Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant...

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Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery

Transcript of Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant...

Page 1: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

Imaging the Stented Superficial Femoral Artery:

Fracture Analysis

John Karwowski, MDAssistant Professor

Division of Vascular Surgery

Page 2: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

The Superficial Femoral Artery

Supplies the leg below the knee

Straight line conduit

Page 3: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

The Superficial Femoral Artery

Prone to atherosclerosis and occlusion

Page 4: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

Stent Failure

In-stent restenosis De facto primary failure

mode of SFA stenting Flow Compromise Thrombosis

Page 5: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

Intimal Hyperplasia

Injury response Cellular mediated Pathologic

narrowing

J Invasive Cardiol 2003

Page 6: Imaging the Stented Superficial Femoral Artery: Fracture Analysis John Karwowski, MD Assistant Professor Division of Vascular Surgery.

Stent Fractures

Unclear contribution Severe recoil of the

original lesion? Mobile and free

superficial femoral artery?

Cause or coincidence?

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Classification

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Current Methods

FluoroscopyHi definition X-ray

Not validatedDifficult to reproduce

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Open Cell Units