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Hamostaseologie 2003; 23(02): 71-73
DOI: 10.1055/s-0037-1619571
Research Articles
Schattauer GmbH

Stenting der Arteria femoralis aus angiologischer Sicht

Stenting of the femoral artery: the angiologist’s perspective
R. M. Bauersachs
1   I. Medizinische Klinik, Schwerpunkt Angiologie (komm. Leiter: Priv.-Doz. Dr. med. R. M. Bauersachs), Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt am Main
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Publication History

Publication Date:
27 December 2017 (online)

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Zusammenfassung

Die perkutane transluminale Angioplastie ist eine gut etablierte, wirksame und sichere Behandlungsoption für Stenosen und kurzstreckige Verschlüsse im Bereich der Oberschenkelarterien. Die zusätzliche Einlage von Stents ist allerdings mit einer häufigen und relativ raschen Restenosierung durch Intimaproliferation vergesellschaftet. Aufgrund dieser Problematik ist die Stenteinlage besonderen Situationen vorbehalten, z. B. Auftreten einer PTA-induzierten Dissektion, elastisches Recoil, insbesondere bei exzentrischen Stenosen.

Bei der Platzierung in Bewegungssegmenten im Bereich der Arteria femoralis communis oder der Arteria poplitea kann es zur Desintegration des Stents kommen. Eine Stenteinlage sollte deshalb vermieden werden. Die aktuelle zurückhaltende angiologische Beurteilung des Stentings in der Arteria femoralis könnte durch effektive Maßnahmen zur Eindämmung der intimalen Hyperplasie (z. B. Brachytherapie oder Sirolimusbeschichtete Stents) revidiert werden.

Summary

The percutaneous transluminal angioplasty of stenosis and short occlusions of the femoral artery is a well established, safe and effective treatment option. The additional placement of stents during angioplasty is associated with frequent and rapid restenosis due to intimal hyperplasia.

Therefore, stent placement of the femoral artery is commonly recommended only for special circumstances, including PTA-induced dissection of the vessel wall, elastic recoil, and excentric stenosis.

Placement of stents near joints, e. g. in the common femoral artery or the popliteal artery should be avoided as it may lead to structural damage of the stents. The current angiological statement concerning stent implantation in the femoral artery may be revised if effective measures to inhibit intimal hyperplasia such as brachy therapy or sirolimus coated stents become available.

Schlüsselwörter

Arteria femoralis - Stents

Keywords

Arteria femoralis - Stents
 

  • Literatur

  • 1 Dormandy JA, Rutherford RB. Management of peripheral arterial disease (PAD). TASC Working Group. J Vasc Surg 2000; 31: S1-S296.
    CrossrefPubMedGoogle Scholar
  • 2 Duda SH, Pusich B, Richter G, Landwehr P, Oliva VL, Tielbeek A, Wiesinger B, Hak JB, Tielemans H, Ziemer G, Cristea E, Lansky A, Beregi JP. Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month results. Circulation 2002; 106: 1505-9.
    CrossrefPubMedGoogle Scholar
  • 3 Henry M, Amor M, Ethevenot G, Henry I, Amicabile C, Beron R, Mentre B, Allaoui M, Touchot N. Palmaz stent placement in iliac and femoropopliteal arteries: primary and secondary patency in 310 patients with 2-4-year follow-up. Radiology 1995; 197: 167-74.
    CrossrefPubMedGoogle Scholar
  • 4 Hunink MG, Wong JB, Donaldson MC, Meyerovitz MF, de Vries J, Harrington DP. Revascularization for femoropopliteal disease. A decision and cost-effectiveness analysis. JAMA 1995; 274: 165-71.
    CrossrefPubMedGoogle Scholar
  • 5 Johnston KW. Femoral and popliteal arteries: reanalysis of results of balloon angioplasty. Radiology 1992; 183: 767-71.
    CrossrefPubMedGoogle Scholar
  • 6 Martin EC, Katzen BT, Benenati JF, Diethrich EB, Dorros G, Graor RA, Horton KM, Iannone LA, Isner JM, Ramee SR. et al. Multicenter trial of the wallstent in the iliac and femoral arteries. J Vasc Interv Radiol 1995; 6: 843-9.
    CrossrefPubMedGoogle Scholar
  • 7 Mehta SR, Yusuf S, Peters RJ, Bertrand ME, Lewis BS, Natarajan MK, Malmberg K, Rupprecht H, Zhao F, Chrolavicius S, Copland I, Fox KA. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527-33.
    CrossrefPubMedGoogle Scholar
  • 8 Rosenfield K, Schainfeld R, Pieczek A, Haley L, Isner JM. Restenosis of endovascular stents from stent compression. J Am Coll Cardiol 1997; 29: 328-38.
    CrossrefPubMedGoogle Scholar
  • 9 Schopohl B, Liermann D, Pohlit LJ, Heyd R, Strassmann G, Bauersachs R, Schulte-Huermann D, Rahl CG, Manegold KH, Kollath J, Bottcher HD. 192IR endovascular brachytherapy for avoidance of intimal hyperplasia after percutaneous transluminal angioplasty and stent implantation in peripheral vessels: 6 years of experience. Int J Rad Oncol Biol Phys 1996; 36: 835-40.
    CrossrefPubMedGoogle Scholar
  • 10 Strecker EP, Hagen B, Liermann D, Schneider B, Wolf HR, Wambsganss J. Iliac and femoropopliteal vascular occlusive disease treated with flexible tantalum stents. Cardiovasc Intervent Radiol 1993; 16: 158-64.
    CrossrefPubMedGoogle Scholar
  • 11 Strecker EP, Hagen B, Liermann D, Boos I. Long-Term Results following Treatment of Iliac Artery Stenoses and Occlusions with flexible Tantalum stents. In: Stents: State of the art and future developments. Liermann D. (ed). Morin Heights. Canada: Polyscience Publications Inc; 1995: 23-9.
    Google Scholar
  • 12 Strecker EP, Boos IB, Gottmann D. Femoropopliteal artery stent placement: evaluation of long-term sucess. Radiology 1997; 205: 375-83.
    CrossrefPubMedGoogle Scholar