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Home > Vascular Annual Meeting > PP15. Radial Force of Carotid Stents: Uncovered...

PP15. Radial Force of Carotid Stents: Uncovered Ground with Potential Clinical Consequences

Michiel T. Voûte1, Johanna M. Hendriks1, Jorinde H.H. Van Laanen1, Peter M.T. Pattynama1, Bart E. Muhs2, Hence J.M. Verhagen1
1Erasmus Medical Centre, Rotterdam, Netherlands; 2Yale New Haven Hospital, New Haven, CT

OBJECTIVES: Carotid angioplasty and stenting (CAS) is an increasingly performed alternative to carotid endarterectomy. Complications include hypoperfusion of the brain as a result of overstimulation of the baroreceptors, by balloon dilatation or by the radial force of the stent. In this study we tested the radial force of four different carotid stents. Two open cell nitinol stents (Acculink® and Protégé®), one hybrid nitinol stent (Cristallo Ideale®) and a braided elgiloy stent (Wallstent®).

METHODS: Five stents of each type were deployed in three loops of bopet film. These films were attached to aluminium rods with copper strain gauges, forming a half Wheatstone bridge. The radial force of the stent leads to pulling of the rods and voltage differences in the strain gauges which can be precisely and reliably measured. We performed two tests, one of stent deployment and one simulation of a clinically relevant stenosis.

RESULTS: In stent deployment, the Protégé® produced a peak radial force of 62cN, the Wallstent® 38cN, the Acculink® 35cN and the Cristallo Ideale® 15cN (p<0,05). In the simulated stenosis (figure 1) the Protégé® had the greatest peak radial force of 328cN and the Wallstent® produced the lowest radial force of 84 cN (p<0,05).

CONCLUSIONS: Radial forces exerted by carotid stents vary significantly between various stent designs. In both tests the Protégé® stent generates a radial force far greater than all the other stents. Clinical results of CAS may be very dependent of the specific stent used and may therefor not be generalized for all carotid stent systems.In our opinion, besides flexibility and free cell area, an objective comparison of radial force is necessary for a well-considered choice of stent type in the individual patient.

AUTHOR DISCLOSURES: M.T. Voûte, None; J.M. Hendriks, None; J.H.H. Van Laanen, None; P.M.T. Pattynama, None; B.E. Muhs, None; H.J.M. Verhagen, None.

Figure 1.