Journal «Angiology and Vascular Surgery» • 

2016 • VOLUME 22 • №3

Use of stents with bioactive coating in treatment of patients with lesions of the superficial femoral artery

Generalov M.I.1, Maistrenko D.N.1, Oleshchuk A.N.1, Ivanov A.S.1, Granov D.A.1, Ovchinnikov I.V.1, Khmelnitsky A.V.2, Gusinskyi A.V.3

1) Department of Vascular Surgery, Russian Scientific Centre of Radiology and Surgical Technologies under the Public Health Ministry of the Russian Federation,
2) Laboratory of Age-Related Pathology of the Cardiovascular System, Saint Petersburg Institute of Bioregulation and Gerontology under the North-West Branch of the Russian Academy of Medical Sciences,
3) North-West Federal Medical Research Centre named after V.A. Almazov under the Public Health Ministry of the Russian Federation, Institute of Heart and Vessels, Saint Petersburg, Russia

The authors analysed the immediate outcomes of implanting stents with bioactive coating in treatment of patients presenting with atherosclerotic lesions of the superficial femoral artery.

Over the period from January 2014 to December 2015, endovascular interventions on the superficial femoral artery were carried out in a total of 18 patients (mean age 61.3±9.2 years). The implants inserted were stents with bioactive coating based on titanium oxinitride, measuring 6 to 8 mm in diameter and being from 50 to 200 mm long. Prior to operation and 7 days after implantation of the stent, the immunoenzymatic assay was used to determine the level of nitrogen nitric oxide (NO) in blood. The stents’ patency was assessed by the findings of ultrasound duplex scanning performed at 30 days, and then 6 and 12 months after the intervention.

There were no complications either during the operation or in the early postoperative period. An increase in the ankle-brachial index was observed in all patients: with the average value prior to treatment amounting to 0.4±0.3 and equalling 1.1±0.2 after stenting (p<0.0001). Normalization of the blood NO level was revealed (was noted to normalize): the mean value prior to operation amounted to 18.9±2.3 µmol/L and after operation to 28.9±4.1 µmol/L (p<0.05). Primary patency rate of the stents was 100% at 30 days, 94.5% (1 occlusion) at 6 months and 88.8% (1 restenosis and 1 occlusion) at 12 months. The patients with occlusion or restenosis were subjected to repeat endovascular interventions, with restoration of patency of the construction (with the construction’s patency restored). By now all the 18 patients show preserved patency (currently patency was preserved) of lower-limb arteries, with no evidence of restenosis in the zones of operations.

It was concluded that using stents with bioactive coating based on titanium oxinitride results in normalization of the level of NO in blood, which may contribute favourably to prolongation of the period of functioning of endovascular constructions. The first data concerning primary patency of stents of this type make it possible to count on betterment of the remote results of treatment of patients presenting with atherosclerotic lesions of the superficial femoral artery.

KEY WORDS: diseases of peripheral arteries, superficial femoral artery, endovascular intervention, stent with drug coating, nitric oxide, zinc oxinitride.

P. 64

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