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Physiology - Radiology and Medical Imaging


Expansion of the Multi-Link Frontier™ Coronary Bifurcation Stent: Micro-Computed Tomographic Assessment in Human Autopsy and Porcine Heart Samples
Published: Thursday, July 21, 2011
Author: Stefan Kralev et al.

by Stefan Kralev, Benjamin Haag, Jens Spannenberger, Siegfried Lang, Marc A. Brockmann, Soenke Bartling, Alexander Marx, Karl-Konstantin Haase, Martin Borggrefe, Tim Süselbeck

Background

Treatment of coronary bifurcation lesions remains challenging, beyond the introduction of drug eluting stents. Dedicated stent systems are available to improve the technical approach to the treatment of these lesions. However dedicated stent systems have so far not reduced the incidence of stent restenosis. The aim of this study was to assess the expansion of the Multi-Link (ML) Frontier™ stent in human and porcine coronary arteries to provide the cardiologist with useful in-vitro information for stent implantation and selection.

Methodology/Principal Findings

Nine ML Frontier™ stents were implanted in seven human autopsy heart samples with known coronary artery disease and five ML Frontier™ stents were implanted in five porcine hearts. Proximal, distal and side branch diameters (PD, DD, SBD, respectively), corresponding opening areas (PA, DA, SBA) and the mean stent length (L) were assessed by micro-computed tomography (micro-CT). PD and PA were significantly smaller in human autopsy heart samples than in porcine heart samples (3.54±0.47 mm vs. 4.04±0.22 mm, p?=?0.048; 10.00±2.42 mm2 vs. 12.84±1.38 mm2, p?=?0.034, respectively) and than those given by the manufacturer (3.54±0.47 mm vs. 4.03 mm, p?=?0.014). L was smaller in human autopsy heart samples than in porcine heart samples, although data did not reach significance (16.66±1.30 mm vs. 17.30±0.51 mm, p?=?0.32), and significantly smaller than that given by the manufacturer (16.66±1.30 mm vs. 18 mm, p?=?0.015).

Conclusions/Significance

Micro-CT is a feasible tool for exact surveying of dedicated stent systems and could make a contribution to the development of these devices. The proximal diameter and proximal area of the stent system were considerably smaller in human autopsy heart samples than in porcine heart samples and than those given by the manufacturer. Special consideration should be given to the stent deployment procedure (and to the follow-up) of dedicated stent systems, considering final intravascular ultrasound or optical coherence tomography to visualize (and if necessary optimize) stent expansion.

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