Journal of Vascular and Endovascular Therapy

Editorial

The first commercially available covered stent was Corvita^®, which was developed in Belgium by Jean Pierre Becquemin [1]. In 1997, we began our experience with corvita, it was a braided elgiloy frame coated by urethane fibers that has been replaced in sequence by Wallgraft. In 2001, I did a monograph “Percutaneous treatment of the vascular trauma” to be holder from the Brazilian college of surgeons (Figure 1).

Figure 1 Braided elgiloy frame coated by urethane fibers has been replaced in sequence by wallgraft.

Covered stents have expanded the use of endovascular procedures [2]; they can be either with Dacron (Wallgraft^®) or polytetrafluoroethylene (Solaris^®, Viabahn^®, iCast^® (outside the United States, Advanta^® V12), Jostent^®, Fluency^®) and can be balloon-expandable (iCast^® or Advanta^® V12) or self-expandable (Solaris^®, Viabahn^®, Jostent^®, Wallgraft^®). The treatment of vascular disease has changed dramatically during the last two decades. They are used mainly for the treatment of traumatic arterial lesions [3], arteriovenous fistulas or false aneurysms, peripheral aneurysms and, more recently, for the treatment of obstructive vascular disease of the aortoiliac and femoropopliteal sectors. To treat visceral artery aneurysms (vaas) covered stents can be useful ,when the artery is not so tortuous and the vaas are not intraparenquimal [4].The major technical limitations to implant it in vaas are severe tortuosity or sometimes small caliber arteries. There are a lot of available stent grafts, we are getting experience, now, with the new brazilian covered stent, Solaris^® (Figures 2-5) This stent-graft is more radiopaque than other conventional nitinol stents available in Brazil, it is a flexible selfexpanding stent graft with PTFE. Those stents are a barrier to the ingrowth of neointimal hyperplasia, sealing off the inflammatory surface, and thus have the potential to inhibit restenosis [5].

Figure 2 Angiotomography before treatment of a very calcified left subclavian artery.

Figure 3 During the endovascular procedure, before covered stent deployment in a symptomatic patient with subclavian steal syndrome.

Figure 4 Arteriography control during surgery.

Figure 5 Final control after after six months and patient with improvement of symptoms.

References

1. Desgranges P, Mialhe C, Cavillon A, Alric P, Qvarfordt P, et al. (1997) Endovascular repair of posttraumatic thoracic pseudoaneurysm with a stent graft. Am J Roentg 169:1743-1745.
2. Raherinantenaina F, Rajaonanahary TMA, RakotoRatsimba HN (2015) Update on diagnostic and therapeutic features of peripheral artery pseudoaneurysms following orthopedic and traumatologic surgery. Rev Vasc Med 3: 16e-21e.
3. Reis PO, Roever L, Reis IO, De AzambujaFontes F, Nascimento MR, et al. (2016) Endovascular stent grafting of a deep femoral artery pseudoaneurysm. EJVES Short Rep 33:5-8.
4. Reis PE, Roever L, Reis IF (2016) Embolization for visceral artery aneurisms: what’s your opinion? J VascEndovascSurg 1:1.
5. Gilbertson JJ, Pettengill OS, Cronenwett JL (1992) Antiproliferative effect of heparin on human smooth muscle cells cultured from intimal hyperplastic lesions of vein grafts. Ann Vasc Surg 6:265-271.