Ocena pierwszego polskiego stentu "Neptun" w leczeniu zmian miażdżycowych tętnic biodrowych

Bibliogr. s. 92

Background: Angioplasty of occluded iliac arteries connected with stent implantation demonstrated the high technical efficacy and good clinical effect of the stent. The patency of iliac vessel stents 12 months after their implantation ranged between 86 and 99%, depending on the author cited. The aim of the study was to determine the safety and clinical efficacy of iliac artery angioplasty following the implantation of the Polish stent Neptun, manufactured by Balton. Material/Methods: The study group comprised 56 patients aged between 39 and 83 years diagnosed with stenosis or iliac artery occlusion, subjected to implantation of 75 stents. The patients were directed towards intravascular procedures on the basis of their medical history as well as clinical and imaging examinations, including Doppler ultrasound and DSA angiography. Clinical symptoms were based on Fontaine's classification, evaluated before the procedure and three days after. Considering the similar time intervals, the ankle-brachial index (ABI) was evaluated. Distant results were determined on the basis of clinical examinations in addition to the ABI estimation performed during the follow-up visit 12 months after the procedure. Thirty-seven patients required single stents, while in 9 subjects both iliac arteries were subjected to stenting, including the abdominal aortic bifurcation. In six patients, stents were implanted to both iliac arteries, the aortic bifurcation excluded. Four patients were subjected to the implantation of two stents, involving one of the iliac arteries. Results: In all patients a positive technical and clinical effect was obtained. Improvement according to Fontaine's classification was observed in the whole study group of patients (evaluation undertaken three days after the procedure). The mean ankle-brachial index on admission was 0.62±0.17. After angioplasty, this index significantly increased (p<0.01) to 0.87±0.19. After the one-year observation period the AB index decreased to 0.82±0.18 (p=NS). Ultrasonographic control comprised 49 patients with 65 implanted stents. Complete vessel patency was confirmed in 60 (92.3%) 12 months after stent implantation. Conclusions: Based on this evaluation, Neptun stents are safe, their technical and clinical efficacy amounting to 100% during the perioperative period. The stents assure good visualization during implantation. Their patency after the one-year observation period proved to be high, being comparable to other previously used stents. Further investigations are required, involving a longer follow-up period.