INDICATIONS AND RESULTS OF ARTERIAL STENTS FOR OCCLUSIVE DISEASE

The application of stents for treatment of peripheral arterial occlusi ve disease has gained widespread clinical use, but their safety and ef ficacy remain unclear. Stent technology is still evolving, and long-te rm follow-up data are sorely needed. Stents have had good success in p roviding a scaffold to maintain the intraluminal structure and patency of an artery. As such, stents appear to play a role in improving earl y results after failed or inadequate balloon angioplasty. However, ste nts do not prevent restenosis due to intimal hyperplasia. Furthermore, stents may be thrombogenic and prone to extrinsic compression in the peripheral position. Thus patency results are clearly worse in the fem oral artery (47% at 3 years) than in the iliac artery (82-84% at 6-24 months). Furthermore, there is no evidence so far that stents improve long-term patency over standard balloon angioplasty without stents; an d complication rates of stent procedures are generally 10%. Currently in the United States stents are approved for use in the iliac artery p osition. However, routine use of stents cannot be recommended until st udies demonstrate that the results with stents are better than those w ith balloon angioplasty alone.