title: A direct nitinol stent delivery technique for endovascular treatment: a sheath-less stenting technique.
abstract: Access site problems often cause serious complications in endovascular treatment. The aim of this study is to investigate whether a sheath-less nitinol stenting technique leads to reduce access site complications. This study was a single-center retrospective analysis of a prospectively maintained database. The study enrolled consecutive 98 patients with 111 lesions undergoing provisional stenting for de novo iliac artery or femoro-popliteal artery stenosis between August 2010 and November 2011. The patients were divided into two groups, a conventional procedure group and a sheath-less procedure group. The outcomes of this study were peri-procedural access site complications, initial success rate, procedure time, hemostatic time and bed-rest time. Forty-four lesions in 39 patients that treated using the sheath-less nitinol stent delivery technique were compared with 67 lesions in 59 patients treated using the conventional procedure. All procedures were successful. The incidence of pseudoaneurysm was significantly lower in the sheath-less procedure group than in the conventional procedure group (p = 0.043). However, there were no significant differences in any other complications. No significant difference was observed in the procedural time (p = 0.309). However, hemostatic time and bed-rest time were significantly shorter in the sheath-less procedure than in the conventional procedure (p < 0.0001). A sheath-less stenting technique reduced the access site incidence of pseudoaneurysm and did not increase other access site complications. Besides, this technique shortened hemostatic time and bed-rest time. The sheath-less stenting technique is considered to be a useful method for endovascular treatment.
authors.affiliation: Department of Cardiology, Cardiovascular Center, Shin-Koga Hospital, 120 Tenjin-cho, Kurume, 830-8577, Japan, yoshiaki0407@yahoo.co.jp.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shintani
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kawasaki
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujimura
authors.forename: Kouichirou
authors.initials: K
authors.lastname: Ishida
authors.forename: Takanori
authors.initials: T
authors.lastname: Higuchi
authors.forename: Masataka
authors.initials: M
authors.lastname: Kajiwara
authors.forename: Ryota
authors.initials: R
authors.lastname: Fukuoka
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Orita
authors.forename: Kyoko
authors.initials: K
authors.lastname: Umeji
authors.forename: Hisashi
authors.initials: H
authors.lastname: Koga
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Koga
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D000800:Angioplasty, Balloon / Q000295:instrumentation*; D057510:Endovascular Procedures; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011150:Popliteal Artery; D012189:Retrospective Studies; D015607:Stents
chemical_list: D000497:Alloys; C013616:nitinol