Advances in stent technology for femoral artery lesions and use of stents for venous pathology

Endovascular surgery with femoral superficial artery stent implantation was first conducted over 20 years ago. However, the first experiments with steel stents were relatively disappointing. A notable advance was the development of nitinol stents, which led to an initial improvement in clinical outcomes, but a relatively high rate of fractures. A better understanding of the biomechanics of the superficial femoral artery and technological developments have led to a second generation of nitinol stents with improved flexibility, and thereby fewer fractures. The phenomenon of restenosis related to neointimal hyperplasia has also led to the development of new concepts in stents including: drug-eluting, biodegradable, and covered stents. These technologies are of use for treating the more complex lesions of the superficial femoral artery, but also extend the endovascular indications of stents to venous pathology, such as vein compression syndrome in the upper or lower deep veins with deep vein thrombosis, and postthrombotic syndrome of the lower legs.