The greatest accolade that can be given to any inventor is to have the initial capital letter dropped from his name, for that is recognition that the word is now in the general language. 3 D. S harp “Stent” in common parlance is used to describe a tubular structure inserted into the heart of a patient suffering a “heart attack.” Little is known about the origin of the word “stent” and its significance. In medical language, a stent is a mold or device used in anchoring skin grafts and for supporting body openings and cavities during grafting of vessels
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Charles Stent and the mystery behind the word “stent”
Historical vignette
Sudheer Ambekar and Anil Nanda
Nam K. Yoon, Al-Wala Awad, M. Yashar S. Kalani, Philipp Taussky, and Min S. Park
E ach year, approximately 800,000 people in the US will experience a new or recurrent stroke, of which 87% are ischemic in nature. 47 A large proportion of these strokes are secondary to vascular atherosclerotic disease, some of which can be refractory to best medical management. To treat atherosclerotic disease, endovascular revascularization with the use of stents has gained increasing popularity and acceptance as a safe and less-invasive alternative to open surgical revascularization procedures. In this review, we discuss studies that have attempted to
Dale Ding and Kenneth C. Liu
much promise in treating this disease. 7 Similarly, angioplasty provides only a temporary solution to a permanent problem and is associated with its own pitfalls, such as acute and chronic restenosis of the treated vessel and arterial dissection. 5 , 23 The advent of flexible stents that could be deployed in intracranial vessels has greatly expanded the endovascular repertoire. 10 , 29 Properly placed stents not only favorably alter intravascular dynamics, but also they have the potential to reverse blood vessel stenosis, thereby increasing tissue perfusion
Gayle S. Storey, Michael P. Marks, Michael Dake, Alexander M. Norbash, and Gary K. Steinberg
P ercutaneous transluminal angioplasty (PTA) has been widely used in the treatment of atherosclerotic lesions of the peripheral vascular system, renal arteries, and cardiovascular system. Results in smaller studies have indicated that there is a role for PTA in the treatment of lesions in the cerebrovascular system. 11, 12, 14, 15, 29, 31 Some atherosclerotic lesions have a poor response to angioplasty due to elastic recoil or early restenosis. 8 Intraluminal stents are now widely used in the peripheral vascular system, 1, 9, 17, 22, 33 cardiovascular
Miguel Bussière, Stephen P. Lownie, Donald Lee, Irene Gulka, Andrew Leung, and David M. Pelz
, can occur in up to 17% of patients, and is associated with an increased risk of periprocedural complications. 8 Stenosed carotid arteries can be successfully treated with the placement of SESs alone without balloon angioplasty. 2 , 13–15 After an initial moderate and more rapid dilation that occurs at the time of stent deployment, SESs gradually and gently dilate stenosed carotid arteries over the next year of follow-up. 2 , 13 , 14 We speculated that not using balloon angioplasty would reduce trauma to the vessel wall, minimizing stimulation of carotid
Arnd Doerfler, Isabel Wanke, Thomas Egelhof, Dietmar Stolke, and Michael Forsting
E ndovascular treatment of intracranial aneurysms has substantially improved in recent years. Nevertheless, despite rapid advancement in the development of endovascular devices such as new coil configurations, embolic materials, and stents, wide-necked aneurysms still pose a therapeutic challenge. The release of 3D coils, balloon-assisted embolization, or the combination of stents and detachable coils have all proved helpful in the treatment of wide-necked aneurysms. 5, 7, 12–15, 19 The combination of stent placement followed by filling the aneurysm sac with
Naoki Toma, Satoshi Matsushima, Kenichi Murao, Kenji Kawaguchi, Kyoko Imanaka-Yoshida, Toshimichi Yoshida, and Waro Taki
C arotid artery stent implantation has been developed as a potential therapeutic alternative to carotid endarterectomy for the treatment of atherosclerotic lesions of the CA. High technical success rates and acceptable morbidity and mortality rates have been reported to be associated with CA stent placement. 13, 19 Restenosis rates of approximately 5% during 6- to 12-month follow-up periods have also been documented, 17, 19, 20 whereas the long-term safety, efficacy, and durability of CA stents are still unknown. Therefore, it seems important to investigate
Marco Zenteno, Jorge Santos-Franco, Yolanda Aburto-Murrieta, Jose-María Modenesi-Freitas, Guadalupe Ramírez-Guzmán, Sergio Gómez-Llata, and Angel Lee
affected vessel segment. Nevertheless, these lesions still represent a technical challenge to most neurosurgeons. 2 Endovascular coil embolization of intracranial aneurysms has been widely adopted, even as the first choice in posterior circulation lesions because of its efficacy and safety. Intracranial stenting recently has been incorporated into the endovascular armamentarium, and the concept of sole stenting endovascular bypass, in particular, was introduced by us in a paper published in 2005. 37 In that article, we hypothesized that the ability of the stent to
Young Soo Kim, Sang Won Lee, Jeong A Yeom, Chang Hyo Yoon, and Seung Kug Baik
E ndovascular treatment of intracranial aneurysms is a useful alternative to open clipping. A recent multicenter randomized trial demonstrated improved safety and clinical outcomes of endovascular treatment compared with neurosurgical clipping. Furthermore, an increasing trend toward endovascular treatment for aneurysm elimination is reported, and results from recent studies have shown that stent-assisted coil embolization (SACE) now accounts for about one-fourth to one-fifth of all endovascular treatments. 1 However, while most SACE studies appear to be
Sandeep Muram, Ronan Corcoran, Jillian Cooke, Kendall Forrester, Elana Lapins, Rosalie Morrish, Osama Zahoor Ahmad Cheema, Mayank Goyal, Muneer Eesa, David Fiorella, John H. Wong, Chander Sadasivan, and Alim P. Mitha
F low-diverting stents are an important option for the treatment of intracranial aneurysms. The nature of their low-porosity metal mesh, however, requires patients to be on long-term antiplatelet agents and results in significant metal artifacts on noninvasive follow-up imaging. Furthermore, aneurysm persistence rates at 1 year of up to 20%–40% have been reported. 1 – 3 For patients with persistent aneurysms, few additional treatment options can be offered other than the placement of another flow diverter due to the inability to access the aneurysm
