Contemporary issues of femoropopliteal stenting

Peripheral artery disease (PAD) is one of the most common cardiovascular diseases with serious sequelae. Every year, 120–500 amputations are performed per 1 million people worldwide. The severe consequences of amputation include the mental trauma caused by loss of a limb, disability and a real risk of death for the patient, since the mortality rate associated with the development of gangrene remains extremely high. PAD is most frequently located in the femoral-popliteal segment, which is the longest vascular segment in the human body. Over the past decade, the endovascular approach has become the main therapeutic strategy for PAD, given its lower risk of complications and comparable efficacy to open interventions. Femoral-popliteal stenting provides advantages over balloon angioplasty, preventing vessel wall recoil and providing necessary frame support. This review aims to describe the latest progress of endovascular surgery for the treatment of femoral-popliteal artery disease and to discuss its limitations. The introduction of nitinol stents and new drug coated stents into clinical practice has improved the results of femoral-popliteal endovascular treatment. Despite this, stent failure remains a pressing problem that significantly impacts the results of endovascular treatment of atherosclerotic lesions of lower limb arteries. Received 6 June 2019. Revised 8 October 2019. Accepted 10 October 2019. Funding: The study did not have sponsorship. Conflict of interest: Authors declare no conflict of interest. Author contributions Conception and design: D.U. Malaev, A.R. Tarkova, A.A. Prokhorkhin, A.A. Boykov Drafting the article: D.U. Malaev, A.A. Prokhorkhin, A.A. Boykov Critical revision of the article: D.L. Merson, A.Yu. Vinogradov, V.I. Baystrukov, E.I. Kretov Final approval of the version to be published: D.U. Malaev, A.R. Tarkova, A.A. Prokhorkhin, D.L. Merson, A.Yu. Vinogradov, V.I. Baystrukov, A.A. Boykov, E.I. Kretov, M.V. Pryamov