Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents
Purpose: To investigate the incidence, anatomical location, and clinical impact of fractures and/or compression of infrapopliteal balloon-expandable metal stents implanted for critical limb ischemia (CLI) treatment. Methods: This prospective study included 63 CLI patients (45 men; mean age 71.3±9.5...
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| Veröffentlicht in: | Journal of endovascular therapy 2009-02, Vol.16 (1), p.15-22 |
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| creator | Karnabatidis, Dimitris Katsanos, Konstantinos Spiliopoulos, Stavros Diamantopoulos, Athanasios Kagadis, George C. Siablis, Dimitris |
| description | Purpose:
To investigate the incidence, anatomical location, and clinical impact of fractures and/or compression of infrapopliteal balloon-expandable metal stents implanted for critical limb ischemia (CLI) treatment.
Methods:
This prospective study included 63 CLI patients (45 men; mean age 71.3±9.5 years) who had been treated with infrapopliteal angioplasty and stent placement for 191 lesions in 84 limbs. In all, 369 stents (296 stainless steel and 73 cobalt-chromium alloy) were implanted; 239 were placed overlapping in tandem lesions. Mean length of the overall stented segment was 4.4±6.3 cm (range 1.6–14.0). Stents were located in the tibioperoneal (n=34), anterior tibial (n=195), posterior tibial (n=63), and peroneal (n=77) arteries. Follow-up consisted of digital subtraction angiography and infrapopliteal radiography imaging at 2 different angles. Evaluation of stents for the presence of fracture and/or compression was done after digital processing at the highest possible magnification. Stent fractures were defined according to published standards, whereas compression was classified as severe shape alteration and/or collapse of the stent mesh. Angiographic restenosis was based on a 50% threshold.
Results:
Mean follow-up was 15±11 months (range 6–60). Image analysis detected 1 (0.3%) severe stent fracture (complete separation and misalignment of stent struts) and 11 (3.0%) stent compressions. Infrapopliteal stent fracture and compressions were associated with increased artery restenosis [100% (12/12) versus 47.3% (169/357), p |
| doi_str_mv | 10.1583/08-2530.1 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_67031651</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sage_id>10.1583_08-2530.1</sage_id><sourcerecordid>1652601531</sourcerecordid><originalsourceid>FETCH-LOGICAL-c407t-b1f7255e7860796f6b56044c984a45f2608d0f67bda9eff244837de8320f0f363</originalsourceid><addsrcrecordid>eNplkcFuFSEUhonR2Fpd-AKGuDAx6SgwA8Ms25tWb3KNC3VNGObQ0DAwApPoI_jWMu1NbqIrDicfHyfnR-g1JR8ol-1HIhvG23p5gs4p73hDOSdPt5qJRhAmz9CLnO8JYZRR-hyd0YFJymR_jv7sg3ETBAOX-CroEmdntMeHaHRxMVxiHSa88y48tL-5u-BsLSuPo8W7OC8Jcq5kfiBvkzZlrS3sAt4Hm_QSF-8K1MfX2vsYQ3Pza6moHj3gL1A2a4FQ8kv0zGqf4dXxvEA_bm--7z43h6-f9rurQ2M60pdmpLZnnEMvBekHYcXIBek6M8hOd9wyQeRErOjHSQ9gLes62fYTyJYRS2wr2gv07tG7pPhzhVzU7LIB73WAuGYletJSwWkF3_4D3sc1hTqbqlukdKhbrtD7R8ikmHMCq5bkZp1-K0rUFo4iUm3hqE345ihcxxmmE3lM4zRa1ndw-u1_01-NKJVG</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>211119155</pqid></control><display><type>article</type><title>Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents</title><source>Access via SAGE</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Karnabatidis, Dimitris ; Katsanos, Konstantinos ; Spiliopoulos, Stavros ; Diamantopoulos, Athanasios ; Kagadis, George C. ; Siablis, Dimitris</creator><creatorcontrib>Karnabatidis, Dimitris ; Katsanos, Konstantinos ; Spiliopoulos, Stavros ; Diamantopoulos, Athanasios ; Kagadis, George C. ; Siablis, Dimitris</creatorcontrib><description>Purpose:
To investigate the incidence, anatomical location, and clinical impact of fractures and/or compression of infrapopliteal balloon-expandable metal stents implanted for critical limb ischemia (CLI) treatment.
Methods:
This prospective study included 63 CLI patients (45 men; mean age 71.3±9.5 years) who had been treated with infrapopliteal angioplasty and stent placement for 191 lesions in 84 limbs. In all, 369 stents (296 stainless steel and 73 cobalt-chromium alloy) were implanted; 239 were placed overlapping in tandem lesions. Mean length of the overall stented segment was 4.4±6.3 cm (range 1.6–14.0). Stents were located in the tibioperoneal (n=34), anterior tibial (n=195), posterior tibial (n=63), and peroneal (n=77) arteries. Follow-up consisted of digital subtraction angiography and infrapopliteal radiography imaging at 2 different angles. Evaluation of stents for the presence of fracture and/or compression was done after digital processing at the highest possible magnification. Stent fractures were defined according to published standards, whereas compression was classified as severe shape alteration and/or collapse of the stent mesh. Angiographic restenosis was based on a 50% threshold.
Results:
Mean follow-up was 15±11 months (range 6–60). Image analysis detected 1 (0.3%) severe stent fracture (complete separation and misalignment of stent struts) and 11 (3.0%) stent compressions. Infrapopliteal stent fracture and compressions were associated with increased artery restenosis [100% (12/12) versus 47.3% (169/357), p<0.001] and an increased rate of clinical deterioration and clinically-driven reinterventions [41.7% (5/12 limbs) versus 19.4% (14/72 limbs), p=0.04]. The single fracture and most of the compressions were located in the distal third of the anterior tibial artery.
Conclusion:
Stent fractures and compressions of infrapopliteal balloon-expandable metal stents are infrequent. However, they may be related to increased restenosis.</description><identifier>ISSN: 1526-6028</identifier><identifier>EISSN: 1545-1550</identifier><identifier>DOI: 10.1583/08-2530.1</identifier><identifier>PMID: 19281287</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Aged ; Aged, 80 and over ; Angiography, Digital Subtraction ; Angioplasty, Balloon - instrumentation ; Arterial Occlusive Diseases - complications ; Arterial Occlusive Diseases - diagnostic imaging ; Arterial Occlusive Diseases - therapy ; Business growth ; Chromium Alloys ; Constriction, Pathologic ; Data bases ; Design ; Equipment Failure Analysis ; Female ; Humans ; Ischemia - diagnostic imaging ; Ischemia - etiology ; Ischemia - therapy ; Lower Extremity - blood supply ; Male ; Mechanical properties ; Medical imaging ; Metal fatigue ; Middle Aged ; Patients ; Popliteal Artery - diagnostic imaging ; Prospective Studies ; Prosthesis Design ; Prosthesis Failure ; Recurrence ; Stainless Steel ; Standard deviation ; Statistical analysis ; Stents ; Stress, Mechanical ; Tibial Arteries - diagnostic imaging ; Time Factors ; Treatment Failure ; Veins & arteries ; Wound healing</subject><ispartof>Journal of endovascular therapy, 2009-02, Vol.16 (1), p.15-22</ispartof><rights>2009 International Society of Endovascular Specialists</rights><rights>Copyright Allen Press Publishing Services Feb 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c407t-b1f7255e7860796f6b56044c984a45f2608d0f67bda9eff244837de8320f0f363</citedby><cites>FETCH-LOGICAL-c407t-b1f7255e7860796f6b56044c984a45f2608d0f67bda9eff244837de8320f0f363</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://journals.sagepub.com/doi/pdf/10.1583/08-2530.1$$EPDF$$P50$$Gsage$$H</linktopdf><linktohtml>$$Uhttps://journals.sagepub.com/doi/10.1583/08-2530.1$$EHTML$$P50$$Gsage$$H</linktohtml><link.rule.ids>314,780,784,21819,27924,27925,43621,43622</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/19281287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Karnabatidis, Dimitris</creatorcontrib><creatorcontrib>Katsanos, Konstantinos</creatorcontrib><creatorcontrib>Spiliopoulos, Stavros</creatorcontrib><creatorcontrib>Diamantopoulos, Athanasios</creatorcontrib><creatorcontrib>Kagadis, George C.</creatorcontrib><creatorcontrib>Siablis, Dimitris</creatorcontrib><title>Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents</title><title>Journal of endovascular therapy</title><addtitle>J Endovasc Ther</addtitle><description>Purpose:
To investigate the incidence, anatomical location, and clinical impact of fractures and/or compression of infrapopliteal balloon-expandable metal stents implanted for critical limb ischemia (CLI) treatment.
Methods:
This prospective study included 63 CLI patients (45 men; mean age 71.3±9.5 years) who had been treated with infrapopliteal angioplasty and stent placement for 191 lesions in 84 limbs. In all, 369 stents (296 stainless steel and 73 cobalt-chromium alloy) were implanted; 239 were placed overlapping in tandem lesions. Mean length of the overall stented segment was 4.4±6.3 cm (range 1.6–14.0). Stents were located in the tibioperoneal (n=34), anterior tibial (n=195), posterior tibial (n=63), and peroneal (n=77) arteries. Follow-up consisted of digital subtraction angiography and infrapopliteal radiography imaging at 2 different angles. Evaluation of stents for the presence of fracture and/or compression was done after digital processing at the highest possible magnification. Stent fractures were defined according to published standards, whereas compression was classified as severe shape alteration and/or collapse of the stent mesh. Angiographic restenosis was based on a 50% threshold.
Results:
Mean follow-up was 15±11 months (range 6–60). Image analysis detected 1 (0.3%) severe stent fracture (complete separation and misalignment of stent struts) and 11 (3.0%) stent compressions. Infrapopliteal stent fracture and compressions were associated with increased artery restenosis [100% (12/12) versus 47.3% (169/357), p<0.001] and an increased rate of clinical deterioration and clinically-driven reinterventions [41.7% (5/12 limbs) versus 19.4% (14/72 limbs), p=0.04]. The single fracture and most of the compressions were located in the distal third of the anterior tibial artery.
Conclusion:
Stent fractures and compressions of infrapopliteal balloon-expandable metal stents are infrequent. However, they may be related to increased restenosis.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Angiography, Digital Subtraction</subject><subject>Angioplasty, Balloon - instrumentation</subject><subject>Arterial Occlusive Diseases - complications</subject><subject>Arterial Occlusive Diseases - diagnostic imaging</subject><subject>Arterial Occlusive Diseases - therapy</subject><subject>Business growth</subject><subject>Chromium Alloys</subject><subject>Constriction, Pathologic</subject><subject>Data bases</subject><subject>Design</subject><subject>Equipment Failure Analysis</subject><subject>Female</subject><subject>Humans</subject><subject>Ischemia - diagnostic imaging</subject><subject>Ischemia - etiology</subject><subject>Ischemia - therapy</subject><subject>Lower Extremity - blood supply</subject><subject>Male</subject><subject>Mechanical properties</subject><subject>Medical imaging</subject><subject>Metal fatigue</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Popliteal Artery - diagnostic imaging</subject><subject>Prospective Studies</subject><subject>Prosthesis Design</subject><subject>Prosthesis Failure</subject><subject>Recurrence</subject><subject>Stainless Steel</subject><subject>Standard deviation</subject><subject>Statistical analysis</subject><subject>Stents</subject><subject>Stress, Mechanical</subject><subject>Tibial Arteries - diagnostic imaging</subject><subject>Time Factors</subject><subject>Treatment Failure</subject><subject>Veins & arteries</subject><subject>Wound healing</subject><issn>1526-6028</issn><issn>1545-1550</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNplkcFuFSEUhonR2Fpd-AKGuDAx6SgwA8Ms25tWb3KNC3VNGObQ0DAwApPoI_jWMu1NbqIrDicfHyfnR-g1JR8ol-1HIhvG23p5gs4p73hDOSdPt5qJRhAmz9CLnO8JYZRR-hyd0YFJymR_jv7sg3ETBAOX-CroEmdntMeHaHRxMVxiHSa88y48tL-5u-BsLSuPo8W7OC8Jcq5kfiBvkzZlrS3sAt4Hm_QSF-8K1MfX2vsYQ3Pza6moHj3gL1A2a4FQ8kv0zGqf4dXxvEA_bm--7z43h6-f9rurQ2M60pdmpLZnnEMvBekHYcXIBek6M8hOd9wyQeRErOjHSQ9gLes62fYTyJYRS2wr2gv07tG7pPhzhVzU7LIB73WAuGYletJSwWkF3_4D3sc1hTqbqlukdKhbrtD7R8ikmHMCq5bkZp1-K0rUFo4iUm3hqE345ihcxxmmE3lM4zRa1ndw-u1_01-NKJVG</recordid><startdate>200902</startdate><enddate>200902</enddate><creator>Karnabatidis, Dimitris</creator><creator>Katsanos, Konstantinos</creator><creator>Spiliopoulos, Stavros</creator><creator>Diamantopoulos, Athanasios</creator><creator>Kagadis, George C.</creator><creator>Siablis, Dimitris</creator><general>SAGE Publications</general><general>Allen Press Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>200902</creationdate><title>Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents</title><author>Karnabatidis, Dimitris ; Katsanos, Konstantinos ; Spiliopoulos, Stavros ; Diamantopoulos, Athanasios ; Kagadis, George C. ; Siablis, Dimitris</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c407t-b1f7255e7860796f6b56044c984a45f2608d0f67bda9eff244837de8320f0f363</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2009</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Angiography, Digital Subtraction</topic><topic>Angioplasty, Balloon - instrumentation</topic><topic>Arterial Occlusive Diseases - complications</topic><topic>Arterial Occlusive Diseases - diagnostic imaging</topic><topic>Arterial Occlusive Diseases - therapy</topic><topic>Business growth</topic><topic>Chromium Alloys</topic><topic>Constriction, Pathologic</topic><topic>Data bases</topic><topic>Design</topic><topic>Equipment Failure Analysis</topic><topic>Female</topic><topic>Humans</topic><topic>Ischemia - diagnostic imaging</topic><topic>Ischemia - etiology</topic><topic>Ischemia - therapy</topic><topic>Lower Extremity - blood supply</topic><topic>Male</topic><topic>Mechanical properties</topic><topic>Medical imaging</topic><topic>Metal fatigue</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Popliteal Artery - diagnostic imaging</topic><topic>Prospective Studies</topic><topic>Prosthesis Design</topic><topic>Prosthesis Failure</topic><topic>Recurrence</topic><topic>Stainless Steel</topic><topic>Standard deviation</topic><topic>Statistical analysis</topic><topic>Stents</topic><topic>Stress, Mechanical</topic><topic>Tibial Arteries - diagnostic imaging</topic><topic>Time Factors</topic><topic>Treatment Failure</topic><topic>Veins & arteries</topic><topic>Wound healing</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Karnabatidis, Dimitris</creatorcontrib><creatorcontrib>Katsanos, Konstantinos</creatorcontrib><creatorcontrib>Spiliopoulos, Stavros</creatorcontrib><creatorcontrib>Diamantopoulos, Athanasios</creatorcontrib><creatorcontrib>Kagadis, George C.</creatorcontrib><creatorcontrib>Siablis, Dimitris</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of endovascular therapy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Karnabatidis, Dimitris</au><au>Katsanos, Konstantinos</au><au>Spiliopoulos, Stavros</au><au>Diamantopoulos, Athanasios</au><au>Kagadis, George C.</au><au>Siablis, Dimitris</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents</atitle><jtitle>Journal of endovascular therapy</jtitle><addtitle>J Endovasc Ther</addtitle><date>2009-02</date><risdate>2009</risdate><volume>16</volume><issue>1</issue><spage>15</spage><epage>22</epage><pages>15-22</pages><issn>1526-6028</issn><eissn>1545-1550</eissn><abstract>Purpose:
To investigate the incidence, anatomical location, and clinical impact of fractures and/or compression of infrapopliteal balloon-expandable metal stents implanted for critical limb ischemia (CLI) treatment.
Methods:
This prospective study included 63 CLI patients (45 men; mean age 71.3±9.5 years) who had been treated with infrapopliteal angioplasty and stent placement for 191 lesions in 84 limbs. In all, 369 stents (296 stainless steel and 73 cobalt-chromium alloy) were implanted; 239 were placed overlapping in tandem lesions. Mean length of the overall stented segment was 4.4±6.3 cm (range 1.6–14.0). Stents were located in the tibioperoneal (n=34), anterior tibial (n=195), posterior tibial (n=63), and peroneal (n=77) arteries. Follow-up consisted of digital subtraction angiography and infrapopliteal radiography imaging at 2 different angles. Evaluation of stents for the presence of fracture and/or compression was done after digital processing at the highest possible magnification. Stent fractures were defined according to published standards, whereas compression was classified as severe shape alteration and/or collapse of the stent mesh. Angiographic restenosis was based on a 50% threshold.
Results:
Mean follow-up was 15±11 months (range 6–60). Image analysis detected 1 (0.3%) severe stent fracture (complete separation and misalignment of stent struts) and 11 (3.0%) stent compressions. Infrapopliteal stent fracture and compressions were associated with increased artery restenosis [100% (12/12) versus 47.3% (169/357), p<0.001] and an increased rate of clinical deterioration and clinically-driven reinterventions [41.7% (5/12 limbs) versus 19.4% (14/72 limbs), p=0.04]. The single fracture and most of the compressions were located in the distal third of the anterior tibial artery.
Conclusion:
Stent fractures and compressions of infrapopliteal balloon-expandable metal stents are infrequent. However, they may be related to increased restenosis.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>19281287</pmid><doi>10.1583/08-2530.1</doi><tpages>8</tpages></addata></record> |
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| subjects | Aged Aged, 80 and over Angiography, Digital Subtraction Angioplasty, Balloon - instrumentation Arterial Occlusive Diseases - complications Arterial Occlusive Diseases - diagnostic imaging Arterial Occlusive Diseases - therapy Business growth Chromium Alloys Constriction, Pathologic Data bases Design Equipment Failure Analysis Female Humans Ischemia - diagnostic imaging Ischemia - etiology Ischemia - therapy Lower Extremity - blood supply Male Mechanical properties Medical imaging Metal fatigue Middle Aged Patients Popliteal Artery - diagnostic imaging Prospective Studies Prosthesis Design Prosthesis Failure Recurrence Stainless Steel Standard deviation Statistical analysis Stents Stress, Mechanical Tibial Arteries - diagnostic imaging Time Factors Treatment Failure Veins & arteries Wound healing |
| title | Incidence, Anatomical Location, and Clinical Significance of Compressions and Fractures in Infrapopliteal Balloon-Expandable Metal Stents |
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