Long-term results with a Palmaz stent in the femoropopliteal arteries.

Highly contradictory results are achieved with stents in the superficial femoral and popliteal arteries. In order to compare our experience, we have reviewed a series of patients in whom a Palmaz stent was implanted at the femoropopliteal level. From January, 1991, to December, 1994, 35 patients were treated for claudication (63%) or for critical ischemia (37%), using endoluminal angioplasty and the implantation of a Palmaz stent. The stents were impianted in the superficial femoral artery in 26 cases (74%) and in the popliteal artery in 9 cases (26%). In case of restenosis (1 case), calcified stenosis (2 cases), complications of endoluminal angioplasty (32 cases), 44 stents were implanted in 35 stenoses (71.5%) and 10 short thromboses (28.5%). Follow-up was ensured periodically in all cases (D1, 2 months, 6 months, then every six months) using a clinical examination and a study with Doppler and duplex scanning. All stents were inserted without complications, with an initial success rate of 100%. During the follow-up period (32 +/- 4 months), two patients died (patent stent) and two were lost to follow-up. Acute thrombosis occurred in two cases (6%) and restenosis in five (14%) during the first six months after the operation. Restenosis occurred in all but one cases with a poor distal arterial runoff (p < 0.05). The popliteal artery was not more often affected by restenosis than the superficial femoral artery. Primary patency after one year is 80.4 +/- 7%, and 75.7 +/- 8% after two years. Assisted primary patency after 2 years is 83.3 +/- 7%. The implantation of a Palmaz stent is still a safe method, with low rates of acute thrombosis and a satisfactory long-term patency. Periodic and sonographic follow-up should allow improving the patency of restenosis by more than 50% under treatment.