ABSTRACT
The Sorin Carbostent is characterized by a complete set of original features aimed to address major procedural and long-term outcome issues (Table 12.1). The design is based on an homogeneous cellular architecture (Figure 12.1). The cell interconnection scheme provides longitudinal flexibility, avoids a fishscale effect consequent to bending during implantation, and obtains zero shortening of the stent upon expansion. Two radiopaque platinum markers positioned at the stent ends ensure excellent fluoroscopic visibility, while the low degree of Carbostent radiopacity does not interfere with the angiographic appearance and quantitative coronary angiography (QCA) analysis of the contrast-filled coronary lumen. The presence of radiopaque markers, together with no shortening upon expansion, allows very precise positioning and safe postdilatation. Each cell of the Carbostent is designed to realize an ideal elastic matching between the stent and the vessel wall, in order to avoid stress concentration, which can stimulate neointimal proliferation and in-stent restenosis. To achieve this goal, the cell consists of different curved segments, each one characterized by a variable cross-section to optimize individual mechanical response to stent expansion, flexure, and torsion (Figure 12.1). The entire surface of the Carbostent is treated with electrochemical and diamond polishing, derived from Sorin’s heart valve technology that provides round edges and a mirror-like surface (Figure 12.2a). The smooth surface enhances stent trackability, while stent rounded edges minimize the risk of vessel injury during stent advancement into the coronary arteries. The stent is available in a full range of sizes. The lengths are 9, 12, 15, 19, 25, and 32 mm. The diameters are 2.5 mm (4 cells configuration), 3.0-3.5 mm (5 cells), and 4.0 mm (6 cells). The characteristics of the Carbostent delivery system are summarized in Table 12.2.
