Bare Metal Stents Can Maintain Arterial Patency in Traumatic Occlusion

Abstract

Background: The standard approach to an occlusive vascular injury is open arterial reconstruction, although endovascular stenting is becoming more common, despite limited evidence. The aim of this study is to examine whether bare-metal stents can be effective in an ovine model of occlusive arterial trauma. Methods: Through a groin incision, a 2-cm segment of the left superficial femoral artery (SFA) was bluntly injured using a hemostat and injection of air to achieve thrombosis. Animals then underwent a stent deployment (stent group, n = 5) or no-treatment (control group, n = 5). In the stent group, recanalization of the thrombotic lesion, thromboaspiration, and bare-metal stent deployment were performed. Enoxaparin 1.5 mg/kg was given to all animals. The stent group animals were fed clopidogrel 75 mg and aspirin 125 mg daily. Angiography and Doppler ultrasound were used to evaluate arterial patency during the 7-day observation period. Results: A thrombosis was obtained in all cases. After a fall in the systolic velocity (SV, cm/sec) in both the control (43 (36–56) to 6 (0–16); P < 0.001) and stent groups (45 (32–53) to 8 (0–12); P < 0.001), stent implantation resulted in a significant permanent increase of the SV. Day 7 angiography confirmed SFA patency in all (5/5) stented animals, with persisting occlusions in the control group (P = 0.008). There was no evidence of distal emboli in the run-off arteries. Conclusions: Bare-metal stent implantation restores arterial patency of a traumatic occlusive lesion in a standardized ovine model with a short follow-up period.

Keywords

• Arterial Trauma
• Trauma Surgery
• Endovascular Trauma Management
• Bare-Metal Stent
• Vascular Surgery