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Comparison of visibility for four self-expanding nitinol bare stents in vitro.
MedLine Citation:
PMID:  22969090     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BackgroundSufficient radiopacity of stents is a prerequisite for safe interventions and minimization of the radiation dose for the patient and the interventionist. Modern nitinol stents are considered less radiopaque compared to formerly used stents.PurposeTo evaluate the objective detection rate (ODR) and the subjective radiopacity score (SRS) of four self-expanding nitinol stents with their markers on a phantom human pelvis.Material and MethodsWe evaluated the ODR (as a percentage of correctly identified stents) and the SRS (on a scale from 0 = not visible to 4 = excellent visibility) for four self-expanding nitinol stents (SinusSuperflex, SMART, Luminexx, Zilver) with 8 mm diameter and 40 mm length. Stents were placed on a phantom human pelvis and images of the stents were taken in four different positions (right and left lumbosacral joint and near the right and left limbus acetabuli) using the following modes: spotfilm, pulsed fluoroscopy (4, 7.5, 15, and 30 pulses/min) and at three different digital magnification modes. Dose area products (DAPs) were assessed.ResultsODR and SRS, respectively, were significantly increased for the SMART stent compared to all other tested stents (P < 0.05): SMART 93.53% and 2.43, SinusSuperflex 90.81% and 2.21, Luminexx 90.39% and 2.20, and Zilver 89.28% and 2.21. ODR was significantly reduced in position 3 where the bone overlap was more pronounced for all stents (detection rates 77.14-79.56%). An increase in magnification significantly improved the ODR and SRS for all stents (70.33-99.25% and 1.07-3.28, respectively, P < 0.05). Increased pulsing frequency did not improve the ODR of the various stents but did increase the DAP.ConclusionThe SMART stent had the best overall performance. In the presence of bone overlap, all self-expanding nitinol stents had poor results. Increased pulsing frequency did not improve ODR or SRS but did increase the DAP. Use of digital magnification modes had no effect on DAP increasing ODR and SRS.
Authors:
Benjamin Wiesinger; Alexander Stütz; Jörg Schmehl; Gerd Groezinger; Claus Detlef Claussen; Jakub Wiskirchen
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-11
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  -     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Division of Diagnostic Radiology, Department of Radiology, University of Tübingen.
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