Patients with Failed Femoropopliteal Covered Stents are More Likely to Present with Acute Limb Ischemia than Those with Failed Femoropopliteal Bare-Metal Stents

AbstractObjectiveTo describe endovascular stent placement using partially covered stents to preserve flow in head and neck vessels.BackgroundEndovascular stent placement has become established as a first-line therapy for native coarctation of the aorta or re-coarctation in older children and adults. Increasingly covered stents are becoming the preferred option over bare-metal stents because of the perceived lower risk of aneurysm formation. Open-cell bare-metal stents are chosen when there is a high likelihood of jailing a head and neck vessel. Here we describe partial uncovering of a covered stent before implantation to allow flow through the uncovered portion of the stent to the branch vessel but preserve the covering over the majority of the remaining stent.MethodsWe describe two cases with aortic arch hypoplasia and re-coarctation, both of which required two partially uncovered stents for a satisfactory result.ConclusionsEndovascular stent placement is becoming the preferred option in the management of coarctation of the aorta in older children and adults. Strategies to deal with transverse arch hypoplasia and multiple levels of aortic arch obstruction frequently involving branch vessels or aneurysms need to be considered before these procedures are embarked upon. Partially uncovering stents may afford more protection than using bare-metal stents in the transverse and distal arch while preserving flow in head and neck branches, and is a technically straightforward procedure.

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5-Year Follow-Up of Polytetrafluoroethylene-Covered Stents Compared With Bare-Metal Stents in Aortocoronary Saphenous Vein Grafts

JACC Cardiovascular Interventions ◽

10.1016/j.jcin.2010.11.013 ◽

2011 ◽

Vol 4 (3) ◽

pp. 300-309 ◽

Cited By ~ 49

Author(s):

Gregg W. Stone ◽

Sheldon Goldberg ◽

Charles O'Shaughnessy ◽

Mark Midei ◽

Robert M. Siegel ◽

...

Keyword(s):

Saphenous Vein ◽

Bare Metal Stents ◽

Metal Stents ◽

Covered Stents ◽

Bare Metal ◽

Vein Grafts ◽

Saphenous Vein Grafts

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Superior Patency of Covered Stents Over Bare Metal Stents in Patients with Chronic Mesenteric Ischemia

Journal of Vascular Surgery ◽

10.1016/j.jvs.2010.11.090 ◽

2011 ◽

Vol 53 (2) ◽

pp. 559 ◽

Cited By ~ 4

Author(s):

Luke Erdoes ◽

Heather Mixon ◽

Christopher Lesar ◽

Denny Schoch

Keyword(s):

Mesenteric Ischemia ◽

Bare Metal Stents ◽

Metal Stents ◽

Covered Stents ◽

Chronic Mesenteric Ischemia ◽

Bare Metal

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Lower Rate of Restenosis and Reinterventions With Covered vs Bare Metal Stents Following Innominate Artery Stenting

Journal of Endovascular Therapy ◽

10.1177/1526602819838867 ◽

2019 ◽

Vol 26 (3) ◽

pp. 385-390 ◽

Cited By ~ 5

Author(s):

Myriam Ammi ◽

Samir Henni ◽

Lucie Salomon Du Mont ◽

Nicla Settembre ◽

Hélène Loubiere ◽

...

Keyword(s):

Bare Metal Stents ◽

Innominate Artery ◽

Symptomatic Patient ◽

Artery Stenosis ◽

Metal Stents ◽

Covered Stents ◽

Bare Metal ◽

University Hospitals ◽

Relative Risks ◽

Innominate Artery Stenosis

Purpose: To determine any difference between bare metal stents (BMS) and balloon-expandable covered stents in the treatment of innominate artery atheromatous lesions. Materials and Methods: A multicenter retrospective study involving 13 university hospitals in France collected 93 patients (mean age 63.2±11.1 years; 57 men) treated over a 10-year period. All patients had systolic blood pressure asymmetry >15 mm Hg and were either asymptomatic (39, 42%) or had carotid (20, 22%), vertebrobasilar (24, 26%), and/or brachial (20, 22%) symptoms. Innominate artery stenosis ranged from 50% to 70% in 4 (4%) symptomatic cases and between 70% and 90% in 52 (56%) cases; 28 (30%) lesions were preocclusive and 8 (9%) were occluded. One (1%) severely symptomatic patient had a <50% stenosis. Demographic characteristics, operative indications, and procedure details were compared between the covered (36, 39%) and BMS (57, 61%) groups. Multivariate analysis was performed to determine relative risks of restenosis and reinterventions [reported with 95% confidence intervals (CI)]. Results: The endovascular procedures were performed mainly via retrograde carotid access (75, 81%). Perioperative strokes occurred in 4 (4.3%) patients. During the mean 34.5±31.2–month follow-up, 30 (32%) restenoses were detected and 13 (20%) reinterventions were performed. Relative risks were 6.9 (95% CI 2.2 to 22.2, p=0.001) for restenosis and 14.6 (95% CI 1.8 to 120.8, p=0.004) for reinterventions between BMS and covered stents. The severity of the treated lesions had no influence on the results. Conclusion: Patients treated with BMS for innominate artery stenosis have more frequent restenoses and reinterventions than patients treated with covered stents.

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Faculty Opinions recommendation of Comparison of covered stents versus bare metal stents for treatment of chronic atherosclerotic mesenteric arterial disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718026804.793481246 ◽

2013 ◽

Author(s):

Norman Hertzer

Keyword(s):

Bare Metal Stents ◽

Arterial Disease ◽

Metal Stents ◽

Covered Stents ◽

Bare Metal

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Antegrade biliary stenting for obstructive jaundice

Annaly khirurgicheskoy gepatologii = Annals of HPB surgery ◽

10.16931/1995-5464.2019225-35 ◽

2019 ◽

Vol 24 (2) ◽

pp. 25-35

Author(s):

A. V. Andreev ◽

V. M. Durleshter ◽

A. I. Leveshko ◽

S. A. Gabriel ◽

E. V. Tokarenko

Keyword(s):

Obstructive Jaundice ◽

Bare Metal Stents ◽

Metallic Stents ◽

Metal Stents ◽

Covered Stents ◽

Bare Metal ◽

Biliary Stenting ◽

Malignant Obstructive Jaundice ◽

Invasive Approach ◽

Expandable Metallic Stents

Objective. To determine the role bile duct stenting with self-expandable metallic stents in the treatment of malignant obstructive jaundice. Material and methods. Eight-year experience of palliative antegrade stenting with self-expandable metallic stents was analyzed. There were 218 patients with malignant obstructive jaundice. Distal and proximal obstruction was diagnosed in 118 (54%) and 100 (46%) patients, respectively. We have used self-expandable metallic covered, partially covered and bare-metal stents with diameter of 10, 8 and 6 mm and length of 40, 60 and 80 mm. Results. Technical success in antegrade two-stage installation of self-expandable stents have been achieved in 208 (99%) patients. There were 230 deployed self-expandable metallic stents. Seven (3%) patients underwent simultaneous stenting of right and left hepatic ducts and confluence area with bare-metal stents. Stenting of right or left hepatic ducts and confluence area with partially covered stents was carried out in 34 (16%) patients. Other 59 (27%) patients with proximal biliary obstruction and no separation of lobar bile ducts underwent stenting with 27 partially covered and 31 covered stents. Distal obstruction was managed by using of covered stents as a rule (63%). Complications after antegrade biliary stenting occurred in 29 (13%) patients. Conclusion. Antegrade biliary stenting with metallic self-expandable stents is effective and minimally invasive approach. Moreover, it is comparable with conventional palliative interventions aimed at bile outflow recovery.

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