CardioVascular and Interventional Radiology

, Volume 15, Issue 5, pp 306–312 | Cite as

A comparison study of self-expandable stents vs balloon angioplasty alone in femoropopliteal artery occlusions

  • Do-dai-Do
  • Jürgen Triller
  • Beat H. Walpoth
  • Peter Stirnemann
  • Felix Mahler
Vascular Applications: Arteries


In a group of 26 patients percutaneous transluminal (balloon) angioplasty (PTA) and stents (Wallstents) were applied and in another 26 matched patients PTA alone was used as primary treatment for femoropopliteal occlusions of 3 cm or longer. Five patients with stents showed early thrombosis necessitating catheter thrombolysis and/or thrombus aspiration. Ten patients had recurrent stenoses within 12 months, mostly due to neointimal hyperplasia. Following three late catheter reinterventions, a cumulative secondary patency rate of 69% was achieved after 12 months. The group of patients treated by PTA alone showed a 12 months patency rate of 65% without reinterventions. In 8 other patients, stents were inserted for recurrent obstructive or PTA-resistant lesions, and similar results as with the stents above were obtained. Thus, these stents do not improve primary results of PTA in femoropopliteal occlusions but may be useful secondarily after unsuccessful PTA.

Key words

PTA, thrombosis Neointimal hyperplasia Patency rate Controlled study Vascular endoprosthesis Angioplasty 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Sigwart U, Puel J, Mikrovitch V, Joffre F, Kappenberger L (1987) Intravascular stents to prevent occlusion and restenosis after transluminal angioplasty. N Engl J Med 316:701–706CrossRefPubMedGoogle Scholar
  2. 2.
    Günther RW, Vorwerk D, Bohndorf K, Peters I, El-Din Ad, Messmer B (1989) Iliac and femoral artery stenoses and occlusions: Treatment with intravascular stents. Radiology 172:725–730CrossRefPubMedGoogle Scholar
  3. 3.
    Günther RW, Vorwerk D, Antonucci F, Beyssen B, Essinger A, Gaux JC, Joffre F, Raynaud A, Rousseau H, Zollikofer CH (1991) Iliac artery stenosis or obstruction after unsuccessful balloon angioplasty: Treatment by a self-expandable stent. AJR 156:389–393CrossRefPubMedGoogle Scholar
  4. 4.
    Joffre FA, Bernadet P, Rousseau HP, Nomblot C, Durand D, Knight CJ, Chamontin B, Suc JM (1989) The usefulness of an endovascular prosthesis for treatment of renal artery stenosis. Diagn Interv Radiol 1:15–21Google Scholar
  5. 5.
    Palmaz JC, Richter GM, Noeldge G, Schatz RA, Robison PD, Gardiner GA, Becker GJ, McLean GK, Denny DF, Lammer J, Paolini RM, Rees CR, Alvarado R, Heiss HW, Root HD, Rogers W (1988) Intraluminal stents in atherosclerotic iliac artery stenosis: Preliminary report of a multicenter study. Radiology 168:727–731CrossRefPubMedGoogle Scholar
  6. 6.
    Rousseau HP, Raillat CR, Joffre FG, Knight CJ, Ginestet MC (1989) Treatment of femoro-popliteal stenoses by means of self-expandable endoprostheses: Midterm results. Radiology 172:961–964CrossRefPubMedGoogle Scholar
  7. 7.
    Strecker EP, Liermann D, Barth KH, Wolf HRD, Freudenberg N, Berg G, Westphal M, Tsikuras P, Savin M, Schneider B (1990) Expandable tubular stents for treatment of arterial occlusive diseases: Experimental and clinical results. Radiology 175:97–102CrossRefPubMedGoogle Scholar
  8. 8.
    Triller J, Mahler F, Do DD, Thalmann R, Wallsten H (1989) Vascular endoprostheses (Stents) in the treatment of femoropopliteal vascular occlusions. In: Zeitler E, Seyferth W (eds) Pros and cons in PTA. Springer, Berlin, Heidelberg, pp 162–169Google Scholar
  9. 9.
    Zollikofer CL, Antonucci F, Pfyffer M, Redha F, Salomonowitz E, Stuckmann G, Largiadèr J, Marty AH (1991) Arterial stent placement with use of Wallstent: Midterm results of clinical experience. Radiology 179:449–456CrossRefPubMedGoogle Scholar
  10. 10.
    Günther RW, Vorwerk D, Bohndorf K, Klose KC, Kistler D, Mann H, Sieberth HG, El-Din A (1989) Venous stenoses in dialysis shunts: Treatment with self-expanding metallic stents. Radiology 170:401–405CrossRefPubMedGoogle Scholar
  11. 11.
    Zollikofer CL, Largiader J, Brühlmann WF, Uhlschmid GK, Marty AH (1988) Endovascular stenting of veins and grafts: Preliminary clinical experience. Radiology 167:707–712CrossRefPubMedGoogle Scholar
  12. 12.
    Gallino A, Mahler F, Probst P, Nachbur B (1984) Percutaneous transluminal angioplasty of the arteries of the lower limbs: A 5 year follow-up. Circulation 70:619–623CrossRefPubMedGoogle Scholar
  13. 13.
    Mahler F (1990) Katheterinterventionen in der Angiologie. Thieme, StuttgartGoogle Scholar
  14. 14.
    Zeitler E, Richter EI, Roth FJ, Schoop W (1983) Results of percutaneous transluminal angioplasty. Radiology 146:57–60CrossRefPubMedGoogle Scholar
  15. 15.
    Do DD, Mahler F, Triller J (1989) Catheter thrombolysis with streptokinase, urokinase and recombinant tissue plasminogen activator for peripheral arterial occlusion. In: Zeitler E, Seyferth W (eds) Pros and cons in PTA and auxiliary methods. Springer, Berlin, pp 248–253CrossRefGoogle Scholar
  16. 16.
    Starck EE, McDermott JC, Crummy AB, Turnipseed WD, Acher CW, Burgess JH (1985) Percutaneous aspiration thrombolectomy. Radiology 156:61–66CrossRefPubMedGoogle Scholar
  17. 17.
    Triller J, Do DD, maddern G, Mahler F (1992) Clinical experience with the Kensey catheter in subacute and chronic femoro-popliteal artery occlusion. Radiology 182:257–261CrossRefPubMedGoogle Scholar
  18. 18.
    Strecker EP, Liermann D, Hellmut RD, Wolf MD (1990) Treatment of iliac and femoro-popliteal artery occlusive disease with the flexible tantalum stent (abstract) CIRSE meeting, p 248Google Scholar
  19. 19.
    El Ashmaoui A, Do DD, Triller J, Stirnemann P, Mahler F (1991) Angioplasty of the terminal aorta: Follow-up of 20 cases treated by PTA or PTA with stents. Eur J Radiol 13:113–117CrossRefPubMedGoogle Scholar
  20. 20.
    Serruys PW, Beatt KJ, van der Giessen WJ (1989) Stenting of coronary arteries. Are we the sorcerer’s apprentice? (editorial) Eur Heart 10:774–782CrossRefGoogle Scholar
  21. 21.
    Serruys PW, Strauss BH, Beatt KJ, Bertrand ME, Puel J, Rickards AF, Meier B, Goy JJ, Vogt P, Kappenberger L, Sigwart U (1991) Angiographic follow-up after placement of a self-expanding coronary-artery stent. N Engl J Med 324:13–17CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag New York Inc. 1992

Authors and Affiliations

  • Do-dai-Do
    • 1
  • Jürgen Triller
    • 2
  • Beat H. Walpoth
    • 3
  • Peter Stirnemann
    • 3
  • Felix Mahler
    • 1
  1. 1.Angiology Division, Department of MedicineUniversity of BernBernSwitzerland
  2. 2.Institute of Diagnostic RadiologyUniversity of BernBernSwitzerland
  3. 3.Department of Thoracic and Cardiovascular SurgeryUniversity of BernBernSwitzerland

Personalised recommendations