Infrapopliteal drug-eluting stents for chronic limb ischemia

Grant, A. G., White, C. J., Collins, T. J., Jenkins, J. S., Reilly, J. R. and Ramee, S. R. (2008) Infrapopliteal drug-eluting stents for chronic limb ischemia. Catheterization and Cardiovascular Interventions, 71 1: 108-111. doi:10.1002/ccd.21367


Author Grant, A. G.
White, C. J.
Collins, T. J.
Jenkins, J. S.
Reilly, J. R.
Ramee, S. R.
Title Infrapopliteal drug-eluting stents for chronic limb ischemia
Journal name Catheterization and Cardiovascular Interventions   Check publisher's open access policy
ISSN 1522-1946
1522-726X
Publication date 2008-01
Sub-type Article (original research)
DOI 10.1002/ccd.21367
Volume 71
Issue 1
Start page 108
End page 111
Total pages 4
Place of publication Hoboken, NJ, United States
Publisher John Wiley & Sons
Language eng
Abstract Objective: We report our experience with the elective placement of below-knee, drug-eluting stents in patients with chronic limb ischemia. Background: Infrapopliteal percutaneous transluminal angioplasty has been associated with a lower rate of procedural success and high rate of restenosis because of the small size of the tibial vessels and the prevalence of calcified and diffuse atherosclerotic disease. Prior published data reports 3-year patency rates below 25%. Bare metal stents have been reported in bailout situations. Drug-eluting stents have markedly reduced restenosis compared to bare metal stents in the coronary vasculature, but there is little data supporting the use of these devices below the knee. Methods: Elective placement of drug-eluting stents in infrapopliteal lesions was performed on 10 patients with severe (≥Fontaine Stage IIb) claudication (n = 1) or limb-threatening ischemia (n = 9) (rest pain, nonhealing ulcers and gangrene). Results: A total of 17 drug-eluting stents were electively placed in 12 below-knee arteries in 10 patients, resulting in an average of 1.7 ± 0.7 stents per patient. The mean lesion length was 24.8 ± 10.9 mm, the mean total stent length was 38.3 ± 19.1 mm, and the mean nominal stent diameter was 2.8 ± 0.3 mm. One patient required target vessel revascularization (TVR) at 3 weeks because of stent thrombosis. TVR was 10% at 12.4 ± 6.5 months of follow-up. Clinically driven angiography in three different patients was performed at 4, 15, and 16 months and confirmed drug-eluting stent patency in each case. Conclusions: The use of below-knee drug-eluting stents is feasible and appears to be safe in our small series of complex infrapopliteal lesions causing chronic limb ischemia. The occurrence of a single case of stent thrombosis warrants continued observation in this cohort. Prospective clinical trials will be necessary to confirm the benefits and justify the costs of this strategy for treating patients with infrapopliteal culprit lesions and chronic limb ischemia.
Keyword peripheral vascular disease
restenosis
drug delivery
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 28 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 36 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 14 Mar 2011, 10:22:05 EST