Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-18T19:15:34.807Z Has data issue: false hasContentIssue false

Initial assessment of a novel delivery system (NuDEL ®) for the covered Cheatham-Platinum stent

Published online by Cambridge University Press:  15 June 2017

Gareth J. Morgan*
Affiliation:
Departments of Paediatric and Adult Congenital Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, London, United Kingdom
Damien Kenny
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Christopher Duke
Affiliation:
East Midlands Congenital Heart Centre, Glenfield Hospital, Leicester, United Kingdom
Kevin P. Walsh
Affiliation:
Department of Paediatric Cardiology, Our Lady’s Hospital for Sick Children, Crumlin, Dublin, Ireland
Shakeel A. Qureshi
Affiliation:
Departments of Paediatric and Adult Congenital Cardiology, Evelina London Children’s Hospital, Guy’s and St Thomas’ NHS Foundation Trust, King’s College London, London, United Kingdom
*
Correspondence to: Dr G. J. Morgan, Department of Congenital Cardiology, Children’s Hospital of Colorado, University of Colorado, Denver, CO 80045, United States of America. Tel: +1 720 777 3379; Fax: +1 720 777 7177; E-mail: [email protected]

Abstract

Aims

We sought to evaluate the first-in-man use of a new system for implantation of covered stents in patients with complex structural and CHD.

Methods and results

Retrospective data were collected of the first 13 NuDEL™ delivery systems used in patients. The NuDEL™ comprises a covered Cheatham-Platinum stent mounted on a balloon-in-balloon and pre-loaded in a long delivery sheath. Data were collected from three centres in the United Kingdom and Ireland. A total of 13 covered stents were delivered via 12 NuDEL™ delivery systems in 12 patients. Among them, six patients had coarctation of the aorta, five patients had right ventricular outflow tract stenosis, and one patient had severe stenosis of a Mustard systemic venous baffle. There were no complications, and all the stents were deployed in the desired position with satisfactory haemodynamic results.

Conclusions

The development of a bespoke system of a pre-mounted, pre-loaded covered stent may negate some of the technical challenges that complicate large-calibre stent deployment. Our preliminary results suggest that the NuDEL™ system is a safe and effective means of covered stent deployment in challenging anatomy.

Type
Original Articles
Copyright
© Cambridge University Press 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Boe, BA, Zampi, JD, Schumacher, KR, Yu, S, Armstrong, AK. The use and outcomes of small, medium and large premounted stents in pediatric and congenital heart disease. Pediatr Cardiol, 2016; 37: 15251533.Google Scholar
2. Danon, S, Gray, RG, Crystal, MA, et al. Expansion characteristics of stents used in congenital heart disease: serial dilation offers improved expansion potential compared to direct dilation: results from a Pediatric Interventional Cardiology Early Career Society (PICES) Investigation. Congenit Heart Dis, 2016; 11: 741750.Google Scholar
3. Meadows, J, Teitel, D, Moore, P. Anatomic and technical predictors of stent malposition during implantation for vascular obstruction in patients with congenital and acquired heart disease. JACC Cardiovasc Interv 2010; 3: 10801086.Google Scholar
4. Taggart, NW, Minahan, M, Cabalka, AK, et al. Immediate outcomes of covered stent placement for treatment or prevention of aortic wall injury associated with coarctation of the aorta (COAST II). JACC Cardiovasc Interv 2016; 9: 484493.Google Scholar
5. Vanagt, WY, Cools, B, Boshoff, DE, et al. Use of covered Cheatham-Platinum stents in congenital heart disease. Int J Cardiol 2014; 175: 102107.CrossRefGoogle ScholarPubMed
6. Boudjemline, Y, Malekzadeh-Milani, S, Patel, M, et al. Predictors and outcomes of right ventricular outflow tract conduit rupture during percutaneous pulmonary valve implantation: a multicenter study. Eurointervention 2016; 11: 10531062.Google Scholar
7. Tretter, JT, Jones, TK, McElhenney, DB. Aortic wall injury related to endovascular therapy for aortic coarctation. Circ Cardiovasc Interv 2015; 8: e002840.CrossRefGoogle ScholarPubMed