scholarly journals Aneurysmal degeneration of fluoropolymer-coated paclitaxel-eluting stent in the superficial femoral artery: a rising concern

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Takuya Tsujimura ◽  
Osamu Iida ◽  
Mitsutoshi Asai ◽  
Masaharu Masuda ◽  
Shin Okamoto ◽  
...  
Keyword(s):  
Intermittent Claudication ◽  
Intravascular Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Distal Part ◽  
De Novo ◽  
Vessel Diameter ◽  
Drug Eluting Stent ◽  
Drug Eluting ◽  
The Right

Abstract Background Although several clinical reports demonstrated a durable patency rate after a novel fluoropolymer-coated paclitaxel-eluting stent (Eluvia; Boston Scientific, Marlborough, MA, USA) placement, aneurysmal degeneration after drug-eluting stent (Eluvia) placement has raised clinical concerns. Here, we report a case with progressive aneurysm formation on serial angiography and intravascular ultrasound over 50 months after drug-eluting stent (Eluvia) placement for a superficial femoral artery atheromatous plaque. Case presentation A 79-year-old woman with right leg intermittent claudication at 100 m distance was referred to our hospital. Pre-procedural angiography showed long-segment severe stenosis from the middle-to-distal part of the right superficial femoral artery, and a 7 mm wide drug-eluting stent (Eluvia) was placed. However, the patient had a recurrence of intermittent claudication in the right lower extremity 25 months thereafter. Angiography revealed de novo stenosis in the distal part of the popliteal artery and proximal superficial femoral artery in-stent restenosis. Subsequently, the patient underwent endovascular therapy for these lesions. In addition, intravascular ultrasound at the time of endovascular therapy revealed femoral artery enlargement with a maximum vessel diameter of 10.0 mm at the distal edge of the stent. Intermittent claudication on the right side recurred again 50 months after drug-eluting stent (Eluvia). Angiography demonstrated de novo severe stenosis from the distal part of the superficial femoral artery to the middle part of the popliteal artery. Peri-stent contrast staining was found at the distal part of the drug-eluting stent (Eluvia) site. Intravascular ultrasound showed a further enlargement of maximum vessel diameter to 12.0 mm at the distal edge of the stent. Conclusions We report a case with progressive aneurysm degeneration on serial angiography and intravascular ultrasound over 50 months after drug-eluting stent (Eluvia) placement for a superficial femoral artery stenosis.

scholarly journals Aneurysmal Degeneration of Fluoropolymer-Coated Paclitaxel-Eluting Stent in the Superficial Femoral Artery. A Rising Concern

2021 ◽  
Author(s):  
Takuya Tsujimura ◽  
Osamu Iida ◽  
Mitsutoshi Asai ◽  
Masaharu Masuda ◽  
Shin Okamoto ◽  
...  
Keyword(s):  
Intravascular Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Distal Part ◽  
De Novo ◽  
Vessel Diameter ◽  
Implantation Site ◽  
Severe Stenosis ◽  
Distal Edge ◽  
The Right

Abstract Background: Although several clinical reports demonstrated a durable patency rate after a novel fluoropolymer-coated paclitaxel-eluting stent (Eluvia™; Boston Scientific, Marlborough, MA, USA) implantation, aneurysmal degeneration after implanting Eluvia™ has raised clinical concerns. Here, we report a case with exacerbated aneurysmal degeneration on serial angiography and intravascular ultrasound 50 months after Eluvia™ implantation for a superficial femoral artery lesion.Case presentation: A 79-year-old woman with claudication in the right lower extremity decreasing her quality of life was referred to our hospital. Pre-procedural angiography showed severe stenosis from the middle-to-distal part of the right superficial femoral artery, and Eluvia™ was implanted with optimal expansion. However, the patient had a recurrence of intermittent claudication in the right lower extremity 25 months thereafter. Angiography revealed de novo stenosis in the distal part of the popliteal artery and proximal stent edge restenosis at the Eluvia™ implantation site. Subsequently, the patient underwent endovascular therapy for these lesions. In addition, intravascular ultrasound at the time of endovascular therapy revealed vessel enlargement with a mean vessel diameter of 7.2-9.9 mm at the distal edge of the Eluvia™ implantation site. However, intermittent claudication on the right side recurred again 50 months after Eluvia™ implantation. Angiography demonstrated de novo severe stenosis from the distal part of the superficial femoral artery to the middle part of the popliteal artery. Furthermore, peri-stent contrast staining was found at the distal part of the Eluvia™ implantation site. Intravascular ultrasound showed a further enlargement of mean vessel diameter to 11.9 mm at the distal edge of the Eluvia™ stent. Moreover, enlargement of the lumen and stent malapposition were also found, suggesting exacerbated aneurysmal degeneration 50 months after Eluvia™ implantation.Conclusions: We report a case with exacerbated aneurysmal degeneration on serial angiography and intravascular ultrasound 50 months after Eluvia™ implantation for an SFA lesion. Long-term follow-up should be mandatory for patients receiving Eluvia™ implants.

Cost-Effectiveness Analysis of Drug Coated Balloon vs. Drug Eluting Stent in the Superficial Femoral Artery

2017 ◽  
Vol 41 ◽  
pp. 24 ◽  
Author(s):  
Natalie D. Sridharan ◽  
Aureline Boitet ◽  
Kenneth Smith ◽  
Kathy Noorbakhsh ◽  
Efthymios Avgerinos ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Cost Effectiveness Analysis ◽  
Drug Eluting Stent ◽  
Effectiveness Analysis ◽  
Drug Eluting ◽  
Drug Coated Balloon

Drug-Eluting Stent for Recurrent Mesenteric Artery In-Stent Restenosis

2007 ◽  
Vol 14 (5) ◽  
pp. 748-751 ◽  
Author(s):  
Paolo Cardaioli ◽  
Gianluca Rigatelli ◽  
Luca Zattoni ◽  
Massimo Giordan
Keyword(s):  
Mesenteric Artery ◽  
De Novo ◽  
Vessel Diameter ◽  
Computed Tomographic Angiography ◽  
High Rate ◽  
Drug Eluting Stent ◽  
Computed Tomographic ◽  
Stent Restenosis ◽  
Drug Eluting ◽  
In Stent Restenosis

Purpose: To report the use of a drug-eluting stent (DES) for treatment of symptomatic in-stent restenosis (ISR) in the superior mesenteric artery (SMA). Case Report: A 79-year-old woman suffering from chronic renal failure and needing dialysis was admitted for vomiting, postprandial abdominal pain, and weight loss for 3 months. Computed tomographic angiography (CTA) documented massive calcification of the vascular bed, mainly in the aorta, and a very tight ostial stenosis of the SMA. A 4.5-x20-mm Genesis stent was deployed at the ostium, with good angiographic result and immediate symptomatic benefit. After 3 months, symptoms recurred; angiography demonstrated ISR. Percutaneous angioplasty with a 4-x15-mm cutting balloon was performed. The patient remained asymptomatic for only 2 months; recurrent ISR at this time was treated with a 3.5-x24-mm coronary TAXUS Express paclitaxel-eluting coronary stent deployed inside the previously implanted stent. Under prolonged double antiplatelet regimen, the patient was asymptomatic at the 8-month follow-up; CTA demonstrated patency of the SMA. Conclusion: Considering the high rate of restenosis and the periprocedural complications described with endovascular treatment of SMA stenosis, a drug-eluting stent may be a good option not only for the treatment of restenosis but also in de novo lesions, at least when the vessel diameter is <4.5 mm.

Evaluation of the Biodegradable Igaki-Tamai Scaffold After Drug-Eluting Balloon Treatment of De Novo Superficial Femoral Artery Lesions

2015 ◽  
Vol 23 (1) ◽  
pp. 92-97 ◽  
Author(s):  
Martin Werner ◽  
Andrej Schmidt ◽  
Susanne Scheinert ◽  
Ursula Banning-Eichenseer ◽  
Matthias Ulrich ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
De Novo ◽  
Drug Eluting ◽  
Drug Eluting Balloon

scholarly journals “Low Echoic Area” around stent after bare and drug-coated stenting or stent graft placement for superficial femoral artery disease

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110145
Author(s):  
Yoshimitsu Soga ◽  
Kenji Ando
Keyword(s):  
Stent Graft ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Drug Eluting Stent ◽  
Drug Eluting ◽  
Cook Medical ◽  
Artery Disease ◽  
Zilver Ptx ◽  
Cordis Corporation

Restenosis after stent implantation in femoropopliteal lesions is still big issue. However, restenosis has been reduced by the recent new drug-eluting stent “Eluvia” (Boston Scientific, Marlborough, MA, USA). However, it was reported that “low echoic area (LEA)” finding around stent by ultrasound that they called “aneurysmal degeneration,” but no blood flow was identified outside the stent was confirmed after Eluvia implantation. In this report, we describe the similar findings that were observed after other types of stents (S.M.A.R.T. bare-nitinol stent (Cordis Corporation, Hialeah, FL, USA), Zilver PTX drug-coated stent (Cook Medical, Bloomington, IN, USA), and Viabahn stent graft (W. L. Gore & Associates, Newark, Delaware, USA)) for superficial femoral artery disease. These findings did not change to “aneurysmal change” during the follow-up.

Abstract 13748: Predictors of Yellow Neointima After Stent Implantation in the Superficial Femoral Artery

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Takuya Tsujimura ◽  
Takayuki Ishihara ◽  
Osamu Iida ◽  
Shin Okamoto ◽  
Kiyonori Nanto ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Patient Characteristics ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Drug Eluting ◽  
Neointimal Coverage

Background: Neoatherosclerosis is known to occur after coronary stenting, but whether it occurs following stenting in the superficial femoral artery (SFA) remains unknown. Methods: This study comprised angioscopic evaluations of 149 stents implanted in the 102 SFA lesions from 92 patients from April 2012 to September 2014. Complete neointimal coverage (defined as struts fully embedded and invisible) was found in 87 stents in the 67 native lesions from the 61 patients. We compared characteristics between the cases with (23 stents, 26%) and without yellow neointima (YN) at the site of complete neointimal coverage, and evaluated the predictors of YN. Results: Median follow-up duration was significantly longer in the YN(+) than YN(-) group (370 [interquartile range: 282-884] days vs. 350 [95-394] days, P<0.001), while patient characteristics, medication use, rate of drug-eluting stent and bare-metal stent use (48% vs. 50%, P=1.0), and lesion and procedural characteristics were similar between them. Low-density lipoprotein cholesterol (LDL-C) level at intervention was higher in the YN(+) than YN(-) group (109±25 mg/dL vs. 97±25 mg/dL, P=0.049). At angioscopic follow-up, LDL and total cholesterol (TC) levels were higher in the YN(+) than YN(-) group (109±27 mg/dL vs. 97±25 mg/dL, P= 0.046; and 188±33 mg/dL vs. 172±34 mg/dL, P=0.048, respectively). Conclusions: YN was associated with the degree of dyslipidemia, suggesting the presence of neoatherosclerosis in the SFA following stenting.

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