Early outcome and intermediate follow-up of vascular stents in the femoral and popliteal arteries without long-term anticoagulation

White, Geoffrey H.; Liew, Stephen C.C.; Waugh, Richard; Stephen, Michael S.; Harris, John P.; Kidd, Jenifer; Sachinwalla, Toos; Yu, Weiyun; May, James R.

doi:10.1016/s0741-5214(95)70268-7

Cited by 89 publications

(33 citation statements)

References 28 publications

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“…13,14 However, mechanical factors may contribute to late stent failure in the peripheral arteries. In a controlled study using intravascular ultrasound to examine stents implanted in compressible vascular sites, including the superficial femoral artery and hemodialysis fistulae, 'stent compression' was identified as the principal cause of restenosis.…”

Section: Discussionmentioning

confidence: 99%

Fracture of Popliteal Artery Stents

Babalık

Gülbaran

Gürmen

et al. 2003

Circ J

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tent implantation in the peripheral arteries is a safe and effective treatment not only for obstructive diseases, but also non-obstructive conditions such as aneurysm formation. 1,2 More than 50% of all obstructive lesions are located in the femoropopliteal segment where they tend to be longer and have multiple coexisting atherosclerotic lesions at different levels. Surgical revascularization is the treatment of choice for these diffuse femoropopliteal stenoses and although percutaneous transluminal angioplasty (PTA) has a high risk of occlusion, it is the recommended primary treatment. Stent implantation for femoropopliteal occlusions is not recommended because of poor patency rates, and should only be considered for major dissections after PTA because stenting has been associated with acute thrombosis, stent embolization or migration, distal embolization by plaque contents, vessel rupture or dissection. [3][4][5][6] In addition to these acute complications, late stent restenosis remains an unresolved clinical problem. Although stent fracture occurs rarely, it may contribute to or cause late stent failure when implanted in arteries near or at flexion points in the peripheral arteries. Stent fracture has occurred after iliac arterial stenting 7 and we describe a case of fracture in overlapping stents implanted in the left popliteal artery. Case ReportA 48-year-old man was referred for coronary and peripheral arteriography. He reported left calf claudication of 3 years' duration that had progressively worsened in the past few months. His complaints were pain and numbness with mild exercise. He had had non-insulin dependent diabetes mellitus for 1 year and had smoked 1 pack of cigarettes per day for 33 years. On physical examination, both his lower limbs were pale and cool. His left femoral pulse was present, but the left popliteal and left lower extremity pulses were absent. Right femoral and popliteal pulses were present, and the distal pulses in right lower extremity were also palpable. The ankle -brachial index was 0.32 for the left limb. There was not any ulcer formation related to occlusive arterial disease on either leg.The diagnostic coronary and peripheral arteriography revealed 2-vessel coronary artery disease: a severe stenosis in the proximal segment of the left popliteal artery and 50% narrowing of the right popliteal artery. There was late filling of the vasculature distal to the severely narrowed left popliteal artery (Fig 1). We used a standard angioplasty technique from an antegrade, ipsilateral puncture of the left common femoral artery with an 8F sheath. The lesion was crossed Circ J 2003; 67: 643 -645 (Received November 14, 2001; revised manuscript received January 21, 2002; accepted February 15, 2002

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Section: Discussionmentioning

confidence: 99%

Fracture of Popliteal Artery Stents

Babalık

Gülbaran

Gürmen

et al. 2003

Circ J

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“…[3][4][5][6][13][14][15][16][17] Those studies disclose quite different results because of differences of the extent and characteristics of the lesions, differences among patients, and variable use of stents.…”

Section: Discussionmentioning

confidence: 99%

Primary Utilization of Stents in Angioplasty of Superficial Femoral Artery

Wolosker

Nakano

Morales³

et al. 2003

Vasc Endovascular Surg

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Percutaneous transluminal angioplasty (PTA) of infrainguinal arteries has been frequently reported in the literature. Independent of the technical feasibility, the results, in short-and long-term follow-up differ among published series. The objective of this article was to assess the long-term results of angioplasty in small, (<3 cm) segmental lesions of the superficial femoral artery treated with primary stenting. Eighteen patients (12 men, 6 women) with lesions of the superficial femoral artery smaller than 3 cm were selected for endovascular treatment and follow-up. The median patient age was 65 years (range, 54 to 84). The indication for treatment was intermittent claudication in 7 patients and critical ischemia (ischemic pain associated with trophic lesions) in 11 patients (62%). Of these, 13 lesions were stenoses and 5 total occlusions. The run-off was good in 15 patients who had more than 2 distal arteries and 3 had only 1 patent artery. During follow-up, all patients were observed with physical examination, progressive exercise treadmill test; pulse volume was measured with Doppler and duplex scan after 1, 3, and 6 months, and then twice a year. There was only 1 primary failure; the initial success rate was 94%. During follow-up of 40 months (6 to 70 months), only 1 patient presented with thrombosis of the stent 6 months after the procedure. There was no symptomatic restenosis in our study. One patient suffered an acute myocardial infraction after 45 months and died. The primary patency after 1 and 3 years was 88%. No patient was lost to follow-up. Primary stenting of segmental lesions (less than 3 cm) of the superficial femoral artery produced satisfactory results immediately and during long-term follow-up.

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“…While we routinely prescribe antiplatelet agents for months after carotid stenting, long-term anticoagulation does not appear to be necessary. 13 During the procedure, we selected a delivery sheath larger than the recommended 8-F SIMIONATO ET AL. J ENDOVASC THER 2000;7:136-140 size in order to have sufficient working space.…”

Section: Discussionmentioning

confidence: 99%