Abstract
Selection of the optimum instrumentation in individual cases represents an important part of interventional decision making. To date, the majority of these decisions are based on personal experience, evidence-based clinical data, availability, and costs. Decisions based on objective performance criteria are relatively rare due to the lack of a more detailed technical documentation of individual products. Although it is true that even the best technical description of a specific product may not fully capture the behavior of the product in clinical settings, the availability of technical data has a direct impact on the ability of the operators to weight advantages and drawbacks of interventional instrumentation and make informed and better choices between similar and dissimilar products. Given the wealth of products reaching the growing markets, such ability shall likely become even more important in the future. To realize better choices for instrumentation, four basic steps should be considered. First, standard methodology of measurements of biomechanical properties of stents and SDS must be improved; examples and some proposals have been provided in this paper. Second, industry needs to adopt these methods and market their stent products along with the disclosure of the relevant nonproprietary biomechanical data. Third, biomechanical interactions between stents and lesions need to be better studied and understood. Fourth, the results of steps 1–3 need to be clinically applied. Further advancements of the state of the practice and art of intracoronary stenting are an important future goal of the interventional community. This goal will require an ongoing strong interdisciplinary cooperation of physicians, medical engineers, and natural scientists.
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Schmidt, W., Lanzer, P. (2013). Instrumentation. In: Lanzer, P. (eds) Catheter-Based Cardiovascular Interventions. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-27676-7_27
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DOI: https://doi.org/10.1007/978-3-642-27676-7_27
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