Masterclass #13: Laser-cut and Braided Stents: Enemy Brothers?

Guilherme DABUS, Tufail PATANKAR, Vitor MENDES PEREIRA, Jacques MORET, Laurent SPELLE

From the provocative title, to the carefully chosen clinical cases, join Professors Jacques Moret and Laurent Spelle and their expert panel as they discuss, review and illuminate the nature and different clinical options of these self-expandable stents.

Beginning with the “technological duality” inherent in their design, learn about the differences between “closed” and “open cell” laser-cuts stents and how they compare to braided stents.

Learn how laser-cut stents are compressed on themselves within the catheter and are approximately the same length in and outside the catheter, while braided stents are stretched to fit inside the catheter and appear shorter outside.

• In choosing between laser-cut and braided stents, what role does this difference in length play? Could there be a danger in choosing the wrong length of an open-cell, laser-cut stent? Why?
• The discontinuous body of an open-cell laser-cut stent makes it impossible to recapture or re-sheath – but could its excellent predictability and precision of deployment compensate for this?
• What clinical situations would lead you to choose a braided stent?
• What about conformability to the vessel? Which of these stents changes the anatomy the least, and why?
• Is there still an indication for using a stent in a carotid siphon or saccular bifurcation aneurysm or is this now the sole domain of the flow diverter?

These questions and more are answered in the following cases, specially chosen to explore the use of laser-cut and braided stents and to better understand why, where and how they are employed…