Stent fractures in the superficial femoral artery: predisposing factors and their implications

Abstract

Background Fractures in stents implanted in the superficial femoral artery (SFA) are recognized complications of endovascular management of this arterial territory. Objectives The objective of this study was to determine the prevalence of fractures in stents implanted in the SFA and to identify predisposing factors for these fractures together with their impact on the patency of these devices. Methods The study included 39 patients (65.7±9.0 years) who previously underwent angioplasty for delivery of 56 stents into the SFA. During follow-up, which ranged from 7 to 46 months, variables were collected on the characteristics of the lesions treated and characteristics of the stents implanted. Two examiners independently analyzed digital radiographs for the presence of stent fractures and the patency of the devices. Results We found a 10.7% prevalence of fracture of implanted stents. Implantation of multiple stents was identified as a significant predisposing factor for fractures. We observed a marked tendency for fractures in female patients and in lesions treated with longer stents (> 150 mm). Stenosis exceeding 50% and occlusions were significantly more frequent in fractured stents. Conclusions This study suggests that implants longer than 150 mm and multiple stents are associated with higher device fracture rates. In cases with stent fractures, stenoses exceeding 50% and occlusions were significantly more frequent.

A multicenter prospective observational study appraising the effectiveness of the Supera stent after subintimal recanalization of femoro‐popliteal artery occlusion: The SUPERSUB II study

“…Similarly, stents face constant exposure to simultaneous and opposing biodynamic forces (compression, torsion, flexion, extension, and rotation). Furthermore, the lack of native intima‐media tissues, may lead, on one hand, to compression, kinking, and fractures, and, on the other hand, enhanced inflammatory response of the arterial wall, potentially leading to accelerated restenosis or thrombosis 8 . Accordingly, there is ongoing debate on the most appropriate optimization strategy in patients with CLI exhibiting femoropopliteal occlusions who have been successfully recanalized using a subintimal tracking technique.…”