid plastic tubes to flexible self-expanding metal (SEMS), plastic (SEPS) and biodegradable stents. For the palliative treatment of malignant dysphagia both SEMS and SEPS effectively provide a rapid relief

  6. Rescue coronary stenting in acute myocardial infarction

    Science.gov (United States)

    Barbieri, Enrico; Meneghetti, Paolo; Molinari, Gionata; Zardini, Piero

    1996-01-01

    Failed rescue coronary angioplasty is a high risk situation because of high mortality. Coronary stent has given us the chance of improving and maintaining the patency of the artery. We report our preliminary experience of rescue stenting after unsuccessful coronary angioplasty.

  7. 21 CFR 876.4620 - Ureteral stent.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Ureteral stent. 876.4620 Section 876.4620 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES GASTROENTEROLOGY-UROLOGY DEVICES Surgical Devices § 876.4620 Ureteral stent. (a) Identification. A ureteral...

  8. Routine intraoperative stenting for renal transplant recipients.

    Science.gov (United States)

    Wilson, Colin H; Bhatti, Aftab A; Rix, David A; Manas, Derek M

    2005-10-15

    Major urological complications (MUCs) after kidney transplantation contribute to patient morbidity and compromise graft function. Ureteric stents have been successfully used to treat such complications and a number of centers have adopted a policy of universal prophylactic stenting, at the time of graft implantation, to reduce the incidence of urine leaks and ureteric stenosis. In conjunction with the Cochrane Renal Group we searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, reference lists of articles, books and abstracts and contacted companies, authors and experts to identify randomized controlled trials examining the use of stents in renal transplantation. The primary outcome was the incidence of MUCs and data on this statistic was pooled and analyzed using a random effects model. Seven randomized controlled trials (1154 patients) of low or moderate quality were identified. The incidence of MUCs was significantly reduced (relative risk [RR] 0.24; 95% CI: 0.07 - 0.77; P=0.02; number needed to treat = 13) by prophylactic ureteric stenting. Urinary tract infections were more common in stented patients (RR 1.49), unless the patients were prescribed 480 mg cotrimoxazole once daily. With this antibiotic regime the incidence of infection was equivalent between the two groups (RR 0.97). Stents appeared generally well tolerated, although trials using longer stents (> or = 20 cm) for longer periods of time (>6 weeks) reported more problems with encrustation and migration. Universal prophylactic stenting reduces the incidence of MUCs and should be recommended on the basis of currently available randomized controlled trials.

  9. Drug eluting stents: Current status and new developments

    NARCIS (Netherlands)

    G. Ertaş; H.M.M. van Beusekom (Heleen)

    2012-01-01

    textabstractDespite the favorable impact of drug eluting stents on stent restenosis, their long-term reliability is considered worrisome by some because of stent thrombosis. Often attributed to adverse reactions to the stent platform, both the drugs and polymer characteristics have been further adva

  10. Bacterial colonization of double J stents and bacteriuria frequency

    Directory of Open Access Journals (Sweden)

    Berat Cem Ozgur

    2013-12-01

    Full Text Available Stents and catheters are widely used in urology. In this study, the frequency of double J (DJ stent colonization and stent-associated bacteriuria was investigated. Between June 2011 and June 2012, 130 patients (17–72 years old who underwent DJ stenting were enrolled in the study. Surgeries prior to stenting included stone extraction/lithotripsy, endopyelotomy, and diagnostic ureteroscopy. Prior to stenting, sterile urine samples were obtained, and urinary cultures were performed upon removal of the DJ stents, the second procedure. DJ stent cultures were also performed. Sixty-three stents were inserted into the right ureter and 67 into the left ureter of the patients. Cultures showed bacterial colonization in 10 (7.7% cases. There was no significant association between positive stent culture and patient age, sex, or stent laterality. The rate of colonization was 2.2%, 2.9%, and 25% when indwelling time was less than 4 weeks, 4–6 weeks, and more than 6 weeks, respectively. In the present study, the rate of infection associated with a DJ stent and urinary infection was not very high. However, bacterial colonization increases significantly with indwelling time of the stent, and sterile culture of urine does not rule out colonization of the stent. Bacteriological investigation showed very low rates of colonization within 6 weeks after the insertion of stents, indicating that ureteral stents can be used safely within that time period.

  11. Drug eluting stents: Current status and new developments

    NARCIS (Netherlands)

    G. Ertaş; H.M.M. van Beusekom (Heleen)

    2012-01-01

    textabstractDespite the favorable impact of drug eluting stents on stent restenosis, their long-term reliability is considered worrisome by some because of stent thrombosis. Often attributed to adverse reactions to the stent platform, both the drugs and polymer characteristics have been further

  12. Mesenchymal stem cell seeding promotes reendothelialization of the endovascular stent.

    Science.gov (United States)

    Wu, Xue; Wang, Guixue; Tang, Chaojun; Zhang, Dechuan; Li, Zhenggong; Du, Dingyuan; Zhang, Zhengcai

    2011-09-01

    This study is designed to make a novel cell seeding stent and to evaluate reendothelialization and anti-restenosis after the stent implantation. In comparison with cell seeding stents utilized in previous studies, Mesenchymal stem cells (MSCs) have advantages on promoting of issue repair. Thus it was employed to improve the reendothelialization effects of endovascular stent in present work. MSCs were isolated by density gradient centrifugation and determined as CD29(+) CD44(+) CD34(-) cells by immunofluorescence and immunocytochemistry; gluten and polylysine coated stents were prepared by ultrasonic atomization spray, and MSCs seeded stents were made through rotation culture according to the optimized conditions that were determined in previous studies. The results from animal experiments, in which male New Zealand white rabbits were used, show that the reendothelialization of MSCs coated stents can be completed within one month; in comparison with 316L stainless steel stents (316L SS stents) and gluten and polylysine coated stents, the intimal hyperplasia and in-stent restenosis are significantly inhibited by MSCs coated stents. Endovascular stent seeded with MSCs promotes reendothelialization and inhibits the intimal hyperplasia and in-stent restenosis compared with the 316L SS stents and the gluten and polylysine coated stents.

  13. Promoting endothelial recovery and reducing neointimal hyperplasia using sequential-like release of acetylsalicylic acid and paclitaxel-loaded biodegradable stents

    Directory of Open Access Journals (Sweden)

    Lee CH

    2014-08-01

    Full Text Available Cheng-Hung Lee,1,2 Chia-Ying Yu,2 Shang-Hung Chang,1 Kuo-Chun Hung,1 Shih-Jung Liu,2 Chao-Jan Wang,3 Ming-Yi Hsu,3 I-Chang Hsieh,1 Wei-Jan Chen,1 Yu-Shien Ko,1 Ming-Shien Wen1 1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital-Linkou, Tao-Yuan, Taiwan; 2Department of Mechanical Engineering, Chang Gung University, Tao-Yuan, Taiwan; 3Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan Introduction: This work reports on the development of a biodegradable dual-drug-eluting stent with sequential-like and sustainable drug-release of anti-platelet acetylsalicylic acid and anti-smooth muscle cell (SMC proliferative paclitaxel.Methods: To fabricate the biodegradable stents, poly-L-lactide strips are first cut from a solvent-casted film. They are rolled onto the surface of a metal pin to form spiral stents. The stents are then consecutively covered by acetylsalicylic acid and paclitaxel-loaded polylactide-polyglycolide nanofibers via electrospinning.Results: Biodegradable stents exhibit mechanical properties that are superior to those of metallic stents. Biodegradable stents sequentially release high concentrations of acetylsalicylic acid and paclitaxel for more than 30 and 60 days, respectively. In vitro, the eluted drugs promote endothelial cell numbers on days 3 and 7, and reduce the proliferation of SMCs in weeks 2, 4, and 8. The stents markedly inhibit the adhesion of platelets on days 3, 7, and 14 relative to a non-drug-eluting stent. In vivo, the implanted stent is intact, and no stent thrombosis is observed in the stent-implanted vessels without the administration of daily oral acetylsalicylic acid. Promotion of endothelial recovery and inhibition of neointimal hyperplasia are also observed on the stented vessels.Conclusion: The work demonstrates the efficiency and safety of the biodegradable dual-drug-eluting stents with sequential and sustainable drug release

  14. Foreign body contamination during stent implantation.

    Science.gov (United States)

    Whelan, D M; van Beusekom, H M; van der Giessen, W J

    1997-03-01

    The treatment of coronary artery disease using stents has become a widely accepted technique. However, the inadvertent co-implantation of contaminating factors with the stent has received little attention. We studied histological cross-sections of stented porcine coronary arteries and observed contamination of some vessels with surgical glove powder and textile fibres. The contaminating particles were associated with a foreign body reaction. Such a reaction could delay the wound-healing response of a stented vessel and thereby prolong the period in which subacute thrombosis could occur. It is also proposed that air contamination could affect the thrombogenicity of the stent. Appropriate measures should be followed to reduce the chance of contamination occurring.

  15. Atrial septal stenting - How I do it?

    Directory of Open Access Journals (Sweden)

    Kothandam Sivakumar

    2015-01-01

    Full Text Available A wide atrial communication is important to maintain hemodynamics in certain forms of congenital and acquired heart defects. In comparison to balloon septostomy or blade septostomy, atrial septal stenting provides a controlled, predictable, and long-lasting atrial communication. It often needs a prior Brockenbrough needle septal puncture to obtain a stable stent position. A stent deployed across a previously dilated and stretched oval foramen or tunnel form of oval foramen carries higher risk of embolization. This review provides technical tips to achieve a safe atrial septal stenting. Even though this is a "How to do it article," an initial discussion about the indications for atrial septal stenting is vital as the resultant size of the atrial septal communication should be tailored for each indication.

  16. Balloon-expandable Metallic Stents for Airway Diseases.

    Science.gov (United States)

    Ohki, Takashi; Sugimoto, Seiichiro; Kurosaki, Takeshi; Otani, Shinji; Miyoshi, Kentaroh; Yamane, Masaomi; Miyoshi, Shinichiro; Oto, Takahiro

    2016-10-01

    Stent placement is an essential treatment for airway diseases. Although self-expandable metallic stents and silicone stents are commonly applied for the treatment of airway diseases, these stents are unsuitable for the treatment of small airway diseases encountered in pediatric patients and lung transplant recipients with airway complications. Currently, only vascular balloon-expandable metallic stents are available for the treatment of small airway diseases; however, little research has been conducted on the use of these stents in this field. We have launched a prospective feasibility study to clarify the safety and efficacy of balloon-expandable metallic stents for the treatment of airway diseases.

  17. Call for standards in technical documentation of intracoronary stents.

    Science.gov (United States)

    Lanzer, Peter; Gijsen, Frank J H; Topoleski, L D Timmie; Holzapfel, Gerhard A

    2010-01-01

    At present, the product information of intracoronary stents provided by the industry contains only limited technical data restricting judgments on the in vivo performance of individual products. Available experimental and clinical evidence suggests that interventional target sites display highly heterogeneous biomechanical behavior needed to be matched by specific stent and stent delivery system characteristics. To allow individualized stent-lesion matching, both, understanding of biomechanical properties of the atherosclerotic coronary artery lesions and expert knowledge of the intracoronary stent systems, are required. Here, the authors review some of the initial data on mechanical properties of coronary artery lesions potentially relevant to stenting and suggest standards for technical documentation of intracoronary stents.

  18. The fabrication, nano/micro-structure, heat- and wear-resistance of the superhydrophobic PPS/PTFE composite coatings.

    Science.gov (United States)

    Wang, Huaiyuan; Zhao, Jingyan; Zhu, Youzhuang; Meng, Yang; Zhu, Yanji

    2013-07-15

    A simple engineering method was used to fabricate stability and wear-resistance of superhydrophobic PPS-based PPS/PTFE surfaces through nano/micro-structure design and modification of the lowest surface energy groups (-CF2-), which was inspired by the biomimic lotus leaves. The hydrophobic properties and wear-resistance of the coatings were measured by a contact angle meter and evaluated on a pin-on-disk friction and wear tester, respectively. Moreover, the surfaces of the PPS/PTFE composite coatings were investigated by means of scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), X-ray diffractometry (XRD), and thermogravimetry (TG) analysis. Results showed that the highest contact angle of the PPS/PTFE surface, with papillae-like randomly distributed double-scale structure, could reach up to 162°. When 1 wt.% PDMS was added, the highest contact angle could hold is 172°. The coatings also retained superhydrophobicity, even under high temperature environment. The investigation also indicated that the coatings were not only superhydrophobic but also oleophobic behavior at room temperature, such as the crude oil, glycerol, and oil-water mixture. The PPS/45%PTFE coatings had more stable friction coefficient and excellent wear-resistance (331,407 cycles) compared with those with less than 45% of PTFE.

  19. Changes in the tribological behavior of an epoxy resin by incorporating CuO nanoparticles and PTFE microparticles

    DEFF Research Database (Denmark)

    Larsen, Thomas Ricco Ølholm; Andersen, Tom Løgstrup; Thorning, Bent

    2008-01-01

    Different amounts of CuD nanoparticles are incorporated into both a neat epoxy resin and into an epoxy resin containing PTFE microparticles. The content of CuD is varied in the range of 0-10 vol.% while the PTFE content is fixed at 7.5 vol.%. The dispersion state of added particles is examined...... of thenano-CuO content. However, both parameters are reduced when PTFE is added. Friction and wear data is collected using a custom-made tribotester of the pin-on-disk type. Measurements are performed under dry-sliding conditions against smooth steel counterfaces. When a pressure-velocity (pv) condition of 0.......25 MPa, 6.0 m1s is applied the following is found: without PTFE, the coefficient of friction (p,) is roughly independent of the nano-CuO content. When PTFE is added, an average reduction in p, of 35% is found in the CuD range of 0-0.4 vol.%. At higher CuD concentrations the friction lowering effect...

  20. Mechanism of Friction and Wear in MoS2 and ZDDP/F-PTFE Greases under Spectrum Loading Conditions

    Directory of Open Access Journals (Sweden)

    Sujay D. Bagi

    2015-12-01

    Full Text Available Two different greases formulated using MoS2 and a combination of ZDDP and functionalized PTFE (F-PTFE were examined under spectrum loading conditions where loads, frequency, and duration of the steps were treated as variables. Combination of ZDDP and F-PTFE were synergistic resulting in a significant reduction in the wear and friction under spectrum loading condition. Decreasing the time step during the ramp up and ramp down cycles resulted in larger wear for the grease containing MoS2 particles in comparison to ZDDP/F-PTFE in grease. The tribofilm formed on the surface was analyzed using various characterization techniques like SEM, EDS, and Stereo Optical Microscopy. Tribofilms from MoS2 additives had extensive amounts of abrasive and adhesive wear and showed the formation of MoS2 on the surface on the other hand the tribofilms from ZDDP/F-PTFE had smaller amounts of severe wear and exhibited patchy tribofilms of Zn-phosphates as well as sulfides of Zn and Fe.

  1. Radiation synthesis and characteristics of PTFE-g-PSSA ion exchange membrane applied in vanadium redox battery

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Radiation-induced grafting of styrene onto polytetrafiuoroethylene (PTFE) membranes was studied by a simultaneous irradiation technique. Grafting was carried out using γ-radiation from a 60Co source at room temperature.Effects of absorbed dose, atmosphere, dose rate, and the concentration of initial monomer on the degree of grafting (DOG) were investigated and the most appropriate grafting condition was obtained. Subsequently, sulphonation of the grafted PTFE membrane (PTFE-g-PS) was carried out and a series of ion exchange membranes (PTFE-g-PSSA) was prepared. Further characterizations of FTIR, TGA, and SEM testified that grafting and sulphonation of the membranes were successfully processed; moreover, grafting of styrene not only occurred in the surface of PTFE membrane, but also in the micropores of the membrane. Ion exchange capacity (IEC) and conductivity were found increase with the grafting yield. The results suggest that at a low dose, such as 17 kGy, the ion exchange membrane (IEM) which will be suitable for vanadium redox battery (VRB) use can be obtained.

  2. Prosthetic bypass for restenosis after endarterectomy or stenting of the carotid artery.

    Science.gov (United States)

    Illuminati, Giulio; Belmonte, Romain; Schneider, Fabrice; Pizzardi, Giulia; Calió, Francesco G; Ricco, Jean-Baptiste

    2017-06-01

    The objective of this study was to evaluate the results of prosthetic carotid bypass (PCB) with polytetrafluoroethylene (PTFE) grafts as an alternative to carotid endarterectomy (CEA) in treatment of restenosis after CEA or carotid artery stenting (CAS). From January 2000 to December 2014, 66 patients (57 men and 9 women; mean age, 71 years) presenting with recurrent carotid artery stenosis ≥70% (North American Symptomatic Carotid Endarterectomy Trial [NASCET] criteria) were enrolled in a prospective study in three centers. The study was approved by an Institutional Review Board. Informed consent was obtained from all patients. During the same period, a total of 4321 CEAs were completed in the three centers. In these 66 patients, the primary treatment of the initial carotid artery stenosis was CEA in 57 patients (86%) and CAS in nine patients (14%). The median delay between primary and redo revascularization was 32 months. Carotid restenosis was symptomatic in 38 patients (58%) with transient ischemic attack (n = 20) or stroke (n = 18). In this series, all patients received statins; 28 patients (42%) received dual antiplatelet therapy, and 38 patients (58%) received single antiplatelet therapy. All PCBs were performed under general anesthesia. No shunt was used in this series. Nasal intubation to improve distal control of the internal carotid artery was performed in 33 patients (50%), including those with intrastent restenosis. A PTFE graft of 6 or 7 mm in diameter was used in 6 and 60 patients, respectively. Distal anastomosis was end to end in 22 patients and end to side with a clip distal to the atherosclerotic lesions in 44 patients. Completion angiography was performed in all cases. The patients were discharged under statin and antiplatelet treatment. After discharge, all of the patients underwent clinical and Doppler ultrasound follow-up every 6 months. Median length of follow-up was 5 years. No patient died, sustained a stroke, or presented with a

  3. Updates on the use of ureteral stents: focus on the Resonance® stent

    Directory of Open Access Journals (Sweden)

    Thomas MT Turk

    2010-12-01

    Full Text Available Manoj V Rao, Anthony J Polcari, Thomas MT TurkDepartment of Urology, Loyola University Medical Center, Maywood, IL, USAAbstract: The Resonance® metallic ureteral stent is one of the latest additions to the urologist’s armamentarium in managing ureteral obstruction. One advantage of this stent over traditional polymer-based stents is resistance to encrustation with stone material, which allows longer dwell times and less frequent exchange procedures. Although exchanging a metallic stent is slightly more complicated than exchanging a polymer stent, the fluoroscopic techniques required are familiar to most urologists. The Resonance stent is also more resistant to compression by external forces, potentially allowing greater applicability in patients with metastatic cancer. Furthermore, the use of this stent in patients with benign ureteral obstruction is shown to be associated with significant cost reduction. Clinical studies on the use of this stent are accumulating and the results are mixed, although Level 1 evidence is lacking. In this article we present a comprehensive review of the available literature on the Resonance metallic ureteral stent.Keywords: resonance, metallic, ureteral, stent, obstruction

  4. Biliary stenting: indications, choice of stents and results: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline.

    Science.gov (United States)

    Dumonceau, J-M; Tringali, A; Blero, D; Devière, J; Laugiers, R; Heresbach, D; Costamagna, G

    2012-03-01

    This article is part of a combined publication that expresses the current view of the European Society of Gastrointestinal Endoscopy about endoscopic biliary stenting. The present Clinical Guideline describes short-term and long-term results of biliary stenting depending on indications and stent models; it makes recommendations on when, how, and with which stent to perform biliary drainage in most common clinical settings, including in patients with a potentially resectable malignant biliary obstruction and in those who require palliative drainage of common bile duct or hilar strictures. Treatment of benign conditions (strictures related to chronic pancreatitis, liver transplantation, or cholecystectomy, and leaks and failed biliary stone extraction) and management of complications (including stent revision) are also discussed. A two-page executive summary of evidence statements and recommendations is provided. A separate Technology Review describes the models of biliary stents available and the stenting techniques, including advanced techniques such as insertion of multiple plastic stents, drainage of hilar strictures, retrieval of migrated stents and combined stenting in malignant biliary and duodenal obstructions.The target readership for the Clinical Guideline mostly includes digestive endoscopists, gastroenterologists, oncologists, radiologists, internists, and surgeons while the Technology Review should be most useful to endoscopists who perform biliary drainage.

  5. Hybrid stent device of flow-diverting effect and stent-assisted coil embolization formed by fractal structure.

    Science.gov (United States)

    Kojima, Masahiro; Irie, Keiko; Masunaga, Kouhei; Sakai, Yasuhiko; Nakajima, Masahiro; Takeuchi, Masaru; Fukuda, Toshio; Arai, Fumihito; Negoro, Makoto

    2016-05-01

    This paper presents a novel hybrid medical stent device. This hybrid stent device formed by fractal mesh structures provides a flow-diverting effect and stent-assisted coil embolization. Flow-diverter stents decrease blood flow into an aneurysm to prevent its rupture. In general, the mesh size of a flow-diverter stent needs to be small enough to prevent blood flow into the aneurysm. Conventional flow-diverter stents are not available for stent-assisted coil embolization, which is an effective method for aneurysm occlusion, because the mesh size is too small to insert a micro-catheter for coil embolization. The proposed hybrid stent device is capable of stent-assisted coil embolization while simultaneously providing a flow-diverting effect. The fractal stent device is composed of mesh structures with fine and rough mesh areas. The rough mesh area can be used to insert a micro-catheter for stent-assisted coil embolization. Flow-diverting effects of two fractal stent designs were composed to three commercially available stent designs. Flow-diverting effects were analyzed using computational fluid dynamics (CFD) analysis and particle image velocimetry (PIV) experiment. Based on the CFD and PIV results, the fractal stent devices reduce the flow velocity inside an aneurism just as much as the commercially available flow-diverting stents while allowing stent-assisted coil embolization.

  6. Transient coronary aneurysm formation after Nevo™ stent implantation versus persistent coronary aneurysm after Cypher Select™ stent implantation

    DEFF Research Database (Denmark)

    Christiansen, Evald Høj; Lassen, Jens Flensted; Jensen, Lisette Okkels

    2011-01-01

    We implanted a Cypher Select™ coronary stent and two months later a Nevo™ sirolimus-eluting coronary stent in another vessel. At a prescheduled angiographic follow-up, coronary aneurysms were seen in the two stented segments, 6 and 8 months after stent implantation, respectively. Six months later...

  7. Stent graft versus balloon angioplasty for failing dialysis access grafts: a long-awaited advance in the treatment of permanent hemodialysis access.

    Science.gov (United States)

    Dolmatch, Bart L

    2010-01-01

    Arteriovenous grafts (AVGs) for hemodialysis have a high failure rate, often due to the development of stenosis at the graft-to-vein anastomosis. Angioplasty (PTA) has been used for over two decades to treat AVG stenosis, with good technical success but limited AVG patency. Results of a prospective multi-center randomized trial, comparing stent graft to PTA in AVGs, has demonstrated superior access circuit patency for the stent graft group. Recent publication of this clinical study brings us into an exciting new era of dialysis access management using covered stents to improve durability of catheter-based therapy.

  8. Ionizing radiation effects on ISS ePTFE jacketed cable assembly

    Science.gov (United States)

    Koontz, S. L.; Golden, J. L.; Lorenz, M. J.; Pedley, M. D.

    2003-09-01

    Polytetrafluoroethylene (PTFE), which is susceptible to embrittlement by ionizing radiation, is used as a primary material in the Mobile Transporter's (MT) Trailing Umbilical System (TUS) cable on the International Space Station (ISS). The TUS cable provides power and data service between the ISS truss and the MT. The TUS cable is normally stowed in an uptake reel and is fed out to follow the MT as it moves along rails on the ISS truss structure. For reliable electrical and mechanical performance, TUS cable polymeric materials must be capable of >3.5% elongation without cracking or breaking. The MT TUS cable operating temperature on ISS is expected to range between -100°C and +130°C. The on-orbit functional life requirement for the MT TUS cable is 10 years. Analysis and testing were performed to verify that the MT TUS cable would be able to meet full-life mechanical and electrical performance requirements, despite progressive embrittlement by the natural ionizing radiation environment. Energetic radiation belt electrons (trapped electrons) are the principal contributor to TUS cable radiation dose. TUS cable specimens were irradiated, in vacuum, with both energetic electrons and gamma rays. Electron beam energy was chosen to minimize charging effects on the non-conductive ePTFE (expanded PTFE) targets. Tensile testing was then performed, over the expected range of operating temperatures, as a function of radiation dose. When compared to the expected in-flight radiation dose/depth profile, atomic oxygen (AO) erosion of the radiation damaged TUS cable jacket surfaces is more rapid than the development of radiation induced embrittlement of the same surfaces. Additionally, the layered construction of the jacket prevents crack growth propagation, leaving the inner layer material compliant with the design elongation requirements. As a result, the TUS cable insulation design was verified to meet performance life requirements.

  9. Nafion/PTFE/silicate composite membranes for direct methanol fuel cells

    Energy Technology Data Exchange (ETDEWEB)

    Huang, Li-Ning; Chen, Li-Chun; Yu, T. Leon; Lin, Hsiu-Li [Department of Chemical Engineering and Materials Science, Yuan Ze University, Taoyuan 32026 (Taiwan)

    2006-10-27

    Poly(tetrafluoro ethylene) (PTFE)/Nafion composite membranes (PN composite membranes) were prepared by impregnating micro-porous PTFE membranes in Nafion/2-propanol/water solutions. The PN composite membranes were then further impregnated with tetraethoxysilane (TEOS) solutions to prepare PTFE/Nafion/silicate (PNS) composite membranes. The influence of hybridizing silicate into the PN membranes on their direct methanol fuel cell (DMFC) performance and methanol crossover was investigated. Silicate in PN membranes causes reduction both in proton conductivity and methanol crossover of membranes. Thus PNS had a higher voltage than PN at low current densities due to the lower methanol crossover of PNS. However, at high current densities, PNS had a lower voltage than PN due to the higher resistance to proton transference of PNS. The range of lower current densities where PNS had a higher voltage than PN was i=0-120mAcm{sup -2} when the methanol feed concentration was 2M. This lower current density range became broader as the methanol feed concentration was increased, and it was broadened to i=0-190mAcm{sup -2} as the methanol feed concentration was increased to 5M. A comparison of the methanol crossover on the DMFC performance of PN and PNS with Nafion-112 was also studied. We showed that Nafion-112 exhibits higher methanol electro-osmosis than PN and PNS. Thus at a high current density, the higher methanol crossover via electro-osmosis caused Nafion-112 to have a lower voltage than PN and PNS. (author)

  10. Characterization of the early pulmonary inflammatory response associated with PTFE fume exposure

    Science.gov (United States)

    Johnston, C. J.; Finkelstein, J. N.; Gelein, R.; Baggs, R.; Oberdorster, G.; Clarkson, T. W. (Principal Investigator)

    1996-01-01

    Heating of polytetrafluoroethylene (PTFE) has been described to release fumes containing ultrafine particles (approximately 18 nm diam). These fumes can be highly toxic in the respiratory tract inducing extensive pulmonary edema with hemorrhagic inflammation. Fischer-344 rats were exposed to PTFE fumes generated by temperatures ranging from 450 to 460 degrees C for 15 min at an exposure concentration of 5 x 10(5) particles/cm3, equivalent to approximately 50 micrograms/m3. Responses were examined 4 hr post-treatment when these rats demonstrated 60-85% neutrophils (PMNs) in their lung lavage. Increases in abundance for messages encoding the antioxidants manganese superoxide dismutase and metallothionein (MT) increased 15- and 40-fold, respectively. For messages encoding the pro- and anti-inflammatory cytokines: inducible nitric oxide synthase, interleukin 1 alpha, 1 beta, and 6 (IL-1 alpha, IL-1 beta, and IL-6), macrophage inflammatory protein-2, and tumor necrosis factor-alpha (TNF alpha) increases of 5-, 5-, 10-, 40-, 40-, and 15-fold were present. Vascular endothelial growth factor, which may play a role in the integrity of the endothelial barrier, was decreased to 20% of controls. In situ sections were hybridized with 33P cRNA probes encoding IL-6, MT, surfactant protein C, and TNF alpha. Increased mRNA abundance for MT and IL-6 was expressed around all airways and interstitial regions with MT and IL-6 demonstrating similar spatial distribution. Large numbers of activated PMNs expressed IL-6, MT, and TNF alpha. Additionally, pulmonary macrophages and epithelial cells were actively involved. These observations support the notion that PTFE fumes containing ultrafine particles initiate a severe inflammatory response at low inhaled particle mass concentrations, which is suggestive of an oxidative injury. Furthermore, PMNs may actively regulate the inflammatory process through cytokine and antioxidant expression.

  11. MR safety and imaging of neuroform stents at 3T.

    Science.gov (United States)

    Nehra, Arvind; Moran, Christopher J; Cross, Dewitte T; Derdeyn, Colin P

    2004-10-01

    The Neuroform stent is a self-expanding nitinol stent designed for use in wide-necked intracranial aneurysms. Heating and imaging artifacts were evaluated by using a porcine carotid artery aneurysm model in a 3T MR system. A suspended Neuroform stent was tested for deflection. No heating was measured, and no evidence of deflection of the stent was found. Imaging artifacts were minimal. MR imaging in patients with Neuroform stent-treated aneurysms is safe and feasible.

  12. The Organize Structure and Property of Eletroless Ni-P/PTFE Composite Layer

    Institute of Scientific and Technical Information of China (English)

    WANG Zhou; ZHANG Xu-yun; LI Guo-xiang; ZHAO Fu-jun; LI Hong-liang; LI Guo-xi; HAO Wen-sen; XA Li-fang

    2004-01-01

    The surface appearance of Ni-P/PTFE composite layer made by the method of electroless depositing on 45steel substrate is observed by SEM; The influence of different temperature, different activator and heat treatment temperature on the joint force of composite layer are discussed. The results show that when the temperature of the solution is at 75 ℃ and the composition of the activator is about 0.6 g/L,the joint force of composite layer is best for 60 N. With the increase of the temperature of heat treatment, the joint force of the composite layer is decreased.

  13. Management of iatrogenic RV injury - RV packing and CPB through PTFE graft attached to femoral artery.

    Science.gov (United States)

    Mangukia, Chirantan V; Agarwal, Saket; Satyarthy, Subodh; Aggarwal, Satish Kumar; Datt, Vishnu; Satsangi, Deepak Kumar

    2015-01-01

    Cardiac injuries during repeat sternotomy are rare. While undergoing debridement for chronic osteomyelitis (post arterial septal defect closure), a 4-year-old girl sustained significant right ventricular (RV) injury. Bleeding from the RV was controlled by packing the injury site, which helped in maintaining stable hemodynamics till arrangements were made for instituting cardiopulmonary bypass (CPB). Since the femoral artery was very small and unsuitable for direct cannulation, a polytetrafluoroethylene (PTFE) graft sutured end-to-side to the femoral artery was used for establishing CPB. The injury was successfully repaired.

  14. Lamp system with conditioned water coolant and diffuse reflector of polytetrafluorethylene(PTFE)

    Energy Technology Data Exchange (ETDEWEB)

    Zapata, Luis E. (Livermore, CA); Hackel, Lloyd (Livermore, CA)

    1999-01-01

    A lamp system with a very soft high-intensity output is provided over a large area by water cooling a long-arc lamp inside a diffuse reflector of polytetrafluorethylene (PTFE) and titanium dioxide (TiO.sub.2) white pigment. The water is kept clean and pure by a one micron particulate filter and an activated charcoal/ultraviolet irradiation system that circulates and de-ionizes and biologically sterilizes the coolant water at all times, even when the long-arc lamp is off.

  15. Headache after carotid artery stenting.

    Science.gov (United States)

    Suller Marti, A; Bellosta Diago, E; Velázquez Benito, A; Tejero Juste, C; Santos Lasaosa, S

    2017-04-18

    Headache after carotid artery stenting is a headache with onset during the procedure or in the first few hours after it, and where there is no evidence to suggest a complication of that procedure. The purpose of this study is to describe the main features of these headaches based on our clinical experience. Observational prospective study of a sample of patients undergoing carotid artery stenting at Hospital Clínico Universitario Lozano Blesa, in Zaragoza, Spain. We recorded sociodemographic characteristics, cardiovascular risk factors, carotid artery disease, and history of primary headache; data were gathered using structured interviews completed before and 24hours after the procedure. We included 56 patients (mean age 67±9.52 years); 84% were men. Twelve patients (21.4%) experienced headache, 83.3% of whom were men; mean age was 60.58±9.31 years. Headache appeared within the first 6hours in 7 patients (58.4%) and during the procedure in 4 (33.3%). Pain lasted less than 10minutes in 4 patients (33.3%) and between 10 and 120minutes in 5 (41.7%). Headache affected the frontotemporal area in 7 patients (58.3%); 7 patients (58.3%) described pain as unilateral. It was oppressive in 8 patients (66.7%) and of moderate intensity in 6 (50%). Nine patients (75%) required no analgesics. We found no statistically significant associations with any of the variables except for age (P=.007; t test). In our sample, headache after carotid artery stenting was mild to moderate in intensity, unilateral, oppressive, and short-lasting. Further studies are necessary to gain a deeper knowledge of its characteristics and associated risk factors. Copyright © 2017 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. The Supralimus sirolimus-eluting stent.

    Science.gov (United States)

    Lemos, Pedro A; Bienert, Igor

    2013-05-01

    The use of biodegradable polymeric coatings has emerged as a potential bioengineering target to improve the vascular compatibility of coronary drug-eluting stents (DESs). This review summarizes the main features and scientific facts about the Supralimus sirolimus-eluting stent (Sahajanand Medical Technologies Ltd, Surat, India), which is a biodegradable polymer-based, sirolimus-eluting metallic stent that was recently introduced for routine use in Europe. The novel stent is built on a stainless steel platform, coated with a blend of biodegradable polymers (poly-l-lactide, poly-dl-lactide-co-glycolide and polyvinyl pyrrolidone; coating thickness is 4-5 µm). The active agent is the antiproliferative sirolimus in a dose load of 1.4 µg/mm(2), which is released within 48 days. The Supralimus stent was initially evaluated in the single-arm SERIES-I study, which showed binary angiographic restenosis rates of 0% (in-stent) and 1.7% (in-segment) and an in-stent late lumen loss of 0.09 ± 0.28 mm. The multicenter randomized PAINT trial compared two DESs with identical metallic platforms and biodegradable polymer carriers, but different agents (Infinnium [Sahajanand Medical Technologies Pvt Ltd] paclitaxel-eluting stent or Supralimus sirolimus-eluting stent) against bare stents. After 3 years, the pooled DES population had similar rates of cardiac death or myocardial infarction (9 vs 7.1%; p = 0.6), but a lower risk of repeat interventions (10 vs 29.9%; p < 0.01) than controls with bare stents. The incidence of definite or probable stent thrombosis in the pooled DES group was 2.3% (1st year: 1.8%; 2nd year: 0.4% and 3rd year: 0%). These results demonstrate that the novel Supralimus stents are effective in reducing reintervention, while potentially improving the safety profile by decreasing the risk of late-term thrombosis, even though further studies would be necessary to confirm these findings.

  17. Effect of the valved stent on closure of patent ductus arteriosus in a miniswine model%带瓣膜心血管内支架封堵动脉导管未闭的可行性研究

    Institute of Scientific and Technical Information of China (English)

    周永新; 王永武; 邵杰; 孙林; 李刚; 梅运清; 胡大一

    2009-01-01

    Objective To evaluate the feasibility of a valved stent on closure patent ductus arteriosas in a Chinese miniswine model. Methods Self-expandable nitinol stents were made of Ni-Ti shape memory alloy (9 nun in diameter). Bovine pericardium was shaped and sutured onto the stents. Fluid passing test, pre-releasing test and static test of pressure in tube were performed in all devices before use. In eight Chinese miniswine, vascular grafts (PTFE vascular prosthesis) were surgically inserted between the descending thoracic aorta and pulmonary artery for establishment of patent duetus arteriasus model Valved stents were deployed to occlude the patent ductus arteriosus. Echocardiography was performed two hours post operation. Aortic angiography was made 30 days post operation in survived animals. Animals were then sacrificed for autopsy and electron microscopy examinations. Results In vitro testing showed that the closure of the valved stent leaflets was satisfactory and fluid flows were not restricted in the opposite direction. The valved stenta could be released through catheter, expanded completely, rapidly fixed in the tube. Closure of patent ductus arteriosas was succeeded in 6 out of 8 animals. One animal died of respiratory failure 2 hours post operation, another one died of pulmonary embolism due to valved stent displacement. Resident shunt was not evidenced by echocardiography, aortic angiography and dissection examinations in the remaining 6 animals. The new endothelial tissue fully covered the pulmonary and aortic sides of patent ductus arteriosus in 4 and 3 animals respectively. The electron microscopic observation revealed endothelial coverage of diveea. Conclusion The valved stent could effectively close artificial patent dactus arteriosus in vivo with satisfactory new intima covering on beth sides of patent ductus arteriosus.%目的 探讨带瓣膜心血管内支架在动脉导管封堵中应用的可行性及其体内特性,以期研制一种用于封堵

  18. The Scandinavian Propaten® trial – Final 5-year Results of a Randomized Trial Comparing Heparin Bonded PTFE Grafts (Propaten®) to standard PTFE Grafts in Fem-Fem and Fem-Pop Position

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Houlind, Kim Christian; Gottschalksen, B;

    2016-01-01

    a randomized trial. Methods: Patients with intermittent claudication or critical limb ischaemia requiring femorofemoral or femoropopliteal bypass grafting were randomized in a clinical trial of Hb-PTFE versus standard PTFE in 11 Scandinavian centres between 2005 and 2009. Patients were followed up for 5 years...... with clinical assessment and surveillance Duplex ultrasound imaging. The primary endpoint of this study was primary patency. Secondary endpoints included major amputation and mortality. Results: Overall, 569 patients were enrolled in the randomized trial. Some 552 had follow-up data available for analysis...

  19. Sganzerla Cover

    Directory of Open Access Journals (Sweden)

    Victor da Rosa

    2014-06-01

    Full Text Available http://dx.doi.org/10.5007/2175-7917.2014v19n1p158 Neste artigo, realizo uma leitura do cinema de Rogério Sganzerla, desde o clássico O bandido da luz vermelha até os documentários filmados na década de oitenta, a partir de duas noções centrais: cover e over. Para isso, parto de uma controvérsia com o ensaio de Ismail Xavier, Alegorias do subdesenvolvimento, em que o crítico realiza uma leitura do cinema brasileiro da década de sessenta através do conceito de alegoria; depois releio uma série de textos críticos do próprio Sganzerla, publicados em Edifício Sganzerla, procurando repensar as ideias de “herói vazio” ou “cinema impuro” e sugerindo assim uma nova relação do seu cinema com o tempo e a representação; então busco articular tais ideias com certos procedimentos de vanguarda, como a falsificação, a cópia, o clichê e a colagem; e finalmente procuro mostrar que, no cinema de Sganzerla, a partir principalmente de suas reflexões sobre Orson Welles, a voz é usada de maneira a deformar a interpretação naturalista.

  20. Cover Picture.

    Science.gov (United States)

    Breuning; Ruben; Lehn; Renz; Garcia; Ksenofontov; Gütlich; Wegelius; Rissanen

    2000-07-17

    The cover picture shows how both, fine arts and science, avail themselves of a system of intertwined symbolic and iconic languages. They make use of a common set of abstracted signs to report on their results. Thus, already in 1925, Wassily Kandinsky painted a masterpiece (bottom), which now, 75 years later, might be regarded as a blueprint for a scientific project. In his painting, Kandinsky pictured a grid-shaped sign that resembles in effect an actual molecular switch. Apparently following an enigmatic protocol, the groups of Lehn and Gütlich (see p. 2504 ff. for more details) constructed a grid-type inorganic architecture that operates as a three-level magnetic switch (center) triggered by three external perturbations (p, T, hnu). The switching principle is based on the spin-crossover phenomenon of Fe(II) ions and can be monitored by Mössbauer spectroscopy (left) and magnetic measurements (rear). Maybe not by chance, the English translation of the title of the painting "signs" is a homonym of "science", since both presented works are a product of the insatiable curiosity of man and his untiring desire to recognize his existence.

  1. Stent graft implantation in an aortic pseudoaneurysm associated with a fractured Cheatham-Platinum stent in aortic coarctation.

    Science.gov (United States)

    Kuhelj, Dimitrij; Berden, Pavel; Podnar, Tomaž

    2016-03-01

    We report a case of aortic pseudoaneurysm associated with a fractured bare Cheatham-Platinum stent following stenting for aortic coarctation. These complications were recognised 6 years after the implantation procedure and were successfully managed by percutaneous stent graft implantation. Staged approach for stent dilatation might prevent development of aortic pseudoaneurysms. In addition, careful follow-up is warranted after stenting for aortic coarctation, particularly in patients with recognised aortic wall injury.

  2. EMPREGO DE STENTS CEREBRAIS NAS PATOLOGIAS CEREBROVASCULARES

    Directory of Open Access Journals (Sweden)

    Laís Rocha Lopes

    2015-06-01

    Full Text Available Objective: To understand the applicability and characteristics of the stents for the treatment of cerebrovascular pathologies in order to understand its viability for the therapy. Methods: Scientific articles were used based on electronic search as PubMed, Scientific Electronic Library Online (SciELO, Intechopen, Medscape. An international and up to date source of articles was used. Results: Cerebrovascular diseases have emerged as the second most important cause of mortality worldwide, from this principle we observe the importance of this study. Recently, as a solution form, stents have become a major treatment option for difficult and not feasible cerebral aneurysms single winding. Intracranial stents serve as a bridge to the neo-endothelialization by providing a reduction in blood flow into the aneurysm. The use of stents for treatment should be seriously analyzed according to their feasibility, the knowledge of the professional about their brands, features and deployment techniques, and theoretical part of the professional needs to have dexterity to the application of an intracranial stent. Conclusions: This review raises an awareness of this subject, starts from the concept of cerebrovascular disease and aneurysms as well as the genesis of the stents, progressing to elucidate all product brands and specific characteristics of each, ending with its applicability, as well as making clear the purpose and mechanism of stents.

  3. The mechanism of PTFE and PE friction deposition: a combined scanning electron and scanning force microscopy study on highly oriented polymeric sliders

    NARCIS (Netherlands)

    Schaeben, H.; Vancso, G. Julius

    1998-01-01

    The mechanism of friction deposition of polytetrafluoroethylene (PTFE) and polyethylene (PE) was studied by scanning electron (SEM) and scanning force microscopy (SFM) on the worn surfaces of PTFE and PE sliders that were used in friction deposition on glass substrates. These surfaces exhibited a fi

  4. The mechanism of PTFE and PE friction deposition: a combined scanning electron and scanning force microscopy study on highly oriented polymeric sliders

    NARCIS (Netherlands)

    Schönherr, Holger; Schaeben, H.; Vancso, Gyula J.

    1998-01-01

    The mechanism of friction deposition of polytetrafluoroethylene (PTFE) and polyethylene (PE) was studied by scanning electron (SEM) and scanning force microscopy (SFM) on the worn surfaces of PTFE and PE sliders that were used in friction deposition on glass substrates. These surfaces exhibited a

  5. Biolimus-eluting stents with biodegradable polymer versus bare-metal stents in acute myocardial infarction

    DEFF Research Database (Denmark)

    Räber, Lorenz; Kelbæk, Henning; Taniwaki, Masanori

    2014-01-01

    BACKGROUND: This study sought to determine whether the 1-year differences in major adverse cardiac event between a stent eluting biolimus from a biodegradable polymer and bare-metal stents (BMSs) in the COMFORTABLE trial (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Meta...... to improve cardiovascular events compared with BMS beyond 1 year. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NTC00962416....

  6. Targeting In-Stent-Stenosis with RGD- and CXCL1-Coated Mini-Stents in Mice.

    Science.gov (United States)

    Simsekyilmaz, Sakine; Liehn, Elisa A; Weinandy, Stefan; Schreiber, Fabian; Megens, Remco T A; Theelen, Wendy; Smeets, Ralf; Jockenhövel, Stefan; Gries, Thomas; Möller, Martin; Klee, Doris; Weber, Christian; Zernecke, Alma

    2016-01-01

    Atherosclerotic lesions that critically narrow the artery can necessitate an angioplasty and stent implantation. Long-term therapeutic effects, however, are limited by excessive arterial remodeling. We here employed a miniaturized nitinol-stent coated with star-shaped polyethylenglycole (star-PEG), and evaluated its bio-functionalization with RGD and CXCL1 for improving in-stent stenosis after implantation into carotid arteries of mice. Nitinol foils or stents (bare metal) were coated with star-PEG, and bio-functionalized with RGD, or RGD/CXCL1. Cell adhesion to star-PEG-coated nitinol foils was unaltered or reduced, whereas bio-functionalization with RGD but foremost RGD/CXCL1 increased adhesion of early angiogenic outgrowth cells (EOCs) and endothelial cells but not smooth muscle cells when compared with bare metal foils. Stimulation of cells with RGD/CXCL1 furthermore increased the proliferation of EOCs. In vivo, bio-functionalization with RGD/CXCL1 significantly reduced neointima formation and thrombus formation, and increased re-endothelialization in apoE-/- carotid arteries compared with bare-metal nitinol stents, star-PEG-coated stents, and stents bio-functionalized with RGD only. Bio-functionalization of star-PEG-coated nitinol-stents with RGD/CXCL1 reduced in-stent neointima formation. By supporting the adhesion and proliferation of endothelial progenitor cells, RGD/CXCL1 coating of stents may help to accelerate endothelial repair after stent implantation, and thus may harbor the potential to limit the complication of in-stent restenosis in clinical approaches.

  7. Targeting In-Stent-Stenosis with RGD- and CXCL1-Coated Mini-Stents in Mice.

    Directory of Open Access Journals (Sweden)

    Sakine Simsekyilmaz

    Full Text Available Atherosclerotic lesions that critically narrow the artery can necessitate an angioplasty and stent implantation. Long-term therapeutic effects, however, are limited by excessive arterial remodeling. We here employed a miniaturized nitinol-stent coated with star-shaped polyethylenglycole (star-PEG, and evaluated its bio-functionalization with RGD and CXCL1 for improving in-stent stenosis after implantation into carotid arteries of mice. Nitinol foils or stents (bare metal were coated with star-PEG, and bio-functionalized with RGD, or RGD/CXCL1. Cell adhesion to star-PEG-coated nitinol foils was unaltered or reduced, whereas bio-functionalization with RGD but foremost RGD/CXCL1 increased adhesion of early angiogenic outgrowth cells (EOCs and endothelial cells but not smooth muscle cells when compared with bare metal foils. Stimulation of cells with RGD/CXCL1 furthermore increased the proliferation of EOCs. In vivo, bio-functionalization with RGD/CXCL1 significantly reduced neointima formation and thrombus formation, and increased re-endothelialization in apoE-/- carotid arteries compared with bare-metal nitinol stents, star-PEG-coated stents, and stents bio-functionalized with RGD only. Bio-functionalization of star-PEG-coated nitinol-stents with RGD/CXCL1 reduced in-stent neointima formation. By supporting the adhesion and proliferation of endothelial progenitor cells, RGD/CXCL1 coating of stents may help to accelerate endothelial repair after stent implantation, and thus may harbor the potential to limit the complication of in-stent restenosis in clinical approaches.

  8. Preparation of PTFE-based fuel cell membranes by combining latent track formation technology with graft polymerization

    Energy Technology Data Exchange (ETDEWEB)

    Yoshida, Masaru [Quantum Beam Science Directorate, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan)], E-mail: yoshida.masaru@jaea.go.jp; Kimura, Yosuke [Graduate School of Engineering, Gunma University, 1-5-1 Tenjin, Kiryu, Gunma 376-8515 (Japan); Chen, Jinhua; Asano, Masaharu; Maekawa, Yasunari [Quantum Beam Science Directorate, Japan Atomic Energy Agency (JAEA), 1233 Watanuki, Takasaki, Gunma 370-1292 (Japan)

    2009-12-15

    Swift heavy 56 MeV {sup 15}N{sup 3+} ions were generated with particle fluences of 0, 3x10{sup 6}, 3x10{sup 7}, 3x10{sup 8}, 3x10{sup 9} ions/cm{sup 2} to form a latent track zone in a 25-{mu}m-thick film of polytetrafluoroethylene (iPTFE). Styrene (St) was then grafted onto the iPTFE films by UV-irradiation or pre-{gamma}-irradiation, and after sulfonation iPTFE-based proton-conducting membranes were obtained, here called, iPTFE-g(UV)-PStSA and iPTFE-g({gamma})-PStSA membranes, respectively, which had a straight cylindrical damage zone around the ion path. The degree of grafting was found to be about 7.5% with a particle fluence of 3x10{sup 7} ions/cm{sup 2} and with either the UV-method or the {gamma}-method. The ion-exchange capacity, proton conductivity in the thickness direction, MeOH permeability, tensile strength and elongation at break of the obtained iPTFE-g(UV)-PStSA membrane were 0.50 mmol/g, 0.06 S/cm, 0.15x10{sup -6} cm{sup 2}/s, 50 MPa and 600%, in contrast to 0.06 mmol/g, 0.06 S/cm, 0.35x10{sup -6} cm{sup 2}/s, 19 MPa and 210% for the iPTFE-g({gamma})-PStSA membrane, respectively. In comparison, the Nafion 112 measured in our laboratory exhibited an ion-exchange capacity of 0.91 mmol/g, a proton conductivity of 0.06 S/cm, a MeOH permeability of 1.02x10{sup -6} cm{sup 2}/s, a tensile strength of 35 MPa and an elongation at break of 295%. It can be concluded from these data that the lower crossover of MeOH, the same proton conductibility, the lower ion-exchange capacity, and the superior mechanical properties of the UV-grafted proton-conducting membranes compared to the Nafion make them promising materials for widespread application in direct methanol fuel cells. On the other hand, the tests of mechanical strength showed that the PTFE base film is subject to degradation by the ion-beam irradiation as well as the {gamma}-irradiation.

  9. The current status of stenting pathobiology.

    Science.gov (United States)

    Fleser, A; Leclerc, G

    1997-01-01

    Stents permanently maximize the arterial lumen following percutaneous transluminal coronary angioplasty (PTCA) at the cost of a vascular injury caused by the deployment of the prosthesis. Even though clinical trials show progressive reduction of restenosis and thrombosis rates in implanted coronary stents, these two events continue to represent a potential limitation to their clinical use. This review is focused on the arterial pathobiology related to the use of permanent and temporary stents. © 1997, Elsevier Science Inc. (Trends Cardiovasc Med 1997;7:24-28).

  10. Efficacy and safety of drug-eluting stent implantation for the treatment of in-stent restenosis occurring within bare-metal stent and drug-eluting stent*

    OpenAIRE

    Ge, Heng; Zhang, Qing; Zhou, Wei; He, Qing; Han, Zhi-hua; He, Ben

    2010-01-01

    Objective: Although drug-eluting stent (DES) implantation is the primary treatment modality for bare-metal stent (BMS) in-stent restenosis (ISR), little is known about the efficacy and safety profile of DES in the treatment of DES-ISR. The goal of this study was to compare the clinical outcomes following DES treatment for BMS-ISR and DES-ISR. Methods: Rates of major adverse cardiac events (MACE) were compared in 97 consecutive patients who underwent DES implantation for the treatment of ISR (...

  11. Trajectory surgical guide stent for implant placement.

    Science.gov (United States)

    Adrian, E D; Ivanhoe, J R; Krantz, W A

    1992-05-01

    This article describes a new implant placement surgical guide that gives both implant location and trajectory to the surgeon. Radiopaque markers are placed on diagnostic dentures and a lateral cephalometric radiograph is made that shows the osseous anatomy at the symphysis and the anterior tooth location. The ideal implant location and trajectory data are transferred to a surgical stent that programs the angle and location of the fixtures at time of surgery. The stent has the additional benefit of acting as an occlusion rim, a mouth prop, and tongue retractor. Use of this stent has resulted in consistently programming the placement of implant fixtures that are prosthodontically ideal.

  12. Carotid Stent Fracture from Stylocarotid Syndrome

    Science.gov (United States)

    Hooker, Jeffrey D; Joyner, David A; Farley, Edward P; Khan, Majid

    2016-01-01

    Eagle syndrome is a rare condition resulting from elongation of the temporal styloid process or calcification of its associated stylohyoid ligaments. Although usually presenting with pain or odynophagia, Eagle syndrome has been reported to cause a multitude of neurologic symptoms or vascular complications, some of which can be life-threatening. We present a case in which an endovascularly placed internal carotid artery stent in close proximity to a calcified stylohyoid ligament resulted in stent fracture with subsequent stent and vessel occlusion. We review and discuss the presentation, diagnosis, etiology, complications and treatment options of the syndrome.

  13. Surface characterization of binary grafting of AAc/NIPAAm onto poly(tetrafluoroethylene) (PTFE)

    Energy Technology Data Exchange (ETDEWEB)

    Adem, E. [Instituto de Fisica-UNAM, A. Postal 20-364, Mexico, DF 01000 (Mexico); Avalos-Borja, M. [Centro de Ciencias de la Materia Condensada-UNAM, A. Postal 2681, Ensenada BC 22800 (Mexico); Bucio, E. [Instituto de Ciencias Nucleares-UNAM, A. Postal 70-543, Mexico, DF 04510 (Mexico); Burillo, G. [Instituto de Ciencias Nucleares-UNAM, A. Postal 70-543, Mexico, DF 04510 (Mexico)]. E-mail: burillo@nuclecu.unam.mx; Castillon, F.F. [Centro de Ciencias de la Materia Condensada-UNAM, A. Postal 2681, Ensenada BC 22800 (Mexico); Cota, L. [Centro de Ciencias de la Materia Condensada-UNAM, A. Postal 2681, Ensenada BC 22800 (Mexico)

    2005-07-01

    The present study shows results on radiation grafting of acrylic acid (AAc) and N-isopropylacrylamide (NIPAAm) mixtures onto polytetrafluoroethylene (PTFE) films. The main objective is to use the modified polymer for immobilization of the avidin-streptavidin systems or other bio-compounds. Grafting onto PTFE was carried out by the pre-irradiation oxidative method in air at different dose rates and irradiation doses. The irradiation was produced with the electron beam of a 2 MV van de Graaff accelerator, and gamma-rays, from a Gamma Beam 651 PT. The samples were placed in glass ampoules with the AAc and NIPAAm mixtures, in an aqueous solution. Graft polymerization was performed by heating of the polymer-monomer composition in an argon atmosphere at temperature of 50 deg. C. Surface funcionalization was studied by X-ray photoelectron spectroscopy (XPS); morphology of the surface was studied by scanning electron microscopy (SEM) and hydrophylization of the surface, by contact angle measurements (static method)

  14. Temperature stable low loss PTFE/rutile composites using secondary polymer

    Energy Technology Data Exchange (ETDEWEB)

    Rajesh, S. [Government of India, Microwave Materials Division, Centre for Materials for Electronics Technology (C-MET), Department of Information Technology, Athani P.O., Thrissur, Kerala (India); University of Oulu, Microelectronics and Materials Physics Laboratories, P.O. Box 4500, Oulu (Finland); Murali, K.P.; Ratheesh, R. [Government of India, Microwave Materials Division, Centre for Materials for Electronics Technology (C-MET), Department of Information Technology, Athani P.O., Thrissur, Kerala (India)

    2011-07-15

    Rutile filled PTFE composites have been fabricated through Sigma Mixing, Extrusion, Calendering and Hot pressing (SMECH) process. Dielectric constant ({epsilon}{sub r}') and loss tangent (tan {delta}) of filled composites at microwave frequency region were measured by waveguide cavity perturbation technique using a Vector Network Analyzer. The temperature coefficient of dielectric constant ({tau}{sub {epsilon}{sub r}'}) was measured in the 0-100 C temperature range. In order to tailor the temperature coefficient of dielectric constant of the composite, thermoplastic Poly (ether ether ketone) (PEEK) has been used as a secondary polymer. Flexible laminate having a dielectric constant, {epsilon}{sub r}'{proportional_to}10.4, loss tangent tan {delta}{proportional_to}0.0045 and {tau}{sub {epsilon}{sub r}'}{proportional_to}-40 ppm/K was realized in Polytetrafluroethylene (PTFE)/rutile composites with the addition of 8 wt% PEEK. The reduction in {tau}{sub {epsilon}{sub r}'} is mainly attributed to the positive {tau}{sub {epsilon}{sub r}'} of PEEK and increased interface region in the composites as a result of the PEEK addition. (orig.)

  15. Temperature stable low loss PTFE/rutile composites using secondary polymer

    Science.gov (United States)

    Rajesh, S.; Murali, K. P.; Ratheesh, R.

    2011-07-01

    Rutile filled PTFE composites have been fabricated through Sigma Mixing, Extrusion, Calendering and Hot pressing (SMECH) process. Dielectric constant (\\varepsilonr') and loss tangent (tan δ) of filled composites at microwave frequency region were measured by waveguide cavity perturbation technique using a Vector Network Analyzer. The temperature coefficient of dielectric constant (tau_{\\varepsilonr'}) was measured in the 0-100°C temperature range. In order to tailor the temperature coefficient of dielectric constant of the composite, thermoplastic Poly (ether ether ketone) (PEEK) has been used as a secondary polymer. Flexible laminate having a dielectric constant, \\varepsilonr'˜10.4, loss tangent tan δ˜0.0045 and tau_{\\varepsilonr'}˜-40 ppm/K was realized in Polytetrafluroethylene (PTFE)/rutile composites with the addition of 8 wt% PEEK. The reduction in tau_{\\varepsilonr'} is mainly attributed to the positive tau_{\\varepsilonr'} of PEEK and increased interface region in the composites as a result of the PEEK addition.

  16. Sulfonation of cPTFE Film grafted Styrene for Proton Exchange Membrane Fuel Cell

    Directory of Open Access Journals (Sweden)

    Yohan Yohan

    2010-10-01

    Full Text Available Sulfonation of γ-ray iradiated and styrene-grafted crosslinked polytetrafluoroethylene film (cPTFE-g-S film have been done. The aim of the research is to make hydropyl membrane as proton exchange membrane fuel cell. Sulfonation was prepared with chlorosulfonic acid in chloroethane under various conditions. The impact of the percent of grafting, the concentration of chlorosulfonic acid, the reaction time,and the reaction temperature on the properties of sulfonated film is examinated. The results show that sulfonation of surface-grafted films is incomplete at room  temperature. The increasing of concentration of chlorosulfonic acid and reaction temperature accelerates the reaction but they also add favor side reactions. These will lead to decreasing of the ion-exchange capacity, water uptake, and proton conductivity but increasing the resistance to oxidation in a perhidrol solution. The cPTFE-g-SS membrane which is resulted has stability in a H2O2 30% solution for 20 hours.

  17. Tribological behavior of high specific strength PTFE-Al alloy composite

    Institute of Scientific and Technical Information of China (English)

    XIANG Ding-han; PAN Qing-lin

    2005-01-01

    Solid lubricants lead to substantial weight savings relative to the use of liquid lubricant, especially in the weight-conscious aerospace industry. A new PTFE-Al alloy composite(A) containing 60% area proportion of PTFE composite was developed. Another type of common metal-plastics multilayer composite, also called DU, was selected for a comparative investigation. Friction and wear tests were carried out in an oscillating sliding tribotester in air at an oscillating frequency of 0.13Hz and contact mean pressures from 10 to 80MPa. The composites slid against a 38CrMoAlA steel shaft. The results show that the composite A exhibits low coefficient of dry sliding friction less than 0.1 and long wear life of 2000m. This is because the composite A can provide a sufficient solid lubrication during the whole tests. SEM examination of the transfer films for the composite A confirms that uniform, thin and coherent transfer films are prerequisites for low friction and good wear resistance.

  18. Forgotten CBD stent (102 months) with stone-stent complex: A case report.

    Science.gov (United States)

    Barai, Varsha; Hedawoo, Jagadish; Changole, Sanjay

    2017-01-01

    Choledocholithiasis is presence of stone in Common bile duct (CBD) which can be treated by endoscopy or surgery [1]. Retained foreign bodies like stents forms a nidus for stone formation resulting in pain, fever, jaundice. 60 years female patient admitted in surgery ward with features of cholangitis with computed tomography showing cholangitic abscess with dilated common bile duct and sludge around stent in situ. Stone was found at proximal end of stent during surgery. Stents may remain without complications or may migrate, and rarely form nidus for stone formation. If kept for long time they lead to bacterial proliferation, biofilm formation and precipitation of calcium bilirubinate presenting as fever, pain, jaundice. Stent-stone complex can be treated endoscopically and surgically [6,7]. As stent can cause stone formation, infection and other complications, timely removal of stent should advised. III-effects of stent in-situ should be explained, record should be maintained [8] and patient should be advised regular follow up and stent removal after 6 weeks. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  19. Paraffin processing of stented arteries using a postfixation dissolution of metallic and polymeric stents.

    Science.gov (United States)

    Fishbein, Ilia; Welch, Tre; Guerrero, David T; Alferiev, Ivan S; Adamo, Richard F; Chorny, Michael; Gupte, Rohit K; Tang, Yanqing; Levy, Robert J

    Studying the morphology of the arterial response to endovascular stent implantation requires embedding the explanted stented artery in rigid materials such as poly(methyl methacrylate) to enable sectioning through both the in situ stent and the arterial wall, thus maintaining the proper anatomic relationships. This is a laborious, time-consuming process. Moreover, the technical quality of stained plastic sections is typically suboptimal and, in some cases, precludes immunohistochemical analysis. Here we describe a novel technique for dissolution of metallic and plastic stents that is compatible with subsequent embedding of "destented" arteries in paraffin, fine sectioning, major staining protocols, and immunohistochemistry.

  20. In situ coronary stent paving by Pluronic F127-alginate gel blends: Formulation and erosion tests.

    Science.gov (United States)

    Dalmoro, Annalisa; Barba, Anna Angela; Grassi, Mario; Grassi, Gabriele; Lamberti, Gaetano

    2016-07-01

    In this work the development of an experimental protocol to perform the in situ gel-paving of coronary stent is presented. Biocompatible aqueous blends of Pluronic F127 and sodium alginates are used as potential drug dosage system for pharmacological in situ treatment of coronary in-stent restenosis. Pluronic F127/alginate aqueous blend has the unique characteristic to be liquid at room condition and to form gel at physiological temperature. The proposed protocol is based on the blend injection on stent wall previously implanted in a flexible silicon pipe mimicking the coronary artery. Injected blend is warmed up until human body temperature achieving a soft gel, then it is reticulated by copper bivalent ions to obtain an hard gel. To test the gel paving resistance to erosion phenomena when it is exposed to fluid flux (i.e. blood flux) a dedicated device, (the Simulated Artery Device, SAD), was built to simulate the human circulatory apparatus. The SAD is an hydraulic circuit in which a buffer solution (at pH 7.4) was fluxed by a peristaltic pump through the pipe hosting the covered stent. Erosion tests were performed monitoring, by gravimetric and spectrophotometric methods, the residual mass anchored to stent mesh after given times. The obtained results showed that the in situ gel-paving developed protocol was efficacious and reliable. The gel-paving was completely eroded in a time of the same order of magnitude of the physiological period required to restore the coronary lesion (subsequent to the atheroma removal) and of a pharmacological therapy to inhibit the in-stent-restenosis pathology. © 2015 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 104B: 1013-1022, 2016.