Does the non-stent area still exist? Preliminary results of popliteal artery stenting in patients with critical limb ischemia

Introduction: femoropopliteal atheroscletoric disease is the main cause of chronic limb ischemia. There are different types of surgical treatment, open by pass or endovascular. Due to high mechanical stress the popliteal artery has always been considered a no-stent zone. Method: observational retrospective one-center study in the treatment of patients with critical limb ischemia (Rutherford-Baker grade 3-5) treated with dual stent along popliteal artery between January 2012 and January 2017. Indication of the stent was primary angioplasty failure (arterial dissection, re-stenosis or recoil). We performed follow-up with ultrasonography at 3, 6 and 12 months. We describe primary patency, secondary patency, limb salvage and mortality. Results: we collected 19 patients, 8 men (42.1%) and 11 women (57.9%), 77.4 years of mean age. The median of follow-up was 8 months (range 1-66 months). Primary patency was 94.7% at 3 months and 88% at 6 and 12 months. Secondary patency was 100% at 3 months and 92.9% at 6 and 12 months. The limb salvage rate was 92.9% at 1 year. Survival rate was 72% for the first year. Conclusion: dual stent of nitinol and fluoropolymers impregnated with heparin seems to be a good option in patients with critical limb ischemia associating popliteal artery lesions. It has high patency and limb salvage rates. Despite that, it is necessary to validate these results in medium and long term.