Modelos europeos de telemedicina, como el servicio finlandés Medilux, permiten realizar consultas médicas online mediante un cuestionario clínico, sin acudir a una consulta presencial.

Stent implantation in the popliteal artery is feasible.

Original title: Treatment of Complex Atherosclerotic PoplitealArtery Disease With a New Self-Expanding Interwoven Nitinol Stent. 12-Month Results of the Leipzig SUPERA Popliteal Artery Stent Registry. Reference: Dierk Scheinert, et al. J Am Coll Cardiol Intv 2013;6:65–71

Currently, peripheral angioplasty (PTA) of the popliteal artery is a real challenge since stent implantation is controversial and the outcome of balloon angioplasty does not always present better results. The aim of this registry was to evaluate the efficacy of the SUPERA nitinol stent at one year, (IDEV Technologies, Webster, Texas), in complex popliteal obstructions.

101 patients were included between January 2008 and April 2010. They all received the SUPERA stent in the popliteal artery, this being the only inclusion criterion.

All were symptomatic with an ankle-brachial index of 0.58 ± 0.15. Half had moderate or severe calcification and stents were implanted in a total of 125. Primary permeability at 12 months was 87.7 ± 3% and the secondary was 96.5 ± 2% with a significant improvement in claudication. The ankle- brachial index also improved from 0.58 ± 0.15 at baseline to 0.97 ± 0.18 after one year (p <0.001). During follow-up a total of 10 patients died, 9 of which were from cardiovascular causes unrelated to the procedure. An acute occlusion was present in one patient and required amputation of the treated limb but he died two months later. This last patient was the only death related to the procedure as well as the only amputation. Radiological control was observed in 51 patients without stent fracture. 

Conclusion: 

At 12 months follow up, both the permeability and durability of the SUPERA stent over popliteal level were high.

Comment: 

The results encourage us to use stents in this territory but we must be aware that not all devices are equal. More studies are still needed to show the safety and efficacy of stents in the popliteal artery, while the use of a stent should be temporary to a suboptimal balloon result. 

Courtesy by Dr Carlos Fava.
Interventional Cardiologist
Favaloro Foundation. Argentina.

Dr. Carlos Fava para SOLACI.ORG

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