Background - The explosive increase in coronary STENTING has made it the primary option for the treatment of many coronary lesions, especially after reducing the risk of subacute stent thrombosis and hemorrhagic complications. This technique is now considered as a promising new technique in highly selected lesions to reduce the time, cost, radiation exposure and dye used in the procedure. Method - In this study from January 1998 to March 2000, we prospectively studied 102 cases of primary coronary STENTING in 96 patients according to pre-specified criteria (absence of severe calcification, angulation > 450, occlusion, bifurcation, and vessel < 2.5 mm diameter). The impact of primary STENTING in terms of cost, time, radiation and the amount of dye used was assessed in comparison to conventional STENTING in our experience. Results- The stent crossed the lesions without predilation in 95 patients (94.3%) and was successfully deployed in all of them. Crossing the lesion was not successful in 7 patients (6.8%). In these cases the stent was retrieved uneventfully and deployed after predilation. Conclusion - Primary STENTING appears to be applicable in selected lesions and seems to be safe and successful in reducing cost, time, radiation and the amount of dye used

Children with diminished pulmonary blood flow (different forms of severe pulmonary stenosis or atresia) suffer from severe life-threatening cyanosis and need interventions to increase this flow. The classic way is a surgical modified BT shunt. However, this operation carries a 10% risk of death and a higher risk of morbidities like chylothorax, phrenic nerve palsy, and others. A substitute to the surgery is ductal STENTING. In many neonates, ductus arteriosus can be left open with the aid of prostaglandins and then by coronary or small peripheral stents to provide enough pulmonary blood flow. The procedure is less traumatic and equally successful. Based on the angle of ductus to the aorta and cardiac anatomy, it can be done via venous or arterial approach. The most fearing complication of the arterial approach is vascular injury which can be reduced almost to nil using small radial sheaths. Heart block is a frequent complication of the venous approach which may fail the procedure. Turtuosity of the ductus with acute angles may hamper its STENTING. The whole length of the ductus should be stented; otherwise the unstented areas will contract and diminish the flow. Origin stenosis of the branch pulmonary arteries is a relative contraindication as ductal STENTING may obliterate one or both branches. In summary, ductal STENTING is a reliable substitute to surgical shunt in many neonates with diminished pulmonary flow.

Background: Carotid artery STENTING is now used as an alternative to surgical endarterectomy. This study was done to assess the feasibility, safety, and immediate and late clinical outcomes in patients undergoing carotid STENTING.Methods: Between July 2008 and December 2009, a total of 40 patients (20 male, mean age: 65±11 years, 19 symptomatic, and 90% high risk for endarterectomy) underwent carotid artery STENTING with different embolic protection devices and carotid stents. Thirty-seven patients had coronary artery disease. Technical success rate, stroke/death/ myocardial infarction rate at 30 days, access-site complications, and contrast-induced nephropathy were assessed. For the evaluation of the influence of experience in carotid artery STENTING on complications, the patients were divided into two groups: Group 1 included the first 20 treated patients and Group 2 comprised the remainder of the patients.Results: The overall technical success rate was 100%. The cumulative in-hospital stroke death rate was 7.5% (n=3: 2 deaths and 1 major stroke). Complications were more frequent in Group 1 (2/20, 10%; 2 deaths) than in Group 2 (1/20, 5%; 1 major stroke), but this was not statistically significant (p value=0.09). No access-site complications occurred, and mild contrast-induced nephropathy occurred in 3 patients (7.5%). No major stroke or neurological deaths occurred during a mean follow-up of 12 months.Conclusion: Carotid STENTING seemed feasible and relatively safe in our experience. Advanced experience in carotid artery STENTING appears to confer an acceptable peri-procedural stroke-death rate.

INTRODUCTION: To evaluate the perioperative complications and long-term restenosis rates following percutaneous transluminal angioplasty and STENTING (PTAS) in patients with intracranial atherosclerotic stenosis (ICAS).METHODS: A retrospective analysis was performed on the clinical data of 102 ICAS patients (103 cases of stenosis) who underwent PTAS. The perioperative complications and long-term restenosis rates were analyzed.RESULTS: The success rate of PTAS was 100%. Six patients (5.83%, 6/103) had perioperative complications. Six cases (6.52%, 6.92) of restenosis occurred and one patient (1.09%) died. Five of the 6 restenosis cases (5.43%) occurred in the blood-supplying region and were associated with ischemic symptoms and one patient (1.09%) had no ischemic symptom. The postoperative restenosis rates at 6, 6 – 12, and 12 – 74 months were 3.26%, 2.56%, and 2.38%, respectively. The postoperative restenosis rates had a significant difference between the residual stenosis rate ≥ 20% and < 20% (P < 0.05), and between postoperative regular medication and non-regular medication (P < 0.05). The postoperative restenosis risk in patients with age ≥ 60 years was 13.481 times to that in patients with age < 60 years. The postoperative restenosis risk in patients with residual stenosis rate < 20% was 31.25 times to that in patients with residual stenosis rate ≥ 20%. The postoperative restenosis risk in patients with regular medication was 12.65 times to that in patients without regular medication.CONCLUSIONS: The vasospasm, arterial dissection, arterial occlusion and acute thrombosis are common perioperative complications following PTAS in patients with ICAS. The medium- and long-term postoperative restenosis rate is low. Age is the risk factor for postoperative restenosis.

Renal artery revascularization is established with regard to its technical efficiency but its place in the total clinical setting is unclear and advances in the available devices continue to change. The situation with regard to referrals varies throughout the world ranging from direct treatment to an integrated team approach. The advantages of the latter will be described with key relationships with, for example, nephrologists and vascular surgeons being described and the mutual benefits being illustrated. Analysis of patient demographics and close monitoring of population changes particularly in those patients with renal impairment can result in greater awareness of renal artery stenos is as a treatable condition in a percentage of the patient group. At the same time as developing a team approach the ability to deliver a reliable low risk intervention in these patients will enhance the team relationship. The newer low profile stent systems allied to a systematic organized protocol will keep complications to a minimum. The lower complication rates and high technical success rates including the ability to use arm access when necessary or preferred will be discussed in relationship to both the ‘GREAT' study and the ‘ODORI' registry (multicentre European studies).