The FDA has granted approval to the Minima stent, a groundbreaking cardiac stent designed specifically for neonates, infants, and young children suffering from aortic coarctation or branch pulmonary artery stenosis. This marks a significant advancement in pediatric cardiology, offering a minimally invasive solution that can expand as the child grows.
The approval was based on data from a national clinical trial spearheaded by Children’s Hospital Los Angeles (CHLA). Just two days after the FDA's decision on August 28, the CHLA team performed the first commercial implantation of the Minima stent in a young patient in the U.S.
A Minimally Invasive Solution for Growing Hearts
Traditionally, balloon-mounted vascular stents used in pediatric patients were originally designed and tested for adults, limiting options for infants and young children. The Minima stent addresses this gap by providing a device tailored to the unique needs of the smallest patients.
"For the first time, we have a vascular stent that’s specifically made for our smallest patients and can potentially provide a lifetime solution for them," said Darren Berman, MD, Director of Congenital Interventional Catheterization at CHLA and national principal investigator of the study. "This is going to help so many babies and young children. It’s a groundbreaking moment."
The Minima stent offers a minimally invasive alternative for neonates and infants with narrowing in the aorta or pulmonary arteries. Previously, the options were limited to balloon angioplasty (less effective than a stent) or repeat open-heart surgery. For pulmonary artery stenosis, interventional cardiologists sometimes adapted adult stents, but size constraints were a challenge.
Clinical Trial Results
The FDA's approval was supported by data from a pivotal clinical trial led by CHLA. The prospective, nonrandomized study included 42 patients across seven centers in the U.S., with 10 patients treated at CHLA. Results showed that 97.6% of patients experienced effective relief from their stenosis.
Six months post-implantation, no patients required additional surgical intervention for stent dysfunction, and no major adverse events were reported. The stent, manufactured by Renata Medical, is pre-mounted and crimped onto a balloon inside a catheter. Its design features long, thin frames (struts) and can be crimped down to less than 2 millimeters, enabling delivery via a slim catheter.
Designed for Growth
A key feature of the Minima stent is its ability to expand from 5 millimeters to 24 millimeters, accommodating growth from infancy to adulthood. Dr. Berman anticipates that patients receiving the stent will likely undergo two to four expansions over their lifetime, performed through minimally invasive catheter procedures, with the goal of providing a lifelong solution.
"This new device opens up treatment options that will allow many of our patients to avoid another major cardiac operation," explained Dr. Sullivan. "And since this stent is designed specifically for babies with these issues, it will allow us to perform these procedures in a more optimal way."
