ABSTRACT
OBJECTIVE: To evaluate the feasibility, safety, and efficacy of an accurate kissing Viabahn stent technique to manage injuries near the innominate artery bifurcation. METHODS: This retrospective study included patients with injuries near the innominate artery bifurcation who were treated with an accurate kissing Viabahn stent technique. Perioperative and follow-up data were extracted and analysed. RESULTS: A total of 10 patients were included (mean age, 52.8 years; six male and four female patients) with injuries at the following sites: the distal end of the innominate artery (n = 2), the innominate artery bifurcation (n = 5), the root of the right common carotid artery (n = 2) and the origin of the right subclavian artery (n = 1). All were successfully treated with the accurate kissing Viabahn stent technique. During follow-up (mean duration, 16.8 months), there were no complications, such as right upper limb ischaemia, neurological dysfunction, stent occlusion or migration. CONCLUSIONS: The accurate kissing Viabahn stent technique to manage injuries near the bifurcation of the innominate artery was safe and effective, with good perioperative and long-term follow-up results.
Subject(s)
Aneurysm, False/surgery , Aortic Aneurysm, Thoracic/surgery , Aortic Dissection/surgery , Brachiocephalic Trunk/injuries , Endovascular Procedures/methods , Adult , Aged , Aortic Dissection/complications , Aortic Dissection/diagnosis , Aneurysm, False/complications , Aneurysm, False/diagnosis , Angiography, Digital Subtraction , Aortic Aneurysm, Thoracic/complications , Aortic Aneurysm, Thoracic/diagnosis , Brachiocephalic Trunk/diagnostic imaging , Brachiocephalic Trunk/surgery , Computed Tomography Angiography , Endovascular Procedures/adverse effects , Endovascular Procedures/instrumentation , Feasibility Studies , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Stents , Treatment OutcomeABSTRACT
The simultaneous loading of multifunctional drugs has been regarded as one of the major challenges in the drug delivery system. Herein, a mesoporous silica coating was constructed on a bare metal stent surface by an evaporation-induced self-assembly method, in which both hydrophilic and hydrophobic drugs (heparin and rapamycin) were encapsulated by a one-pot method for the first time, and the release behaviors of these drugs were studied. The releasing mechanisms of these drugs were investigated in detail. Rapid release of heparin can achieve anticoagulation and endothelialization, whereas slow release of rapamycin can realize antiproliferative therapy for long term. In vitro hemocompatibility and promotion for proliferation of vein endothelial cells and the inhibition of smooth muscle cells were conducted. In vivo stent implantation results verify that the mesoporous silica coating with both heparin and rapamycin can successfully accelerate the endothelialization process and realize the antiproliferative therapy for as long as 3 months. These results indicate that this multifunctional mesoporous coating containing both hydrophilic and hydrophobic drugs might be a promising stent coating in the future.
