Percutaneous implantation of vascular endoprostheses (stents) in the iliac and femoral arteries

Abstract

Flexible, self-expanding metallic mesh stents were implanted via a percutaneous catheter delivery system, immediately after balloon dilatation, in 68 patients (59 males and 9 females; mean age 56.6 [40-73] years). All had stenoses or occlusion of the iliac or femoral arteries. The bridged vessel segments were 3.5-27 cm long; the stent lumen ranged from 6 to 12 mm diameter. Good blood flow was restored in all 68 patients. The Doppler sonographic index increased on average by 0.33 to a mean of 0.9 (0.4-1.2). An early stent occlusion occurred in three patients (one femoral artery with a stented length of 27 cm thrombosed after 24 hours, two iliac stents were found to be occluded four and eight weeks, respectively, after insertion). Transitory peripheral emboli occurred in two patients with femoral stents. In five patients (four with femoral stents, one with an iliac stent) marked intimal hyperplasia with stenosis developed after 4-10 months; in four of them they were successfully treated by the percutaneous technique. The described percutaneous stent placement method is suitable for treating arterial stenoses or occlusions which cannot be satisfactorily dilated by balloon, as well as restenoses and local complications after angioplasty. It is particularly effective in iliac arteries.