P. Desgranges et al., Placement of a fenestrated Palmaz stent across the renal arteries. Feasibility and outcome in an animal study, EUR J VAS E, 19(4), 2000, pp. 406-412
Citations number
13
Categorie Soggetti
Surgery
Journal title
EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Objectives: to investigate the feasibility of placing stents across renal a
rteries.
Design: we have studied in pigs: (i) the feasibility of accurately placing
fenestrated stent in front of one renal ostium; (ii) the short-term effects
on renal arteries and function after the placement of such a fenestrated s
tent.
Materials and methods: eight fenestrated Palmaz stents were placed over pig
s' renal ostia under fluoroscopy. Five weeks later, angiograms were perform
ed and the animals were sacrificed. Proliferation of the healing tissues ov
er the ostia was measured and analysed by microscopy. Serum creatinine was
measured prior to all angiograms and at 5 weeks.
Results: all eight stents were correctly placed. One stent later migrated a
nd was excluded from the study. One pig died at day 1. Gross examination co
nfirmed the correct placement of the fenestrations in four pigs out of seve
n (57%). In the six remaining pigs, at 5 weeks, there was no angiographic e
vidence of stent misplacement and all the kidneys were fully perfused. Nine
renal ostia were covered by struts and neointima with a mean area of cover
age of 38 +/- 5% altogether. No tissue proliferation was observed over the
three renal ostia located in front of the fenestration. Serum creatinine di
d not significantly increase at 5 weeks.
Conclusion: creating a fenestration in a stent for renal arteries may be wo
rth while in order to avoid neointimal covering of the renal ostia. However
, accurate placement of such a fenestrated stent remains a difficult task.