Peripheral Stents: R2P Misago Flashcards
What is the difference between Balloon Expandable (BX) and Self-Expandable (SX) stents?
BX: BMS or DES mounted on balloon. Scaffolding locks permanently after balloon expansions. + radial strenght / - flexibility
SX: collapsed BMS or DES that expands once exposed to heat/moisture within vessel. It is permanent via friction. + flexibility.
What has a higher risk of ISR - a BMS or a DES?
BMS because it depends on endothelial growth to hold it in place, and does not have drugs attached that discourage tissue growth.
What are some of the benefits of RX platform stents?
Single operator
Reduced radiation exposure
Shorter guidewires
Faster device exchange
What are some of the perceived draw backs of a RX stent platform?
Decreased pushability
Increased susceptibility to kinking
What types of stents are most commonly seen in the SFA?
Nitinol, self-expanding
What is the difference between an “open cell” vs. “closed cell” stent design?
Open cells do not have connecting links between the struts so they are more flexible. Close cells have those connecting links and are more rigid.
What are some of the potential issues that operators need to consider when placing a stent?
Foreshortening (shrinking)
Elongation (stretching)
Jumping
Apposition/Expansion
True or False: the Misago stent was originally brought to market as a femoral stent
True
R2P Misago is IFU in the ____________ areas, in ______mm diameter vessels and in lesions ______.
SFA to Proximal Popliteal
4 - 7mm
up to 150cm in length
True or False: Misago can be used from the femoral, pedal or radial access approach.
True
Misago is a BX or SX stent?
SX
Misago is a BMS, DES or Covered stent?
BMS
Misago comes on a Nitinol or Stainless Steel system?
Nitinol
Misago is a OTW or RX system and comes in _____ size?
RX
035
What is the working length of the Misago stent?
200cm
R2P Misago stents come in _____mm diameters and ______mm lenghts.
6-8mm diameters
40-150mm lengths
R2P Misago stents have _____ coating and are ___Fr comptible.
Hydrophilic
6Fr
There are ____ markers on each end of the proximal and distal portion of the stent.
3
What are some contraindications for R2P Misago?
1) Tall patients with radial-iliac artery distance greater than 150cm
2) known UE PVD, severe subclavian disease
3) Extreme tortuosity, known anatomical abnormalities
4) Presence of AVF, aortic aneurysm/dissection
5) anomalous radial take off
6) Buerger’s Disease, Raynaud’s Phenomenon
How many depth markers are on R2P Misago and at what lengths?
2
120 + 150cm from distal tip
What is the general rule of thumb for stent sizing a Misago stent?
The vessel should be 1-2mm smaller than the stent diameter
OR
The stent should be 1-2mm larger than the vessel diameter
Ex: 5mm vessel should have a 6 or 7mm stent
What are the 3 primary F&B’s of Misago?
1) FELXIBILITY - open cell design
2) CONFORMABILITY - high crush resistance
3) DEPLOYMENT - thumbwheel, single-op
What was FF MAE @ 30 days in the OSPREY trial?
99.2%
What was FF TLR @ 12mos in the OSPREY trial?
88.6%
What was Primary Patency @ 12mos in the OSPREY trial?
82.9%
What was FF Stent Fracture x/stent in the OSPREY trial?
99.1%
