Stent as Concertina

A "Stent Concertina"Call it an accordian, a concertina or a “squeezebox”…but don’t call it a stent. Because one thing that is not music to your ears is a coronary stent that you have carefully placed to relieve your patient’s symptoms — and which then gets shorter or longer when you push or pull another catheter, balloon or wire through it.

This is an issue that was first raised a little over a month ago and it has been the subject of a number of news articles. It’s been dubbed “the concertina effect” but its scientific name is “longitudinal stent compression” or “longitudinal stent distortion” and it’s of concern because once a stent has been correctly sized and placed in just the right position to keep a blockage open…well, you don’t want it moving or changing shape.

Yet this can occur during an angioplasty — rarely, but more often in some particular stents than in others, according to a bench-test that was published this week in JACC Cardiovascular Interventions.

For a complete report on this bench-test, read our article, “New Boston Scientific Stent Shows Significant Shortening Compared to Other 2nd Generation DES” and, if you are an interventional cardiologist, read our follow up piece, “Avoiding and Repairing Coronary Stent Distortion“, which contains tips and tricks from Dr. John A. Ormiston, lead author of the JACC study.

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