The stent decade: 1987 to 1997 - 09/09/11
Abstract |
In January 1997, experts from the United States, Europe, and Japan gathered at Stanford University to review their collective experience with intracoronary and noncoronary stenting and to identify and prioritize issues requiring further clinical investigation. This report summarizes the discussions that took place during this stent summit. Knowledge of stent-tissue interaction from animal and human pathologic specimens was reviewed in the context of evolving stent designs. The relative merits of coil and slotted tubular stent designs were discussed. Stent deployment routines, including self-expansion, balloon expansion, and high-pressure delivery were debated. The potential for covered stents and coated stents was explored. Problems surrounding the routine deployment of stents were identified: small vessel disease, long lesions, bifurcation stenoses, vein graft disease, ostial disease, left main stenoses, and intrastent restenosis. The value of intravascular ultrasound, as an adjunct to stenting, was explored and debated. An algorithm for “provisional stenting” based on ultrasound criteria was developed. Noncoronary stenting of the aorta, iliacs, and carotids were discussed. Clinical applications that may lead to randomized clinical trials were identified. (Am Heart J 1998;136:578-99.)
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From the Division of Cardiovascular Medicine and the Division of Interventional Radiology, Stanford University School of Medicine; and the Armed Forces Institute of Pathology. |
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Supported in part by unrestricted grants from Boston Scientific/SciMed Life Systems, Cook Cardiology, Cordis/Johnson & Johnson Interventional Systems, Arterial Vascular Engineering, Guidant, Medtronic, Progressive Angioplasty Systems, and Schneider International. |
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Reprint requests: Stephen N. Oesterle, MD, Division of Cardiovascular Medicine, Stanford University Medical Center, H2103, 300 Pasteur Dr., Stanford, CA 94305. |
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4/1/89572 |
Vol 136 - N° 4
P. 578-599 - octobre 1998 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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