Skip to main content
Log in

The platinum chromium element stent platform: from alloy, to design, to clinical practice

  • Review
  • Published:
Advances in Therapy Aims and scope Submit manuscript

Abstract

Despite advances in polymer and drug technology, the underlying stent platform remains a key determinant of clinical outcome. A clear understanding of stent design and the differences between various stent platforms are of increasing importance for the interventional cardiologist. Reduction in stent strut thickness has been associated with improved stent deliverability, improved procedural outcome, and lower rates of subsequent restenosis. Newer-generation 316L-SS stent designs have enabled reduced strut thickness while retaining radial strength and minimizing recoil, but with significant loss of radiopacity, leading to reduced visibility. Cobalt chromium alloys have enabled a reduction in stent strut thickness to around 80–90 mm while retaining modest radiopacity, but due to higher elastic properties, have been associated with greater stent recoil. Development of a novel 33% platinum chromium alloy with high radial strength and high radiopacity has enabled design of a new, thin-strut, flexible, easily visualized, and highly trackable stent platform, the use of which is further illustrated in several clinical case descriptions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Kastrati A, Mehilli J, Dirschinger J, et al. Intracoronary Stenting and Angiographic Results: Strut Thickness Effect on REstenosis Outcome (ISAR-STEREO) trial. Circulation. 2001;103:2816–2821.

    CAS  PubMed  Google Scholar 

  2. Briguori C, Sarais C, Pagnotta P, et al. In-stent restenosis in small coronary arteries: impact of strut thickness. J Am Coll Cardiol. 2002;40:403–409.

    Article  PubMed  Google Scholar 

  3. Hausleiter J, Kastrati A, Mehilli J, et al. Impact of lesion complexity on the capacity of a trial to detect differences in stent performance: results from the ISAR-STEREO trial. Am Heart J. 2003;146:882–886.

    Article  PubMed  Google Scholar 

  4. Rittersma SZ, de Winter RJ, Koch KT, et al. Impact of strut thickness on late luminal loss after coronary artery stent placement. Am J Cardiol. 2004;93:477–480.

    Article  PubMed  Google Scholar 

  5. Pache J, Kastrati A, Mehilli J, et al. Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO-2) trial. J Am Coll Cardiol. 2003;41:1283–1288.

    Article  PubMed  Google Scholar 

  6. Turco M, Ormiston JA, Popma JJ, et al. Reduced risk of restenosis in small vessels and reduced risk of myocardial infarction in long lesions with the new thin-strut Taxus Liberté stent: one-year results from the Taxus ATLAS program. JACC Cardiovasc Interv. 2008;1:699–709.

    Article  PubMed  Google Scholar 

  7. Kastrati A, Schomig A, Dirschinger J, et al. Increased risk of restensosis after placement of gold-coated stents. Circulation. 2000;101:2478–2483.

    CAS  PubMed  Google Scholar 

  8. Reifart N, Morice MC, Silber S, et al. The NUGGET study: NIR ultra gold-gilded equivalency trial. Catheter Cardiovasc Interv. 2004;62:18–25.

    Article  PubMed  Google Scholar 

  9. Kereiakes DJ, Cox DA, Hermiller JB, et al. Usefulness of a cobalt chromium coronary stent alloy. Am J Cardiol. 2003;92:463–466.

    Article  CAS  PubMed  Google Scholar 

  10. Craig CH, Radisch HR, Trozera TA, et al. Development of a platinum-enhanced radiopaque stainless steel (PERSS). In: Winters GL, Nutt MJ, eds. Stainless Steels for Medical and Surgical Applications, ASTM STP 1438. Conshohocken, PA: ASTM International; 2003;28–38.

    Chapter  Google Scholar 

  11. Craig CH, Friend CM, Edwards MR, Cornish LA, Goken NA. Mechanical properties and microstructure of platinum enhanced radiopaque stainless steel (PERSS) alloys. J Alloys Comp. 2003;361:187–199.

    Article  CAS  Google Scholar 

  12. O’Brien BJ, Stinson JS, Larsen SR, et al. A platinumchromium steel for cardiovascular stents. Biomaterials. 2010;31:3755–3761.

    Article  PubMed  Google Scholar 

  13. Abundes A, Rivera J de, Arizmendi E, et al. [Immediate and long-term results of implantation of the new platinum coronary stent (Atlas stent) in patients with coronary artery disease]. Rev Esp Cardiol. 2002;55:1205–1208. Article in Spanish.

    PubMed  Google Scholar 

  14. Tzifa A, Ewert P, Brzezinska-Rajszys G, et al. Covered Cheatham-platinum stents for aortic coarctation: early and intermediate-term results. J Am Coll Cardiol. 2006;47:1457–1463.

    Article  CAS  PubMed  Google Scholar 

  15. Aggarwal S, Garekar S, Forbes TJ, Turner DR. Is stent placement effective for palliation of right ventricle to pulmonary artery conduit stenosis? J Am Coll Cardiol. 2007;49:480–484.

    Article  PubMed  Google Scholar 

  16. O’Brien B, Carroll W. The evolution of cardiovascular stent materials and surfaces in response to clinical drivers: a review. Acta Materialia. 2009;5:945–958.

    Google Scholar 

  17. Haidopoulos M, Turgeon S, Sarra-Bournet C, Laroche G, Mantovani D. Development of an optimized electrochemical process for subsequent coating of 316 stainless steel for stent applications. J Mater Sci Mater Med. 2006;17:647–657.

    Article  CAS  PubMed  Google Scholar 

  18. Data on file. Boston Scientific 2007 (Liberté), 2008 (Vision), 2009 (Element).

  19. Kereiakes D, et al. TAXUS PERSEUS: a novel platinum chromium, thin-strut TAXUS Element stent for the treatment of de novo coronary stenoses. Presented at: ACC/i2Late Breaking Trials. American College of Cardiology annual meeting; March 15, 2010; Atlanta, GA.

  20. The PLATINUM clinical trial to assess the PROMUS Element stent system for treatment of de novo coronary artery lesions. Available at: www.clinicaltrials.gov/ct2/results?term=The+PLATINUM+Clinical+Trial+to+Assess+the+PROMUS+Element+Stent+System+for+Treatment+of+De+Novo+Coronary+Artery+Lesions. Accessed: March 31, 2010.

  21. Platinum chromium technical bulletin PDM 90353760. Data on file. Boston Scientific; 2009.

  22. Turco MA, Ormiston JA, Popma JJ, et al. Polymerbased, paclitaxel-eluting Taxus Liberté stent in de novo lesions: the pivotal Taxus ATLAS trial. J Am Coll Cardiol. 2007;49:1676–1683.

    Article  CAS  PubMed  Google Scholar 

  23. Data on file. Testing conducted at Boston Scientific; 2008.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ian B. A. Menown.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Menown, I.B.A., Noad, R., Garcia, E.J. et al. The platinum chromium element stent platform: from alloy, to design, to clinical practice. Adv Therapy 27, 129–141 (2010). https://doi.org/10.1007/s12325-010-0022-9

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12325-010-0022-9

Keywords

Navigation