Stenting

In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent. A wide variety of stents are used for different purposes, from expandable coronary, vascular and biliary stents, to simple plastic stents that allow urine to flow between kidney and bladder. "Stent" is also used as a verb to describe the placement of such a device, particularly when a disease such as atherosclerosis has pathologically narrowed a structure such as an artery.

A stent is different from a shunt. A shunt is a tube that connects two previously unconnected parts of the body to allow fluid to flow between them. Stents and shunts can be made of similar materials, but perform two different tasks.

Stent types

Etymology

The current accepted origin of the word ''stent'' is that it derives from the name of an English dentist, Charles Thomas Stent (1807–1885), notable for his advances in the field of denture-making. He was born in Brighton, England, on October 17, 1807, was a dentist in London, and is most famous for improving and modifying the denture base of the gutta-percha, creating the stent's compounding that made it practical as a material for dental impressions. Others attribute the noun ''stent'' to Jan F. Esser, a Dutch plastic surgeon who in 1916 used the word to describe a dental impression compound invented in 1856 by Charles Stent, whom Esser employed to craft a form for facial reconstruction. The full account is described in the ''Journal of the History of Dentistry''. According to the author, from the use of Stent's compound as a support for facial tissues evolved the use of a stent to hold open various body structures.

The verb form "stenting" was used for centuries to describe the process of stiffening garments (a usage long obsolete, per the ''Oxford English Dictionary''), and some believe this to be the origin. According to the Merriam Webster Third New International Dictionary, the noun evolved from the Middle English verb ''stenten'', shortened from ''extenten'' 'to stretch', which in turn came from Latin ''extentus'', the past participle of ''extendō'' 'to stretch out'.

The first (self-expanding) "stents" used in medical practice in 1986 by Ulrich Sigwart in Lausanne were initially called "Wallstents" after their inventor, Hans Wallstén.
Julio Palmaz ''et al.'' created a balloon-expandable stent that is currently used.

History

The first use of a coronary stent is typically attributed to and Ulrich Sigwart, who implanted a stent into a patient in Toulouse, France, in 1986. That stent was used as a scaffold to prevent a vessel from closing and to avoid restenosis in coronary surgery—a condition where scar tissue grows within the stent and interferes with vascular flow. Shortly thereafter, in 1987, Julio Palmaz (known for patenting a balloon-expandable stent ) and Richard Schatz implanted their similar stent into a patient in Germany.

Though several doctors have been credited with the creation of the stent, the first FDA-approved stent in the U.S. was created by Richard Schatz and coworkers. Named the Palmaz-Schatz ( Johnson & Johnson), it was developed in 1987.

To further reduce the incidence of restenosis, the drug-eluting stent was introduced in 2003. Research has led to general stent design changes and improvements since that time. Bioresorbable scaffolds have also entered the market, though a large-scale clinical trial showed higher acute risks compared to drug-eluding stents. As a result, the FDA issued an official warning for their use in 2013, and research on the design and performance optimisation of stents is ongoing.

See also

* Bioresorbable stent
* Bronchoscopy
* Colonoscopy
* Esophagogastroduodenoscopy
* Grommet
* Interventional radiology

References

External links

Coronary Stent



Cardiovascular and Interventional Radiological Society of Europe

The Cardiovascular Forum

Stent for Life Initiative

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Implants (medicine)
Interventional radiology
Medical devices