title: Early experience with the EntrustTM delivery system for stent treatment of the lower extremities' arteries via transbrachial approach.
abstract: OBJECTIVE
  The femoral artery remains the access of choice in the majority of peripheral vascular interventions. However, specific conditions indicate catheterization of the brachial artery. Contrary to balloon catheters, the majority of stent delivery systems are too short to facilitate transbrachial implantation of self-expandable stents (SES) in the superficial femoral artery (SFA). We report our experience with a new 150 cm working length SES-delivery system for transbrachial lower extremity interventions.
  
  
  METHODS
  All patients treated with the Entrust(TM) delivery system (EDS) for lower extremity peripheral arterial disease (PAD) via a transbrachial access between December 2012 and February 2014 were included into this study. All data were prospectively collected and analyzed. Primary endpoints were the feasibility and safety of the EDS in the transbrachial setting. Secondary endpoints consisted of stent length accuracy after deployment, early clinical outcome and perioperative complications.
  
  
  RESULTS
  Thirty-seven EverFlex(TM) stents with Entrust(TM) delivery system were implanted transbrachially in twenty-eight (N.=28) patients. The transbrachial implantation of a SES using the EDS was feasible in all patients. Stent compression or elongation >10%, premature jumping or movements of the implanted stents were not observed in any patient. Although no stent fractures were observed, a single stent occlusion was noticed. Early clinical success was achieved in all but one patient, with one patient requiring a surgical revision of the puncture site due to pseudoaneurysm.
  
  
  CONCLUSIONS
  The early experience with the new SES-delivery system suggests that EDS enables the safe and effective treatment of the lower extremities PAD via a transbrachial approach. However, further evaluation is needed to define whether the use of the new long shaft stent delivery system influences the performance of the EverFlex(TM) stent in the long run.
authors: Department of Vascular Surgery, St Franziskus Hospital Münster,and Clinic for Vascular and Endovascular Surgery, Münster University Hospital, Münster, Germany - stavroulakis.konstantinos@yahoo.gr.
authors: K
authors: K
authors: Stavroulakis
authors: T
authors: T
authors: Bisdas
authors: G
authors: G
authors: Torsello
authors: M J
authors: MJ
authors: Bosiers
authors: A
authors: A
authors: Schwindt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001916:Brachial Artery; D002406:Catheterization, Peripheral / Q000009:adverse effects / Q000379:methods*; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000628:therapy*; D011446:Prospective Studies; D011677:Punctures; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D062666:Vascular Access Devices