Long-term Results with the Palmaz Stent in the Superficial Femoral Artery

Abstract

Purpose: Femoral stenting has demonstrated inconsistent and often disappointing long-term results. To compare our experience, we retrospectively analyzed a series of patients who had Palmaz balloon-expandable stents placed exclusively for superficial femoral artery (SFA) lesions. Methods: From January 1990 to November 1993, 39 patients were evaluated for claudication (79%) or critical ischemia in 42 limbs. The culprit lesions were confined to the SFA: 24 (57%) occlusions and 18 (43%) stenoses, including 3 restenotic lesions. Stenting was elective in 12 (29%) cases: the 3 restenoses and 9 chronic, calcified occlusions. The remaining stents were applied for postangioplasty residual stenosis or angioscopic findings of thrombogenic luminal irregularities. A total of 55 prostheses were successfully implanted. All patients were maintained on ticlopidine and followed by routine duplex scanning. Follow-up angiography was performed in 28 (72%) patients between 4 and 45 months. Results: In the postprocedural period, two acute thromboses (4.8%) occurred within 48 hours in patients who had long occlusions and poor runoff; no other major complications were encountered, for a clinical success rate of 95%. Follow-up evaluation ranged from 4 months to 4 years with a mean of 25 months. The restenosis rate was 19% (34% in occlusions; 10% in stenotic lesions, p = NS). At 24 months, cumulative primary patency was 77% and secondary patency 89%. Conclusions: Palmaz stents performed well in the SFA, demonstrating a low acute thrombosis rate and good long-term patency. The incidence of restenosis is likely to be greater in occlusions than in stenoses.

Midterm Outcomes From the TALON Registry:Treating Peripherals With SilverHawk:Outcomes Collection

“…11,12 For example, a 7% rate of grade ՆC dissection with cryoplasty 12 and dissection rates ranging from 1% to 60% with percutaneous angioplasty 13 have been previously described. The low (0.1%) TALON 30-day occlusion and thrombosis rate also compared well with the data previously reported for stents (as high as 4.8% 14 ). Embolism was observed in 0.1% of the lesions treated.…”

Percutaneous Treatment of Long Superficial Femoral Artery Occlusive Disease: Efficacy of the Hemobahn Stent-Graft

“…18 Some studies have shown early favorable results, but durability was similar or even worse than for angioplasty. 6,[23][24][25] Three randomized studies [26][27][28] comparing femoropopliteal angioplasty and Palmaz stent placement demonstrated improved technical success (84% for dilation versus 99% for stent 26 ), but the 1-year patency rates were similar for both groups (ϳ60% primary and 80% secondary).…”

An Update on Endovascular Therapy of the Lower Extremities

“…The first phase of SIROCCO demonstrated reduction in intimal hyperplasia in the rapamycin-coated stents, but the difference was not significant. 71 However, strut fractures were noted in both the control arm and the drug-eluting stent arm of SIROCCO, which was one of the first studies to look Figure 3ࡗ Pooled data illustrating the primary patency of various SFA revascularization techniques at 1 to 4 years: angioplasty (subintimal), 30,[93][94][95][96][97][98][99][100][101][102] angioplasty (primary), [8][9][10]14 nitinol stents, [68][69][70][71][72] stents (excluding nitinol), [49][50][51][52][53][54][55][56][57][58][59][60][61][62][63][64][65][66] covered stents (Hemobahn), 31,[83][84][85][86][87]…”