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Clinical utility of platinum chromium bare-metal stents in coronary heart disease.

Jorge C, Dubois C - Med Devices (Auckl) (2015)

Bottom Line: Later, cobalt chromium stent alloys outperformed steel as the material of choice for stents, allowing latest generation stents to be designed with significantly thinner struts, while maintaining corrosion resistance and radial strength.Most recently, the introduction of the platinum chromium alloy refined stent architecture with thin struts, high radial strength, conformability, and improved radiopacity.Mechanical properties, clinical utility, and device limitations will be summarized and put into perspective.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.

ABSTRACT
Coronary stents represent a key development for the treatment of obstructive coronary artery disease since the introduction of percutaneous coronary intervention. While drug-eluting stents gained wide acceptance in contemporary percutaneous coronary intervention practice, further developments in bare-metal stents remain crucial for patients who are not candidates for drug-eluting stents, or to improve metallic platforms for drug elution. Initially, stent platforms used biologically inert stainless steel, restricting stent performance due to limitations in flexibility and strut thickness. Later, cobalt chromium stent alloys outperformed steel as the material of choice for stents, allowing latest generation stents to be designed with significantly thinner struts, while maintaining corrosion resistance and radial strength. Most recently, the introduction of the platinum chromium alloy refined stent architecture with thin struts, high radial strength, conformability, and improved radiopacity. This review will provide an overview of the novel platinum chromium bare-metal stent platforms available for coronary intervention. Mechanical properties, clinical utility, and device limitations will be summarized and put into perspective.

No MeSH data available.


Related in: MedlinePlus

Design structure of the element PtCr stent platform.Note: Reproduced with permission from Bennett J, Dubois C. A novel platinum chromium everolimus-eluting stent for the treatment of coronary artery disease. Biologics. 2013;7(1):149–159.25Abbreviation: PtCr, platinum and chromium.
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f2-mder-8-359: Design structure of the element PtCr stent platform.Note: Reproduced with permission from Bennett J, Dubois C. A novel platinum chromium everolimus-eluting stent for the treatment of coronary artery disease. Biologics. 2013;7(1):149–159.25Abbreviation: PtCr, platinum and chromium.

Mentions: The Element portfolio includes stent models with lengths and diameters ranging from 8 mm to 38 mm and from 2.25 mm to 4.0 mm, respectively. Strut thickness of 81 µm, and a unique design of interconnected serpentine segments contribute to an excellent flexibility, deliverability, and conformability.25 Improved stent behavior is further enhanced by a limited number of connectors (n=2) between segments, while connectors arranged in a kind of double helix configuration facilitate independent stent segment motion, while balancing forces in the stent (Figure 2). A particular design feature of the Element platform is the nested orientation of stent segment peaks, hereby avoiding strut-to-strut contact during stent tracking in tortuous anatomies, or during deployment in a bend. Finally, wider segment peaks and shorter segment lengths redistribute expansion strain in the longitudinal direction, hereby increasing radial strength, while simultaneously improving conformability.23,25


Clinical utility of platinum chromium bare-metal stents in coronary heart disease.

Jorge C, Dubois C - Med Devices (Auckl) (2015)

Design structure of the element PtCr stent platform.Note: Reproduced with permission from Bennett J, Dubois C. A novel platinum chromium everolimus-eluting stent for the treatment of coronary artery disease. Biologics. 2013;7(1):149–159.25Abbreviation: PtCr, platinum and chromium.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556305&req=5

f2-mder-8-359: Design structure of the element PtCr stent platform.Note: Reproduced with permission from Bennett J, Dubois C. A novel platinum chromium everolimus-eluting stent for the treatment of coronary artery disease. Biologics. 2013;7(1):149–159.25Abbreviation: PtCr, platinum and chromium.
Mentions: The Element portfolio includes stent models with lengths and diameters ranging from 8 mm to 38 mm and from 2.25 mm to 4.0 mm, respectively. Strut thickness of 81 µm, and a unique design of interconnected serpentine segments contribute to an excellent flexibility, deliverability, and conformability.25 Improved stent behavior is further enhanced by a limited number of connectors (n=2) between segments, while connectors arranged in a kind of double helix configuration facilitate independent stent segment motion, while balancing forces in the stent (Figure 2). A particular design feature of the Element platform is the nested orientation of stent segment peaks, hereby avoiding strut-to-strut contact during stent tracking in tortuous anatomies, or during deployment in a bend. Finally, wider segment peaks and shorter segment lengths redistribute expansion strain in the longitudinal direction, hereby increasing radial strength, while simultaneously improving conformability.23,25

Bottom Line: Later, cobalt chromium stent alloys outperformed steel as the material of choice for stents, allowing latest generation stents to be designed with significantly thinner struts, while maintaining corrosion resistance and radial strength.Most recently, the introduction of the platinum chromium alloy refined stent architecture with thin struts, high radial strength, conformability, and improved radiopacity.Mechanical properties, clinical utility, and device limitations will be summarized and put into perspective.

View Article: PubMed Central - PubMed

Affiliation: Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium.

ABSTRACT
Coronary stents represent a key development for the treatment of obstructive coronary artery disease since the introduction of percutaneous coronary intervention. While drug-eluting stents gained wide acceptance in contemporary percutaneous coronary intervention practice, further developments in bare-metal stents remain crucial for patients who are not candidates for drug-eluting stents, or to improve metallic platforms for drug elution. Initially, stent platforms used biologically inert stainless steel, restricting stent performance due to limitations in flexibility and strut thickness. Later, cobalt chromium stent alloys outperformed steel as the material of choice for stents, allowing latest generation stents to be designed with significantly thinner struts, while maintaining corrosion resistance and radial strength. Most recently, the introduction of the platinum chromium alloy refined stent architecture with thin struts, high radial strength, conformability, and improved radiopacity. This review will provide an overview of the novel platinum chromium bare-metal stent platforms available for coronary intervention. Mechanical properties, clinical utility, and device limitations will be summarized and put into perspective.

No MeSH data available.


Related in: MedlinePlus