Superficial femoral artery recanalization with self-expanding nitinol stents: long-term follow-up results.
OBJECTIVE
Since long-term patency and device integrity of nitinol stents in SFA lesions are not well studied, we examined clinical outcome, patency and device integrity after stenting long lesions using a standardized implantation technique.


METHODS
Between 2001 and 2006, 59 patients (74 lesions) were treated with the same nitinol self-expandable stent (Zilver, Cook, USA) and technique for SFA recanalization. Clinical charts and imaging were retrospectively reviewed for patency (primary and assisted-primary), and device integrity.


RESULTS
Patients were 74.5 (10.9) years old (range 49 to 93), 64% male, 42% diabetic, 62% hypertensive and 67% current or former smokers. Lesions were 23% TASC B, 16% TASC C, or 61% TASC D. Mean recanalization length was 19 cm (range 3 to 53). Mean number of stents per patient was 2.8 (total 210). Mean follow-up time was 2.4 years (range 3 days to 4.8 years). Kaplan-Meier estimates for primary patency rates were 90%, 78%, 74%, 69%, and 69% at 1, 2, 3, 4 and 4.8 years, respectively. Ten restenoses at a mean of 500 (388) days (1-1251 days) were successfully recanalized. The assisted primary patency rates were 96%, 90%, 90%, 90% and 90% at 1, 2, 3, 4 and 5 years, respectively. Six complete occlusions could not be reverted by a second recanalization procedure, and were treated by surgical bypass (1 case), amputation (3 cases), or medical management (2 cases). One (1.04%) Class II stent fracture was noted.


CONCLUSIONS
SFA recanalization with a standardized implantation technique and nitinol stents provides good long-term primary and assisted-primary patency.
Ferreira
M
M
Endovascular Techniques Integrated Service (SITE), Rio de Janeiro, Brazil. mmvf@uol.com.br
Lanziotti
L
L
Monteiro
M
M
Abuhadba
G
G
Capotorto
L F
LF
Nolte
L
L
Fearnot
N
N
D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D004868:Equipment Failure; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D007511:Ischemia / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D019233:Retreatment; D012189:Retrospective Studies; D015607:Stents
D000497:Alloys; C013616:nitinol