Work

OPTILOW: A Low‐Profile Approach for Implanting Optimus‐L Stents in Infants and Children

Year: 2025

Type: article

Abstract: Background Stent implantation poses challenges in small children due to their limited vessel size and rapid growth. This multicenter study evaluates in vivo efficacy of implanting Optimus‐L stents in small patients using a low‐profile approach. Methods We retrospectively reviewed data from children weighing ≤20 kg with congenital heart stenotic lesions who received Optimus‐L stents manually mounted on small‐sized balloon catheters (diameter ≤12 mm) using a hand‐actuated compression tool and implanted through small‐sized sheaths (≤8 Fr) at our institutions between May 2022 and January 2024. Stent performance was assessed. Results We identified 28 patients (67.8% male) with median age and weight of 3.4 years (interquartile range [IQR], 1.5–5.5) and 12.9 kg (IQR, 9.1–16.4). Six (21.4%) were infants, 11 (39.3%) ≤10 kg. Stenotic lesions included 16 branch pulmonary arteries, 9 aortic isthmus, 2 right ventricular outflow tracts, and 1 Glenn anastomosis. Percentage of stenosis was 50% (IQR, 36%–58%). All implantations were successful without complications. The procedures mostly used 7 Fr sheaths for stents on 6, 7, and 8 mm balloons and 8 Fr sheaths for 9, 10, 12 mm balloons. Median stent expansion percentage was 95% (IQR, 90%–96%). Median vessel diameters increased from 4.6 mm (IQR, 3.8–5.1) to 8.8 mm (IQR, 7.5–9.5) ( P <0.001), with median stenosis expansion at 103% (IQR, 51%–146%). Median stent shortening was 1.9% (IQR, 0%–3.9%). Two patients required redo stent balloon dilation after 18 and 20 months. Median follow‐up was 8 months (IQR, 3.2–13.2). Median last recorded Doppler velocity on implanted stents was 1.6 m/s (IQR, 1.2–2). Conclusions Optimus‐L stents can safely treat arterial and venous stenosis in infants and small children via a low‐profile approach with good outcomes.

Source: Journal of the American Heart Association

DOI: 10.1161/jaha.124.038301