Practical Clinical Evaluation of Stents

Abstract

This article discusses the clinical issues pertaining to an optimal stenting result and analyzes relevant stent structures and functions. There are five components of optimal stenting: favorable clinical features, easy stent delivery, ideal scaffolding, low stent thrombosis, and low restenosis. In straightforward cases, such as stenting in the mid‐right coronary artery with a straight proximal segment, procedural success can be achieved with any stent. In vessels with curved, tortuous proximal segments, a highly flexible stent is needed for a smooth and successful delivery. For ostial, protected left main, or aortoanastomotic lesions, stents with sufficient radial strength and good visibility are needed. The two major concerns of an interventional cardiologist choosing a stent are excellent trackability for fast delivery and low long‐term restenosis rate. In all situations, the procedural success depends on the operator's manual dexterity, experience with a particular stent design, and critical evaluation of different structural stent features to maximize benefits. Any new stent with high longitudinal flexibility, excellent scaffolding and radial strength, adequate radiopacity, complete deployment after one inflation, and that is easily recrossed and provides a good symmetrical conduit for a smooth coronary flow resulting in little tendency for thrombosis or restenosis would be today's stent of choice.

Electrochemical and SEM Characterization of Gold-Coated Stents In Vitro

“…Radiopacity of metals used for cardiovascular stents is critical because the radiopacity of metals provides cardiologists with the ability to track the precise location of implanted stents. The mass of gold provides excellent radiopacity, 19,[29][30][31] it is this reason that gold has been used as a marker 8,9 and as a coating for 316L stainless steel stents to enhance stent trackability during intervention.…”

Methodology on Clinical Evaluation of Urinary Stents

“…Randomized-comparative studies are required to demonstrate the risk-benefit profile of the stents. Studies must include enough patients to allow assessment of the primary performance and safety end-points specified in the clinical investigation plan, with a 95% confidence interval [7]. Several criteria need to be met to conduct reliable studies with clear and valuable end-points: Criteria for population selection in clinical investigations.…”