Correction: Blood compatibility of a new zwitterionic bare metal stent with hyperbranched polymer brushes

Correction for ‘Blood compatibility of a new zwitterionic bare metal stent with hyperbranched polymer brushes’ by Xiaobo Wang et al., J. Mater. Chem. B, 2013, 1, 5036–5044, DOI: 10.1039/C3TB20855A.

Endovascular therapy for distal hilar renal artery aneurysm: a case report and literature review

Renal artery aneurysm (RAA), a type of visceral aneurysm with atypical symptoms, is difficult to detect and is usually discovered incidentally by imaging examination. Hilar RAA (HRAA) represents a relatively rare subgroup of RAA that is located in the distal part of the renal artery, close to the renal parenchyma. We reported a 55-year-old woman with an HRAA measuring 19 mm × 20 mm × 20 mm. She underwent endovascular therapy with bare-metal stent implantation with nested coil embolization. She was discharged without complications. The uniqueness of this case is the aneurysm location, which was at the distal right renal artery, making it difficult to preserve the blood supply to the right kidney. The novelty of the minimally invasive technique was that this endovascular treatment not only eliminated the aneurysm, but also preserved the blood supply to the ipsilateral kidney. Endovascular therapy is effective in the management of HRAA.

Zenith AAA endovascular graft suprarenal bare metal stent separation with graft migration and type IA endoleak

Background The Zenith endovascular graft (Cook Medical, Bloomington, IN, USA) is a well-recognised device used in endovascular repair of abdominal aortic aneurysms (EVAR). After a small number of reported cases of suprarenal stent separation from the main body of the graft, modifications were made to the strength and durability of the suture line attachment of the proximal bare metal component prior to release in 2003. This report describes a further case of suprarenal stent separation and type IA endoleak in a patient who underwent an EVAR using the Zenith device in 2012. Methods We present a case report of a 77-year-old male with incidental finding of type IA endoleak on a background of elective endovascular repair for 50.4-mm infrarenal abdominal aortic aneurysm (AAA), with a Cook Zenith endograft. Computed tomography (CT) demonstrated separation of the suprarenal bare metal stent from the main body of the endograft, with resultant graft migration and increase in native aneurysm sac size. Results The patient underwent semi-urgent surgery with successful placement of a bridging thoracic stent graft between the lowest renal artery and main body of the pre-existing graft. Conclusions This case report describes a rare complication of Zenith devices, additionally emphasising the importance of regular surveillance imaging following EVAR.

Bailout stenting in femoropopliteal arterial segment

Summary: Background: Disabling peripheral arterial disease (PAD) of femoropopliteal segment is usually treated with percutaneous balloon dilatation, and when this is not successful, stent is placed. Long-term patency of stent is often compromised due to in-stent restenosis (ISR). We aimed to identify factors associated with bailout stenting, and to recognise risk factors for ISR in procedures without paclitaxel application. Patients and methods: We analysed 592 consecutive successful femoropopliteal interventions performed in patients with either disabling intermittent claudication or chronic critical limb ischemia (CLI). In patients with stent implantation, clinical and ultrasound (US) examination were performed one year after the intervention to establish the presence of ISR, defined as >50% stenosis on US imaging. Results: Bailout stenting was required in 133 (22.5%) procedures. Patients with stent placement were younger (70±10 vs 72±11 years, p=0.007) and less often presented with CLI (29.3% vs 40.5%, p=0.019). They more often reported smoking (63.2% vs 49.2%, p=0.005), less often had diabetes mellitus (35.3% vs 47.5%, p=0.013) and arterial hypertension (82.0% vs 90.8%; p=0.004). Stenting was also dependent on lesion complexity (TASC II C>B>A; p<0.001). Subgroup analysis of 110 procedures with bare metal stent (BMS) placement performed in 107 patients revealed ISR in 46.4% of stents, in half of cases it was symptomatic. Neither clinical nor lesion characteristics proved to differ between the group of procedures with ISR and group of procedures without ISR. Conclusions: Factors associated with bailout stenting were age, diabetes mellitus, arterial hypertension, smoking, clinical picture of PAD and complexity of treated lesions. We did not find any risk factors influencing development of ISR in BMS.

Comparison of BARD®LIFESTREAM™ Covered Balloon-Expandable Stent Versus GORE® VIABAHN™ Covered Self-Expandable Stent in Treatment of Aortoiliac Obstructive Disease: Study Protocol for a Prospective Randomized Controlled Trial(NEONATAL Trial)

Background Covered stent has become one of the mainstream therapies for aortoiliac obstructive disease (AIOD), with higher patency rate compared to bare metal stent. Covered balloon-expandable (CBE) stent can be placed more accurately with higher radial support force, while covered self-expanding (CSE) stent has greater elasticity and higher trackability. However, there is no level I evidence regarding the comparison safety and efficacy between the CSE stent and CBE stent in AIOD up to date. Therefore, this study aims to compare the efficacy and safety of CBE stent (BARD®LIFESTR`EAM™) and CSE stent (GORE® VIABAHN™) in AIOD. Methods This trial is a prospective, single center, paralleled, non-inferiority, randomized controlled trial. A total of 106 patients will be enrolled and these patients will be randomized to either the CBE stent group or CSE stent group. The primary end point of the study is occurrence of Target Lesion Revascularization (TLR) at 12 months after the intervention. Discussion To our knowledge, the NEONATAL trial is the first RCT to compare CBE and CSE stent in AIOD patients. The results of clinical trials may contribute to establishing a strategic guideline for choosing the optimal type of covered stent in treatment of AIOD patients. Trial registration: ChiCTR2100046734; Registered on 27 May, 2021 in Chinese Clinical Trials Registry.

CLINICAL EVALUATION OF THE INDIGENOUSLY MANUFACTURED REJUVENATE® BARE METAL STENT SYSTEM IN PAKISTANI PATIENTS WITH CORONARY ARTERY DISEASE

Objectives: The aim of this pilot study was the first-in-man evaluation of the safety, feasibility, deliverability, and efficiency of the newly developed REJUVENATE® bare metal stent system in coronary artery disease. Methodology: Current study was a pilot non-randomized, multi-centric and prospective study which was intended to study the safety of the REJUVENATE® bare metal stent in Pakistani population over 10 months. Study endpoints included target vessel related myocardial infarction, stent thrombosis, in-stent restenosis, stroke and death. The diameter of the target lesions selected was between 3-4mm with length no more than 22mm. Only one BMS was implanted per patient. These patients had well defined regular clinical follow-ups and CT scan coronary angiography at the end of 10 months. Results: 20 patients suffering from coronary artery disease (CAD) including15 male subjects and 5 female subjects were enrolled in this study and were treated with REJUVENATE® BMS. 65% patients were hypertensive, 25% diabetics and 25% were active smokers. Out of the 20 stents implanted, 14 stents were implanted in the right coronary artery and 6 were implanted in the left circumflex artery. During this 10-month study period there was 10.65% of cases in which late lumen loss (lumen stenosis <70%) was observed, however no cases of in stent restenosis and stent thrombosis were observed. There was no target vessel related myocardial infarction or stroke as well. One patient died of pneumonia during the follow up period. Conclusion: The current study demonstrated the deliverability and clinical safety of REJUVENATE® bare metal stent over a period of 10 months.