title: Chronic vascular response after self-expanding nitinol stent implantation in superficial femoral arteries: a serial intravascular ultrasound analysis.
abstract: The mechanical properties of the self-expanding nitinol stents (SENS) and chronic biological stimulation on the wall from the SENS have not been fully investigated. This study evaluated the mechanical vascular response to SENS implantation in superficial femoral artery (SFA) lesions using serial volumetric intravascular ultrasound (IVUS). Twenty-five symptomatic patients due to de novo SFA lesions scheduled for SENS placement were prospectively enrolled. Serial IVUS studies were performed immediately after crossing with a guidewire, immediately after the procedure, and at a 8-month follow-up. Serial IVUS volumetric analysis was conducted after stent deployment and at follow-up. Mean stent, lumen and neointimal areas were calculated as the volume divided by the stent length, and the calcium arc was measured. At follow-up, SENS had increased 40.6 % in overall volume. The chronic stent expansion tended to be larger, and the mean neointimal area at the 8-month follow-up was significantly larger in less calcified lesions compared to heavily calcified lesions. As a result, the mean late lumen area loss was significantly larger in lesions with calcium arcs of 0° and in the first and second quadrants than in those with calcium arcs in the third and fourth quadrants (2.8 ± 7.2, 1.3 ± 5.6, 0.6 ± 5.9, 1.2 ± 5.4, -0.8 ± 5.2 mm(2), respectively; p < 0.001). SENSs continued to enlarge with intimal proliferation over 8 months in all lesions. Although arterial calcium affected the degree of chronic stent expansion during the follow-up period, neointimal proliferation was smaller in heavily calcified lesion compared to less calcified lesion following SENS implantation.
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Machiko
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan. kfujii@hyo-med.ac.jp.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukunaga
authors.affiliation: Cardiovascular Division, Morinomiya Hospital, Osaka, Japan.
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Miki
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Ten
authors.initials: T
authors.lastname: Saita
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Horimatsu
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Tamaru
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Imanaka
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Naito
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo, 6638501, Japan.
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D057510:Endovascular Procedures / Q000379:methods; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011446:Prospective Studies; D000069322:Self Expandable Metallic Stents; D018084:Ultrasonography, Interventional / Q000379:methods*; D014655:Vascular Resistance / Q000502:physiology*
chemical_list: D000497:Alloys; C013616:nitinol
keywords: Intravascular ultrasound; Self-expanding nitonol stent; Superficial femoral artery