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NIRxcell Co-Cr Coronary Stent System by Medinol

Dr. Alaide Chieffo, MD; Interventional Cardiology Unit, San Raffaele Scientific Hospital, Milan, Italy

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Background

This case outlines  the first in-patient implantation of  the NIRxcell cobalt chromium  bare  metal stent   system  (Medinol).   This  challenging  case  involved  a  patient  with  flow-limiting lesions  and  extensive coronary aneurysms. The new NIRxcell stent system offers very good scaffolding properties while conforming to the vessel’s natural form and dynamic motion. In addition, the delivery system of NIRxcell includes an innovative metallic spring tip that was designed to enhance cross-ability by its superior flexibility and buckle resistance. Other stent delivery systems, typically having polymer distal tips, are prone to flare-out and buckling that may impact deliverability.

Figure 1: Lesions In The OM1
Figure 2: NIRxcell Stent Placement
Figure 3: Final Result

 

Case Report

A 53-year-old male with prior history of coronary artery disease was treated at San Raffaele Hospital in Milan, Italy. His coronary angiography showed extensive coronary artery aneurysms in the LAD, focal lesion in the Ramus and tight lesions within an aneurysm in the proximal segment of a dominant first obtuse marginal (OM1) branch. The lesions in the OM1 were hard to reach due to three tight angulations from the left main to the OM1 and a tight lesion at the end of the third angulation (Figure 1, red dashed line).

 

Discussion and Conclusion

The procedure with the NIRxcell stent system (Medinol) was successful and the final angiographic result was satisfactory. The NIRxcell stent system with the metallic spring tip was highly deliverable; it easily traversed the tight “Z” shaped angulations and crossed the lesion. Moreover, the radiopaque metallic spring tip enabled me to visualize the precise location of the catheter tip during the insertion. Finally, a NIRxcell stent was implanted at the OM1 and blood flow was restored. The new concept and design of the NIRxcell spring tip seem promising and should be further tested following the success of this procedure. Interestingly, exactly 18 years ago, the first NIR stent was implanted at the Columbus Hospital in Milan by Dr. Antonio Colombo (Figure 4). The NIR stent was implanted in a patient with a shephard’s hook that was impossible to cross at the time with the Palmaz-Schatz stent. NIRxcell is the newest generation in the NIR legacy of stents and highlights Medinol’s twenty year commitment to interventional cardiology.

Figure 4: First Implantation of NIR Stent in 1995

Disclosure of Commercial Conflict of Interest: Nothing to disclose