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Endovascular Treatment of In-Stent Occlusion: New Technique for Recanalization of Long Superficial Femoral Artery Occlusion (Direct Stent Puncture Technique)

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Abstract

In-stent reocclusion is a frequent complication of endovascular treatment and stenting, especially in the superficial femoral artery. Neointimal hyperplasia is the main cause of this problem, but in many cases, it occurs as a result of the presence of stent strut fractures. The two treatment options are endovascular and surgical intervention. The effectiveness of endovascular interventions in patients with critical limb ischemia has been well established, but in some cases, crossing the occluded stent is difficult. We describe a new technique to recanalize long in-stent superficial femoral artery occlusions characterized by direct stent puncture, followed by retrograde-antegrade recanalization after antegrade failures.

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References

  1. Duterloo D, Lohle P, Lampmann L (2007) Subintimal double-barrel restenting of an occluded primary stented superficial femoral artery. Cardiovasc Interv Radiol 30:474–476

    Article  Google Scholar 

  2. Minar E, Schillinger M (2009) New stents for SFA. J Cardiovasc Surg 50:635–645

    CAS  Google Scholar 

  3. Schlager O, Dick P, Sabeti S et al (2005) Long-segment SFA stenting—the dark sides: in-stent restenosis, clinical deterioration, and stent fractures. J Endovasc Ther 12:676–684

    Article  PubMed  Google Scholar 

  4. Boisers M, Torsello G, Gissler HM et al (2009) Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURABILITY I study. J Endovasc Ther 16:261–269

    Article  Google Scholar 

  5. Schonefeld E, Schonefeld T, Osada N et al (2009) Ong stents for long femoropopliteal lesions—firs results of 128 Protégé stents. Zentralbl Chir 134:310–315

    Article  PubMed  CAS  Google Scholar 

  6. Iida O, Soga Y, Hirano K et al (2011) Retrospective multicentre analysis of S.M.A.R.T. vs. Luminexx nitinol stent implantation for superficial femoral artery lesions (REAL SL) Registry. 5 Years experience. Circ J 75:421–427

    Article  PubMed  Google Scholar 

  7. Scheinert D, Scheinert S, Sax J et al (2005) Prevalence and clinical impact of stent fractures after femoropopliteal stenting. J Am Coll Cardiol 45:312–315

    Article  PubMed  Google Scholar 

  8. Duda SH, Bosier M, Lammer J et al (2006) Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial. J Endovasc Ther 13:701–710

    Article  PubMed  Google Scholar 

  9. Bosier M, Cagiannos C, Deloose K et al (2008) Drug-eluting stents in the management of peripheral arterial disease. Vasc Health Risk Manag 4:553–559

    Google Scholar 

  10. Kougias P, Chen A, Cagiannos C et al (2009) Subintimal placement of covered stent versus subintimal balloon angioplasty in the treatment of long-segment superficial femoral artery occlusion. Am J Surg 198:645–649

    Article  PubMed  Google Scholar 

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Interventional Radiology Unit, Policlinico Abano Terme, Piazza C. Colombo 1, 35031, Abano Terme, PD, Italy

    Luis Mariano Palena, Giacomo Cester & Marco Manzi

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  1. Luis Mariano Palena
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  2. Giacomo Cester
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  3. Marco Manzi
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Correspondence to Luis Mariano Palena.

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Palena, L.M., Cester, G. & Manzi, M. Endovascular Treatment of In-Stent Occlusion: New Technique for Recanalization of Long Superficial Femoral Artery Occlusion (Direct Stent Puncture Technique). Cardiovasc Intervent Radiol 35, 418–421 (2012). https://doi.org/10.1007/s00270-011-0260-5

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  • DOI: https://doi.org/10.1007/s00270-011-0260-5

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