Efficacious use of nitinol stents in the femoral and popliteal arteries

Todd R. Vogel, Larry E. Shindelman, Gary B. Nackman, Alan M. Graham, Michael Silva, Steven P. Rivers, John J. Ricotta, Sean D. O'Donnell, Hasan Dosluoglu, K. Craig Kent

Research output: Contribution to journalArticle

72 Citations (Scopus)

Abstract

Objective: To evaluate the performance and identify predictors of outcome after the use of self-expanding nitinol stents in the treatment of femoropopliteal arterial occlusive disease. Methods: A retrospective analysis of a prospectively collected database was performed. Outcomes of patients who underwent placement of a nitinol stent in the femoral or above-knee popliteal arteries between 1999 and 2002 were studied. Patency, limb salvage, and patient survival were determined by Kaplan-Meier estimation and intergroup comparisons by log-rank test and Cox proportional hazards model. To define individual factors associated with clinical outcomes, stepwise regression analysis was performed. Results: A total of 41 patients (mean age, 70 ± 10 years; gender, 26 men and 15 women) underwent percutaneous placement of nitinol stents. Limb salvage was the indication for intervention in 68% of patients. Diabetes was present in 54%, and 36% had end-stage renal disease. Nitinol stents were placed in the superficial femoral (35 patients) or the above-knee popliteal (6 patients) arteries. The mean postprocedural increase in ankle-brachial index was 0.32 ± 0.19. The 6-month, 1-year, and 2-year primary patency and limb-salvage rates were 95%, 84%, and 84%, and 92%, 89%, and 89%, respectively. Major amputations occurred only in patients undergoing limb-salvage procedures presenting with major tissue loss. No statistically significant differences in patency were seen with regard to diabetes, end-stage renal disease, runoff score, length of vessel stented (median, 80 mm), hypertension, or smoking. Conclusions: Our initial experience with self-expanding nitinol stents for femoropopliteal occlusive disease appears to demonstrate acceptable patency and limb-salvage rates at these early time points. Further evaluation of clinical outcome with these devices in this and larger groups of patients is warranted.

Original languageEnglish (US)
Pages (from-to)1178-1184
Number of pages7
JournalJournal of Vascular Surgery
Volume38
Issue number6
DOIs
StatePublished - Dec 2003
Externally publishedYes

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Popliteal Artery
Femoral Artery
Stents
Limb Salvage
Thigh
Chronic Kidney Failure
Knee
Ankle Brachial Index
Arterial Occlusive Diseases
nitinol
Amputation
Proportional Hazards Models
Arteries
Smoking
Regression Analysis
Databases
Hypertension
Equipment and Supplies
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Vogel, T. R., Shindelman, L. E., Nackman, G. B., Graham, A. M., Silva, M., Rivers, S. P., ... Kent, K. C. (2003). Efficacious use of nitinol stents in the femoral and popliteal arteries. Journal of Vascular Surgery, 38(6), 1178-1184. https://doi.org/10.1016/j.jvs.2003.09.011

Efficacious use of nitinol stents in the femoral and popliteal arteries. / Vogel, Todd R.; Shindelman, Larry E.; Nackman, Gary B.; Graham, Alan M.; Silva, Michael; Rivers, Steven P.; Ricotta, John J.; O'Donnell, Sean D.; Dosluoglu, Hasan; Kent, K. Craig.

In: Journal of Vascular Surgery, Vol. 38, No. 6, 12.2003, p. 1178-1184.

Research output: Contribution to journalArticle

Vogel, TR, Shindelman, LE, Nackman, GB, Graham, AM, Silva, M, Rivers, SP, Ricotta, JJ, O'Donnell, SD, Dosluoglu, H & Kent, KC 2003, 'Efficacious use of nitinol stents in the femoral and popliteal arteries', Journal of Vascular Surgery, vol. 38, no. 6, pp. 1178-1184. https://doi.org/10.1016/j.jvs.2003.09.011
Vogel, Todd R. ; Shindelman, Larry E. ; Nackman, Gary B. ; Graham, Alan M. ; Silva, Michael ; Rivers, Steven P. ; Ricotta, John J. ; O'Donnell, Sean D. ; Dosluoglu, Hasan ; Kent, K. Craig. / Efficacious use of nitinol stents in the femoral and popliteal arteries. In: Journal of Vascular Surgery. 2003 ; Vol. 38, No. 6. pp. 1178-1184.
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abstract = "Objective: To evaluate the performance and identify predictors of outcome after the use of self-expanding nitinol stents in the treatment of femoropopliteal arterial occlusive disease. Methods: A retrospective analysis of a prospectively collected database was performed. Outcomes of patients who underwent placement of a nitinol stent in the femoral or above-knee popliteal arteries between 1999 and 2002 were studied. Patency, limb salvage, and patient survival were determined by Kaplan-Meier estimation and intergroup comparisons by log-rank test and Cox proportional hazards model. To define individual factors associated with clinical outcomes, stepwise regression analysis was performed. Results: A total of 41 patients (mean age, 70 ± 10 years; gender, 26 men and 15 women) underwent percutaneous placement of nitinol stents. Limb salvage was the indication for intervention in 68{\%} of patients. Diabetes was present in 54{\%}, and 36{\%} had end-stage renal disease. Nitinol stents were placed in the superficial femoral (35 patients) or the above-knee popliteal (6 patients) arteries. The mean postprocedural increase in ankle-brachial index was 0.32 ± 0.19. The 6-month, 1-year, and 2-year primary patency and limb-salvage rates were 95{\%}, 84{\%}, and 84{\%}, and 92{\%}, 89{\%}, and 89{\%}, respectively. Major amputations occurred only in patients undergoing limb-salvage procedures presenting with major tissue loss. No statistically significant differences in patency were seen with regard to diabetes, end-stage renal disease, runoff score, length of vessel stented (median, 80 mm), hypertension, or smoking. Conclusions: Our initial experience with self-expanding nitinol stents for femoropopliteal occlusive disease appears to demonstrate acceptable patency and limb-salvage rates at these early time points. Further evaluation of clinical outcome with these devices in this and larger groups of patients is warranted.",
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AU - Silva, Michael

AU - Rivers, Steven P.

AU - Ricotta, John J.

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