Otaal Parminder Singh, Bootla Dinakar
Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Tehran Heart Cent. 2021 Jul;16(3):123-128. doi: 10.18502/jthc.v16i3.8190.
Longitudinal stent deformation (LSD) is a recently reported problem with newer generation stents. The modification of stent materials and designs to make them more deliverable and conformable, as well as a focused approach in retaining their radial strength, has compromised longitudinal strength in currently available stents. Additionally, enhanced stent radiopacity, improved fluoroscopy, and heightened awareness have led to an increased incidence rate of the potentially under-recognized problem of LSD. Although originally described in deployed stents, LSD is being recognized in undeployed stents too. With available data to suggest an increased rate of adverse cardiac events like stent thrombosis and in-stent restenosis with LSD in deployed stents, an attempt to retrieve an undeployed deformed stent appears justified. We report 3 cases of LSD in undeployed stents and discuss its recognition. We also discuss the retrieval and visual inspection of retrieved stents and the simultaneous completion of coronary interventions via a double guide technique.
纵向支架变形(LSD)是新一代支架最近报道的一个问题。对支架材料和设计进行改进,使其更易于输送和贴合,以及在保持其径向强度方面采取的集中方法,已经损害了目前可用支架的纵向强度。此外,支架显影性增强、荧光透视改善以及认识提高,导致了潜在未被充分认识的LSD问题的发病率增加。虽然LSD最初是在已植入的支架中描述的,但在未植入的支架中也被发现。现有数据表明,已植入支架中出现LSD时,支架血栓形成和支架内再狭窄等不良心脏事件的发生率会增加,因此尝试取出未植入的变形支架似乎是合理的。我们报告3例未植入支架中的LSD病例并讨论其识别方法。我们还讨论了取出支架的取回和目视检查,以及通过双导丝技术同时完成冠状动脉介入治疗。