Strecker stents in the femoropopliteal arteries: value of duplex ultrasonography in restenosis assessment

J Endovasc Surg. 1995 May;2(2):150-60. doi: 10.1583/1074-6218(1995)002<0150:SSITFA>2.0.CO;2.


Purpose: Experience with Strecker stent implantation in the femoropopliteal arteries has been described; however, few of the reports were prospective studies, and none routinely used site-specific assessment methods for follow-up evaluation of stent patency. The purpose of this study was to evaluate 1-year Strecker stent patency using duplex ultrasound imaging to obtain a more precise delineation of stent restenosis than is possible with other noninvasive assessment modalities.

Methods: A prospective study involved 52 patients with 57 sites treated by angioplasty and Strecker stent deployment in the femoropopliteal arteries. Assessment included clinical evaluation; ankle-brachial index (ABI) measurements at rest and after exercise; and duplex ultrasound imaging preprocedurally and at 3 and 12 months after the intervention.

Results: All 74 stents were deployed successfully in the 35 occluded arteries and 22 stenotic lesions. Acute reocclusion occurred in 6 (10%). At 3 months, primary patency was 81% and secondary patency 84%. Mean ( +/- SD) ABIs increased from 0.64 +/- 0.15 at rest and 0.32 +/- 0.17 after exercise to 0.89 +/- 0.14 and 0.68 +/- 0.23, respectively (p < 0.0001). At 12 months, primary patency was 79%, and secondary patency was 82%. Mean ABIs were 0.82 +/- 0.15 at rest and 0.52 +/- 0.22 after exercise at 12 months (p < 0.0002 compared with preprocedural ABIs). Analysis of the length of lesion treated showed betted results with shorter diseased segments, but this was not statistically significant (p > 0.05). Better outcomes were also obtained when one stent was used rather than two stents at 12 months (p = 0.15), but there was no difference at 3 months (p = 0.3). Thirty-four percent of the stented segments progressed from < 20% stenosis at 3 months to > 50% stenosis at 12 months. Overall, 19 (43%) of 44 segments progressed from < 50% stenosis at 3 months to a > 50% stenosis at 12 months. Restenosis seen at 3 months generally was in the native artery just proximal or distal to the stent, but at 12 months, restenosis was mainly inside the stent.

Conclusions: Strecker stents at 1-year demonstrated satisfactory patency in the femoropopliteal arteries when deployed for angioplasty salvage or recurrent disease. The 3- and 12-month evaluations obtained with duplex ultrasound provided site-specific hemodynamic data for stent assessment. Resting ankle pressures were a poor index of restenosis.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon*
  • Arterial Occlusive Diseases / diagnostic imaging
  • Arterial Occlusive Diseases / therapy
  • Arteriosclerosis / diagnostic imaging*
  • Arteriosclerosis / therapy*
  • Constriction, Pathologic
  • Disease Progression
  • Female
  • Femoral Artery* / diagnostic imaging
  • Humans
  • Male
  • Middle Aged
  • Popliteal Artery* / diagnostic imaging
  • Prospective Studies
  • Recurrence
  • Stents*
  • Ultrasonography, Doppler, Duplex*
  • Vascular Patency