Abstract

Significant advances have been made in femoropopliteal stent design and clinical outcomes during the past decade. Initial randomized studies demonstrated superiority of nitinol self-expanding stents to balloon angioplasty for treatment of moderate-length superficial femoral artery stenoses. During longer-term follow-up, first generation nitinol stents were hampered by high rates of stent fracture. A number of newer nitinol stent designs have been developed with improved conformability, greater radial strength and lower rates of long-term stent fracture. These newer stent designs have demonstrated superior primary patency and decreased restenosis for the treatment of moderate-length femoropopliteal lesions relative to historical benchmarks. Recent advances in drug-eluting nitinol stents have also offered treatment options for challenging lesion subsets including very long femoropopliteal lesions and for the treatment of in-stent restenosis. This article reviews recent advances and upcoming research in nitinol self-expanding stent technology for the treatment of superficial femoral and popliteal artery stenosis.

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