Arterial kink and damage in normal segments of the superficial femoral and popliteal arteries abutting nitinol stents--a common cause of late occlusion and restenosis? A single-center experience.
Arterial kink and damage in normal segments of the superficial femoral and popliteal arteries abutting nitinol stents--a common cause of late occlusion and restenosis? A single-center experience.
复制标题
毗邻镍钛合金支架的股浅动脉和腘动脉正常段的动脉扭结和损伤——晚期闭塞和再狭窄的常见原因？
DOI：
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发表时间：
2005
期刊：
影响因子：
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通讯作者：
Frank Arena
中科院分区：
文献类型：
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作者：
Frank Arena
客观化
目的：确定一种新的血管造影参数，该参数与较大的腹股沟下动脉镍钛合金支架置入术的短期和长期效果差有关。
背景
镍钛支架已被证明是治疗跛行和威胁肢体的缺血的有用和安全的工具，但并不完美。镍钛合金支架治疗股浅动脉闭塞1年后原、继发性通畅率达80%，2年后再狭窄率在40~50%之间。SFA和月国窝窝再狭窄的原因尚不清楚。支架断裂在一些再狭窄病例中也有牵连，但这显然是少数。血管-支架相互作用引起的动脉慢性机械损伤，随着时间的推移，肢体运动加剧，似乎是一个更合理的解释。
方法
本文报告2例再狭窄，明显是由于动脉与相对坚硬的镍钛合金支架系统末端的相互作用对血管造成的急慢性损伤所致。
结果
未来一些再狭窄和闭塞事件的来源在常规血管造影术中是不明显的。
结论
在台上进行80-90度的腿部弯曲测试的额外步骤将使干预者能够直观地看到在常规运动过程中发生的许多本征动脉与支架之间的负相互作用。这使得操作员可以潜在地避免支架引起的动脉损伤。
OBJECTIVE
To identify a new angiographic parameter associated with poor short- and long-term outcomes with nitinol stenting in the larger infrainguinal arteries.
BACKGROUND
Nitinol stents have proven to be useful and safe, but imperfect, tools for treating claudication and limb-threatening ischemia. Primary and secondary patency in superficial femoral artery (SFA) occlusions treated with nitinol stents are up to 80% at 1 year, but restenosis is between 40-50% at 2 years. The causes of SFA and popliteal restenosis remain unclear. Stent fracture has been implicated in some cases of restenosis, but this is clearly the minority. Chronic mechanical trauma to the arteries caused by native vessel-stent interaction, intensified by limb motion over time, appears to be a more plausible explanation.
METHODS
Presented here are 2 cases of restenosis apparently caused by acute and chronic trauma to the native vessel from interaction of the artery with the ends of relatively rigid nitinol stent systems.
RESULTS
The source of some future restenotic and occlusive events are not apparent using routine angiography techniques.
CONCLUSION
The additional step of an on-table leg bend test at 80-90 degrees will allow the interventionalist to visualize many cases of negative interaction between the native artery and the stents that will occur during routine movement. This allows the operator to potentially avoid stent-induced arterial trauma.