Der neuartige Propel mini Stent – Indikationen, Operationstechnik und erste klinische Erfahrungen

2019 ◽  
Vol 98 (06) ◽  
pp. 408-412
Author(s):  
Constantin Maximilian Weber ◽  
Ursula Schmidtmayer ◽  
Stefan R.O. Stolle ◽  
Thomas Lenarz
Keyword(s):  
Chirurgische Therapie ◽  
Polyposis Nasi ◽  
Stent System ◽  
Chirurgische Therapieverfahren ◽  
Sinusitis Frontalis ◽  
Klinische Erfahrungen

Zusammenfassung Hintergrund Die Therapie der chronischen Sinusitis frontalis stellt sich aufgrund des anatomisch engen Abflusses in die Nasenhaupthöhle häufig als problematisch dar. Neben konservativen Methoden wurden bisher auch viele chirurgische Therapieverfahren, sowohl mit als auch ohne Einsatz von Platzhaltern, jedoch ohne längerfristigen Therapieerfolg erprobt. Ziel dieser Arbeit war die klinische Testung der allgemeinen Praktikabilität und der kurz- sowie langfristige Therapieerfolg des neuartigen bioresorbierbaren Propel mini Stents. Material und Methoden In einer prospektiven Studie an 21 Patienten mit chronischer Rhinosinusitis mit Polyposis nasi wurde die chirurgische Therapie und das Einbringen des Stents dargestellt und die Degradation von insgesamt 31 Stents sowie der Erfolg dieser Therapieform über einen Zeitraum von 6 Monaten endoskopisch kontrolliert und analysiert. Ergebnisse Hinsichtlich chirurgischer Praktikabilität erwies sich der Stent mit Einführungstool als unkompliziertes und leicht bedienbares System. Alle Patienten haben die Stents gut toleriert. Die durchschnittliche, nachweisbare Materialabsorption überdauerte 28 Tage. Das Patientenkollektiv zeigte in 94 % der Fälle nach 3 Monaten und in 87 % der Fälle nach 6 Monaten einen vollständig sondierbares Neo-Ostium des Sinus frontalis. Schlussfolgerung Die Ergebnisse der prospektiven Studie zeigen insgesamt eine gute Akzeptanz bei den Patienten ohne Komplikationen sowie eine vollständige Stentdegradation. Auch die Follow-Up-Untersuchungen ergaben zufriedenstellende Ergebnisse über 6 Monate. Insbesondere unter dem Aspekt der endoskopischen Operation erwies sich das Stent-System als sehr praktikabel.

Reduction of cerebral DWI lesion burden after carotid artery stenting using the CASPER stent system

2018 ◽  
Vol 11 (1) ◽  
pp. 62-67 ◽  
Author(s):  
Erasmia Broussalis ◽  
Christoph Griessenauer ◽  
Sebastian Mutzenbach ◽  
Slaven Pikija ◽  
Hendrik Jansen ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Carotid Artery Stenting ◽  
Antiplatelet Agents ◽  
Protection Device ◽  
Median Length ◽  
Distal Embolization ◽  
Stent System ◽  
Single Operator ◽  
Excellent Functional Outcome

IntroductionDespite various measures to protect against distal embolization during carotid artery stenting (CAS), periprocedural ischemic lesions are still encountered.ObjectiveTo evaluate the periprocedural cerebral diffusion weighted imaging (DWI) lesion burden after CASPER stent placement.MethodsPatients who underwent CAS using the CASPER stent system were reviewed. Degrees of carotid stenosis and plaque configuration were determined. All patients were pretreated with dual antiplatelet agents and cerebral pre- and postprocedural MRI was obtained. All CAS procedures were performed by a single operator.ResultsA total of 110 patients with severe carotid artery stenosis (median degree of stenosis 80%, median length of stenosis 10 mm) were treated with CAS. Hypoechogenic or heterogeneous, mostly hypoechogenic, plaques were documented in 48.6% (52/107) of patients. Carotid ulceration was present in 15.9% (17/107). Postprocedurally, 7.3% (8/110) of patients were found to have ischemic DWI lesions. They were asymptomatic in all patients. Follow-up at 90 days was available in 88.2% (97/110) of patients with excellent functional outcome (modified Rankin Scale score 0–1) in 95.9% (93/97).ConclusionCarotid artery stenting using the new CASPER stent in combination with a distal embolic protection device is safe and results in a lower rate of periprocedural DWI lesion burden compared with reported results for historic controls.

Erste Ergebnisse der transperinealen Ligatur des Fisteltrakts bei rektovaginalen Fisteln

2019 ◽  
Vol 144 (04) ◽  
pp. 374-379
Author(s):  
Oliver Schwandner ◽  
Claudius Falch ◽  
Christl Reisenauer
Keyword(s):  
Chirurgische Therapie ◽  
Morbus Crohn ◽  
Postoperative Komplikationen ◽  
Erste Ergebnisse

Zusammenfassung Hintergrund Die chirurgische Therapie der rektovaginalen Fistel stellt trotz vielfältiger Operationsverfahren weiterhin eine Herausforderung dar. Es war Ziel dieser prospektiven Studie, die Ergebnisse einer innovativen Operationstechnik zu evaluieren. Material und Methoden Es erfolgte eine transperineale Ligatur des Fisteltrakts ohne Fistulektomie oder Sphinkterplastik. Es wurden ausschließlich tiefe rektovaginale Fisteln für die Operationsmethode ausgewählt. Standardisierte Ein- und Ausschlusskriterien wurden definiert. Ergebnisse Innerhalb eines 16-Monate-Zeitraums wurden an 2 Zentren 7 Patientinnen mit einer tiefen rektovaginalen Fistel über einen transperinealen Zugang operiert. Die Genese der rektovaginalen Fisteln war postpartal, operativ-iatrogen, bei Z. n. Bartholin-Abszess sowie bei Morbus Crohn. In allen Fällen konnte die Fistel identifiziert werden und zwischen einer Ligatur durchtrennt werden. Intra- und postoperative Komplikationen traten nicht auf. Nur eine Operation erfolgte unter Stomaschutz. Nach einem mittleren Follow-up von 9 Monaten kam es zu einer Heilung bei 4 von 7 Patientinnen (Erfolgsrate 57%). Schlussfolgerung Die ersten Ergebnisse einer transperinealen Ligatur des Fisteltrakts bei der rektovaginalen Fistel scheinen vielversprechend. Um den objektiven Stellenwert zu beurteilen, müssen weitere Erfahrungen, Studien mit größerer Fallzahl und Langzeitdaten abgewartet werden.

Follow-up after carotid stenting with the CASPER stent system: A duplex ultrasound evaluation

2020 ◽  
Vol 72 (6) ◽  
pp. 2054-2060.e2
Author(s):  
Johannes Sebastian Mutzenbach ◽  
Christoph Johannes Griessenauer ◽  
Erasmia Broussalis ◽  
Slaven Pikija ◽  
Luis Rafael Moscote-Salazar ◽  
...  
Keyword(s):  
Duplex Ultrasound ◽  
Carotid Stenting ◽  
System A ◽  
Ultrasound Evaluation ◽  
Stent System

Vein-Loaded Stent System to Occlude Wide-Necked Aneurysms

1998 ◽  
Vol 4 (1_suppl) ◽  
pp. 105-108
Author(s):  
T. Okamoto ◽  
T. Iwakoshi ◽  
M. Negoro ◽  
S. Miyachi ◽  
M. Bundou ◽  
...  
Keyword(s):  
Stent Placement ◽  
Carotid Arteries ◽  
Anticoagulation Therapy ◽  
The Other ◽  
Parent Artery ◽  
Clinical Use ◽  
Complete Occlusion ◽  
Stent System ◽  
Common Carotid Arteries

We devised a vein-loaded stent system to immediately close the aneurysmal orifice without interrupting the parent arterial flow. Ten experimental wide-necked aneurysms located on canine common carotid arteries were treated with the implantation of a newly modified vein-loaded stent system. After deploying the stent, half of them were managed under administration of 50 mg of ticlopidine hydrochloride per day and the other half followed up without any anticoagulation therapy. Immediately after the stent placement, all aneurysms were completely obliterated with patency of the parent artery in the successfully implanted vessels in both groups. Follow-up angiography one week later disclosed complete occlusion of the aneurysm with patency of the parent artery in 67% (2/3) of the group with ticlopidine, while none of the group without drugs showed patency of the parent artery. The rate of patency of the parent artery was found to be improved by administration of ticlopidine, but was still lower than that of a conventional stent. Further modifications will be needed before clinical use.

scholarly journals Open descending aortic replacement in a patient with a fractured Djumbodis™ dissection system

2020 ◽  
Vol 58 (1) ◽  
pp. 199-201 ◽  
Author(s):  
Takuya Fujikawa ◽  
Simon C Y Chow ◽  
Aliss T C Chang ◽  
Randolph H L Wong
Keyword(s):  
Aortic Arch ◽  
Acute Type ◽  
Aortic Arch Replacement ◽  
Type A Aortic Dissection ◽  
Endovascular Interventions ◽  
Aortic Replacement ◽  
Stent System ◽  
High Incidence ◽  
Descending Aortic Aneurysm

Abstract The Djumbodis™ dissection system was introduced as an alternative to aortic arch replacement in acute type A aortic dissection involving the arch. In our own experience, some patients with Djumbodis implantation developed distal aortic arch and descending aortic aneurysm during subsequent follow-up and required additional interventions. However, as there is a high incidence of fracture associated with the Djumbodis system, further endovascular interventions are not feasible. We report a case of successful open descending aortic replacement in a patient with a fractured Djumbodis stent system.

Long-term Results of Enterprise Stent-Assisted Coiling of Cerebral Aneurysms

Neurosurgery ◽  
2012 ◽  
Vol 71 (2) ◽  
pp. 239-244 ◽  
Author(s):  
Kyle M. Fargen ◽  
Brian L. Hoh ◽  
Babu G. Welch ◽  
G. Lee Pride ◽  
Giuseppe Lanzino ◽  
...  
Keyword(s):  
Scale Score ◽  
Cerebral Aneurysms ◽  
High Volume ◽  
Vascular Reconstruction ◽  
Long Term Results ◽  
Modified Rankin Scale ◽  
Volume Data ◽  
Stent System

Abstract BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 90% of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.

scholarly journals Multi-centric European post-market follow-up study of the Neuroform Atlas Stent System: primary results

2021 ◽  
pp. neurintsurg-2021-017849
Author(s):  
Pierre-Henri Lefevre ◽  
Peter Schramm ◽  
André Kemmling ◽  
Xavier Barreau ◽  
Gaultier Marnat ◽  
...  
Keyword(s):  
Medium Size ◽  
Mri Imaging ◽  
Clinical Trial Registration ◽  
Multicentric Study ◽  
Aneurysm Neck ◽  
Stent System ◽  
Safety Endpoint ◽  
Primary Safety Endpoint ◽  
Major Stroke

BackgroundFew prospective series have described the safety and effectiveness of the Neuroform Atlas Stent System. We aimed to investigate the efficacy and safety of the device in patients treated for unruptured aneurysm.MethodsATLAS EU PMCF is a consecutive, prospective, multicentric study that included patients with unruptured saccular aneurysm of all sizes. Follow-up visits were scheduled at 3–6 months and 12–16 months with digital subtraction angiography (DSA) or MRI imaging follow-up as per the site standard of care. The primary efficacy endpoint was adequate aneurysm occlusion (Raymond Roy occlusion grade I and II) on 12 month angiography. The primary safety endpoint was any major stroke or ipsilateral stroke or neurological death within 12 months.ResultsOf the 106 patients consented, 105 were treated with at least one Neuroform Atlas stent. There was a failed implantation attempt in 1 patient, 85 patients received lateral stenting, and 19 patients received Y-stenting. Mean aneurysm neck size was 4.2 mm (range 1.9–33 mm). Adequate occlusion was observed in 95.1% immediately after the procedure and in 98.9% of cases at 1 year DSA follow-up. Overall, 1.0% (1/102; 95% CI 0.0% to 5.3%) of patients experienced a primary safety endpoint of major stroke. Three minor strokes resulted in a modified Rankin Scale score of 2.ConclusionsIn this multicentric, prospective study, stent-assisted coiling of medium size unruptured aneurysms with the Neuroform Atlas stent resulted in a favorable rate of satisfactory occlusion. In our findings, the use of the Y-stenting technique was associated with increased rates of procedural complications.Clinical trial registrationhttps://clinicaltrials.gov/ct2/show/NCT02783339.

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