HOME > Publications > Journals > Back Number > Vol.27 No.6 2011 > Therapeutic Catheterization Through the Side-cell of Stent

Therapeutic Catheterization Through the Side-cell of Stent

Pediatric Cardiology and Cardiac Surgery
Vol.27 No.6 2011 (280-285)

Hideshi Tomita1）, Shigeru Uemura1）, Takashi Soga2）, Madoka Sawada2）, Takahiro Nishioka2）, Nobuo Oyama2）, Takanari Fujii3）, Jyunya Iwasaki3）

1）Cardiovascular Center, Showa University Northern Yokohama Hospital, Yokohama, Japan, 2）Children’s Medical Center, Showa University Northern Yokohama Hospital, Yokohama, Japan, 3）Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan

Abstract

Background: In stenting for congenital heart diseases, bifurcation lesions and side branch jail are challenging for an interventionalist. Balloon dilation or stenting through the side-cell to overcome bifurcation lesions or stent jail in congenital heart diseases has been scarcely reported in our country because of limited variations in available stent. The aim of this study is to evaluate the efficacy and safety of therapeutic catheterization through the side-cell of the stent.
Method: 1) We reported balloon dilation or stenting through the side-cell of previously implanted stents in 3 patients. 2) We measured the diameter of the side-cell of the Express® Vascular or Genesis® stent following in vitro balloon dilation.
Results: 1) In patient 1, the Express® Vascular LD stent was implanted in the near occluded ilio-femoral vein at 5 months old. The side-cell was dilated using the Sasuga® balloon Sterling balloon. Retrograde coarctation following duct stenting in hypoplastic left heart syndrome was dilated through the side-cell of the Genesis® stent at 4 months old in patient 2. T stenting using the Express® Vascular LD stent and the Genesis® stent on Amiia® was performed for pulmonary venous obstruction at 10 months old in patient 3. No complications were observed in any patient. 2) The side-cell of the Express® Vascular LD stent was dilated to 5-6 mm maximally, while in the Genesis® stent, its side-cell was dilated to 4-6 mm. Dilation of its side-cell at 5-6 atmospheres broke articulations of the side-cell, while the cell was dilated to 7mm.
Conclusion: Balloon dilation or stenting through the side-cell of the Express® Vascular or the Genesis® stent is feasible. One should bear this technique in mind for stenting in bifurcation lesions of congenital heart disease.