A new ostial stent positioning system (Ostial Pro™) for the accurate placement of stents to treat aorto‐ostial lesions

Abstract

The stenting of aorto-ostial lesions in the native coronary circulation, renal arteries, and saphenous vein grafts is technically challenging. We report the first in the world use of the Ostial Protrade mark, a novel nitinol-based device, utilized in conjunction with standard stenting techniques to assist in the precise placement of stents for the treatment of aorto-ostial lesions. The Ostial Pro, is a relatively simple nitinol device that is positioned within the guiding catheter. It has distal, self-expanding legs that are advanced just distal to the tip of the guiding catheter after the ostial lesion has been crossed with the coronary guidewire and stent delivery system. The expanded nitinol legs prevent the entry of the guiding catheter into the target vessel, mark the plane of the aortic wall, and align the tip of the guide with the aorto-ostial plane. We report the successful and precise placement of stents in the aorto-ostial location in two patients with; (1) a saphenous vein graft ostial lesion and (2) a right coronary ostial lesion, using the new Ostial Pro stent positioning device. Excellent stent positioning, relative to the aorto-ostial plane, was confirmed by angiography and long axis intravascular ultrasound in both cases. (1) The Ostial Pro is a new, commercially available (FDA cleared), nitinol device that is simple to use and appears effective in allowing the precise placement of stent(s) at the aorto-ostial location. (2) This approach may provide a simple and effective means to assure accurate stent placement in these difficult to treat lesions.