ABSTRACT
PURPOSE: To evaluate the effectivity, safety and midterm patency rates of iliac and femoral stent placement with the Memotherm stent (Bard-Angiomed, Karlsruhe). MATERIAL AND METHODS: In 41 patients (11 female, 30 male, mean age 63.9 years) 49 lesions were treated with 50 stents. Mean lesion length was 4.8 cm for 5 occlusions and 3.1 cm for 44 stenoses. Lesions were located in the common iliac (n = 31), the external iliac (n = 15), and the common femoral artery (n = 3). Patients were followed-up clinically, with ankle-brachial indices (ABI), and angiography. Angiographic patency rates (< or = 50% restenosis) were calculated using the Kaplan-Meier method, ABIs were compared before and after therapy with the Wilcoxon test. RESULTS: An immediate technical success was achieved in 48/49 lesions (98%, intention-to-treat). Visibility of the stent was poor. Four stent placement procedures were complicated by an advancement of the stent, which could not be corrected. A thrombosis of one stent during deployment had to be treated surgically. After a mean of 10.4 months (6-24) 33 lesions were followed-up with angiography. The primary angiographic patency rate was determined to be 89.9% after 9 months. An improvement of at least one Fontaine stage was observed in 85.4%. The mean ABI increased significantly from 0.64 to 0.84 after therapy. CONCLUSIONS: The patency rate of the Memotherm stent is comparable to that of other stent systems. The poor visibility and the advancement of the stent during deployment requires further modifications.
Subject(s)
Arterial Occlusive Diseases/surgery , Femoral Artery , Iliac Artery , Stents , Aged , Aged, 80 and over , Angiography, Digital Subtraction , Arterial Occlusive Diseases/diagnostic imaging , Confidence Intervals , Female , Follow-Up Studies , Humans , Male , Middle Aged , Prospective Studies , Stents/adverse effects , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the efficacy of contrast material-enhanced magnetic resonance (MR) angiography for the diagnosis of peripheral arterial occlusion and follow-up after stent placement. MATERIALS AND METHODS: Sixty-seven patients (21 women, 46 men; mean age, 64.6 years) were examined. Digital subtraction angiography and contrast-enhanced MR angiography were performed in 28 patients for preinterventional evaluation of iliofemoral arterial occlusion and in 39 patients for follow-up after stent placement in the iliac or femoral arteries, which had been performed several months before. RESULTS: All 24 occlusions were correctly diagnosed with contrast-enhanced MR angiography. Of the 59 stenoses, 36 were greater than 50% and 23 were 50% or less. Sensitivity and specificity for the detection of stenoses greater than 50% were 100% and 83%, respectively. Patency of the different stents was determined correctly with contrast-enhanced MR angiography. Some stents caused signal intensity dropout, which made MR evaluation of stents difficult. Generally, these signal intensity artifacts were most severe in stainless steel stents and mild in some nitinol stents. CONCLUSION: Contrast-enhanced MR angiography is comparable to digital subtraction angiography for the detection of stenosis greater than 50% and occlusion in the iliofemoral arteries. Stent patency can be determined, but contrast-enhanced MR angiography is not suitable for stent evaluation owing to signal intensity dropout; however, it provides information about the vascular anatomic areas proximal and distal to the stent.
Subject(s)
Arterial Occlusive Diseases/diagnosis , Arterial Occlusive Diseases/therapy , Femoral Artery , Iliac Artery , Magnetic Resonance Angiography , Stents , Angiography, Digital Subtraction , Arterial Occlusive Diseases/diagnostic imaging , Contrast Media , Female , Gadolinium DTPA , Humans , Injections, Intravenous , Male , Middle Aged , Prospective Studies , Sensitivity and Specificity , Vascular PatencyABSTRACT
PURPOSE: Evaluation of midterm success and patency rates after placement of Cragg stents in iliac arteries. MATERIAL AND METHODS: During a period of 26 months 16 patients, with a total of 19 iliac lesions were treated percutaneously by placement of 20 stents. Indications of stent placement were iliac occlusion in 4 cases and high-grade iliac stenoses in 15 cases. Indication for stent placement in the stenotic lesions were insufficient results following balloon angioplasty in 11 cases and extensive dissection in 4 cases. RESULTS: The ankle-brachial index was improved from 0.53 +/- 0.28 to 0.85 +/- 0.26 immediately after the intervention and was 0.80 +/- 0.15 at 16 months follow-up. Cumulative patency rate was 71% after 12 months. CONCLUSION: The occlusion and restenosis rates are high. Disadvantages of Cragg stents are low flexibility and a large bore introducer system. The radiopacity of the Cragg stent is advantageous for fluoroscopic positioning.
