Essay On Biodegradable Stents

Furthermore, the other important pathogenic determinants of CLABSI are the material of which the device is made, the host factors consisting of protein adhesions such as fibrin and fibronectin which form a sheath around the catheter and the intrinsic virulence factors of the infecting organism, including the extracellular polymeric substance (EPS) produced by the adherent organisms. Catheters made of surface irregularities materials are especially vulnerable to microbial colonization and subsequent infection. This association has led to emphasis on preventing catheter-related thrombus as an additional mechanism for reducing CLABSIs.

A stent definitely would have helped in general, but they wanted to avoid it since it would cause the man’s insurance to go up as he would be a higher risk. It was interesting to see how much thought goes into every decision and how it isn’t always related to just the medical side of it. Reichard had another surgeon come in and do a test where they measure the pressure on both sides of the blockage to see if a stent was actually necessary. They cutoff point they were looking for was about .85, any lower and they would put a stent in during his next procedure. It ended up being .91. This second test was important not only because it prevented a stent that wasn’t totally necessary, but it also allowed the man to be eligible for some procedures that he may not have been if a stent was placed. Another interesting angiogram case was on an older woman who most likely needed a replacement of her aortic valve. The aortic valve is usually the size of a quarter, but through initial imagining it was clear that hers was more the size of a pea. However, they wanted to verify this data through an angiogram where they measured the pressure drop-off from before to past the

Stent devices were invented in the 1980s and refined in the 1990s. Stenting techniques have transformed and expanded the therapeutic capabilities of angioplasty. There are two classification for stents based on their mode of deployment balloon-expandable and self-expandable. Stents are small mesh tubes which inserted to keep arteries open after angioplasty procedure. Drug -eluting stents have a polymer coating over mesh. This Polymer coatings have been proven to be durable and deliver drug in a uniform and controlled way ( White, Hollier 2007).

Evaluators compare the three most popular disc on the market. Usually containing one of three agents’ silver, chlorhexidine, or Polyhexamethylene Biguanide (PHMB). The disc is to place at the insertion site where the catheter meets the skin. Due to the clever design of the disc it serves two purposes. One the disc is made with a Polyurethane foam. Making it very absorptive allowing for the collection of drainage therefore decreasing the opportunity for pathogen growth. Secondly the disc is impregnated with chlorhexidine or PHMB, therefore allowing for 7 day extended release antimicrobial protection (Daniels & Frei, 2012). Evaluators concluded Chlorhexidine impregnated discs should be utilized for the duration of catheterization in high risk, critically ill patients and in hospitals (Daniels & Frei,

During this procedure the Doctor/ Surgeon will numb the arm or groin and embed a(n) catheter into your artery. Then the catheter is threaded through the arterial system until it reaches the coronary (heart) artery. The catheter will be visible on an x-ray screen for the doctor or surgeon can see internally. The Doctor will then thread a very thin wire to the catheter across the blockage (cartilage). Right above this wire, a catheter with an expandable balloon is passed to the blockage. Once the balloon is inflated it will push the plaque to the side to open the artery and allow blood to flow through.In more than most, patients will receive a Stent (which is a collapsed wire mesh tube), this procedure is similar to angioplasty except a stent is permanent and angioplasty is temporarily. This stent is mounted on a special balloon, and is moved over the wire to the blocked area. When the balloon is inflated it opens and locks the stent in the artery, keeping it open. Lastly the balloon and catheter are taken out, and the artery will remain open and your heart will receive the blood it

The stent is inserted into the artery by balloon angioplasty, to expand the vessel walls in order to return blood flow back to normal. There are two types of stents, bare-metal stents and drug-eluting stents. Once a BMS is inserted into the vessel, it become fully endothelialized.. However, The animation explains that in about 1/3 of BMS implants, restenosis occurs. On the other hand DES were developed to combat this issue. The polymer coating on the DES contains a drug which aids in the inhibition of restenosis. However, the endothelialization process for drug-eluting stents has shown to be problematic, which can in time cause stent thrombosis, which can possibly lead to myocardial infarction. It is important to note that these stents should be used in patients how do not have complex coronary stenosis because the off-label use is not completely understood and has a higher risk of

One of the leading causes of death for men and women in the United States can be attributed to Coronary Artery Disease. In the medical world, treatments are ever-changing and improving the chance of survival from this disease. One such treatment, Percutaneous Coronary Intervention (PCI) with stent placement, is now used in more than 80% of CAD cases with an exceedingly high success rate (http://emedicine.medscape.com/article/161446-overview). With any procedure, there is a number of tools at the doctor’s fingertips, and a new experimental technology in the stent world has risen with temporary bio-absorbable stents. The following document will briefly explain the procedure and their use in percutaneous coronary intervention.

The doctor will move the tip of the catheter to the narrow section of the artery and inflate the balloon. As the balloon inflates it pushes the plaque against the artery wall, which widens the artery and helps restore blood flow. The fully extended balloon also expands the stent pushing in to place in the artery. The stent supports the inner artery wall and reduces the chance of the artery becoming narrow or blocked again. Once the stent is in place the balloon is deflated and pulled out along with the catheter, the stent remains in your artery. Over time cells in your artery grow to cover the mesh of the stent, they create an inner layer that looks like the inside of a normal blood vessel. Stent usually are made of metal mesh but sometimes they're made of fabric. Fabric stents, also called stent graphs, are used in larger arteries. Some stents are coated with medicine that is slowly and continuously released into the artery. The medicine helps prevent scar tissue from blocking the artery following the procedure. Stents can help prevent arteries from becoming narrow or blocked

Aneurysms, localized enlargements of artery walls, can be treated through unassisted endovascular coiling or stent assisted endovascular coiling (BA Foundation, n.d.). Although the treatment methods are effective, their durability and ability to prevent aneurysm recurrence are under question. The purpose of this study was to compare the recurrence rates of aneurysms treated with unassisted coiling and stent assisted coiling. I conducted a quantitative meta-analysis study and looked at studies from 2009 to 2017 involving the treatment of aneurysms of different characteristics with stent assisted coiling method or unassisted coiling method.

Your surgeon may use a stent if you have a large stone. A stent is

Therefore, carotid artery stenting is considered effective and a viable alternative for the patients who are unsuitable for carotid endarterectomy.

The speed and energy formed from this device grinds and demolishes the calcium 1,2 in the walls of the artery. Heavily calcified vessels come from and are associated with coronary artery disease which affects more people than people expect. When a patient comes into the lab to get their coronary arteries checked due to symptoms that prevented them from continuing out daily life activities sometimes the result can be detrimental. All of the major arteries within the heart can be heavily calcified and diseased. Most of the time these patients are sent for bypass surgery or receive a high risk intervention. Due to orbital atherectomy or CSI, the patients now can be helped immensely. The device will grind away at the plaque using a diamond tip converting them into tiny particles that are smaller 2than a red blood cell. This not only helps eliminate the amount of calcium and plaque within the artery, but also helps the doctor be able to slide a balloon or stent in more easily. Ballooning the calcium or plaque can help open up the vessel to slide a stent, but it is not always recommended due to risk of dissection. Rotational atherectomy will work more efficiently in reducing the vessels diameter to help 3move a balloon and stent in place. Research done on the efficacy in treating coronary lesions using the orbital atherectomy has been shown to improve stent placement and has a success 4rate of 97.7 to 98.6 % . Overall, the research showed that the Orbital has meet and exceeded both the safety and efficacy of calcified plaque removal. This number represents a high success rate of intervention or stenting post orbital atherectomy. This means that it is scientifically proven that orbital atherectomy works to lessen the diameter of the vessel due to calcium to help for a better and more efficient stent

Manipulating the transducer to obtain an optimal angle of incidence is important. Sub-xiphoid, subcostal and intercostal views are all potentially used to align the beam with the vessel of interest. Stent material is easily seen using two-dimensional ultrasound. “Shadowing is only a problem when stents covered with fabric such as polytetrafluoroethylene are used. In these cases, gas that is embedded in the fabric will cause shadowing for several days, but eventually the gas is absorbed and the covered stents then appear similar to conventional stents.”8 Middleton, Teefey and Darcy8 note that the use of PFTE endografts will likely become standard as their performance outweighs the early stent materials used. Color Doppler as well as pulsed Doppler should be used to interrogate the stent and supporting vessels. Velocity measurements are taken using angle correct and spectral waveforms are recorded. Careful examination of the liver vasculature is imperative to verify proper stent function. Specifically, thrombosis or occlusion can be assessed with color and Doppler ultrasound. Velocity parameters may vary from patient to patient and also will change from immediate post procedure velocities to those obtained during long term follow up. Universal Doppler criteria has not been established as of yet, although some physicians and facilities have developed

The ureteric stent may aid in the passage of residual stone fragments secondary to the passive ureteric dilation that occurs with an indwelling ureteric stent. 21

In our study, we could evaluate the patency of the stents of various patients by indirect signs of patency (opacification of the vessels distal to the stent).