Peripheral artery disease (PAD) affects millions globally, often leading to narrowed arteries in the legs that reduce blood flow. Stent placement has emerged as an important, less invasive treatment option for blocked leg arteries. This procedure aims to restore adequate circulation, alleviate PAD symptoms, and improve patient well-being.
What Leg Stents Are For
Leg stents are small, mesh-like tubes placed inside arteries to open blood vessels narrowed or blocked by plaque buildup from peripheral artery disease. This plaque accumulation restricts blood flow to the limbs, causing symptoms like leg pain during walking (claudication), pain at rest, or non-healing wounds in severe cases (critical limb ischemia).
By restoring circulation, stents alleviate these symptoms and improve a person’s ability to walk. For those with advanced disease, stents also help prevent severe complications, including tissue damage or amputation.
How Stent Success is Measured
Measuring the success of leg stents involves evaluating both the procedure’s technical effectiveness and the patient’s clinical improvement. One key metric is patency rate, which indicates how long the stent remains open and allows blood to flow freely. Primary patency means the stent stays open without further interventions, while secondary patency means it was re-opened after initially narrowing.
Patency rates vary significantly based on artery location and stent type. For instance, in the superficial femoral artery (SFA), one-year primary patency rates for bare-metal stents are typically around 70%, with drug-eluting or covered stents often showing higher rates. Long-term patency can range, with some studies indicating five-year rates around 47% in the SFA. Despite these successes, re-narrowing of the artery (restenosis) can occur in 30% to 55% of patients within the first year.
Beyond patency, a stent’s success is also gauged by its ability to improve symptoms. Patients often experience relief from leg pain, an increased ability to walk longer distances, and, for those with critical limb ischemia, better wound healing. Stents also play a role in preventing limb amputation, particularly in severe cases.
Factors Influencing Stent Outcomes
Several factors influence the long-term success of leg stents. The specific location and extent of the blockage play a significant role; longer or more complex lesions present greater challenges than shorter ones.
A patient’s overall health and lifestyle habits also significantly impact stent outcomes. Co-existing medical conditions like diabetes, kidney disease, and high blood pressure can affect healing and long-term patency. Smoking, in particular, reduces stent patency and increases disease progression. Adherence to prescribed medications and healthy lifestyle changes are important for maintaining stent function. The number of healthy “runoff” vessels, which carry blood away from the stented area, also influences blood flow restoration.
Advancements in stent technology, including drug-eluting stents (DES), have improved outcomes. These stents release medication to prevent tissue overgrowth and re-narrowing, often showing better patency rates than bare-metal stents. Self-expanding stents are chosen for mobile areas like the thigh due to their flexibility. The medical team’s experience and skill also influence the procedure’s success.
Living with a Leg Stent
Receiving a leg stent is a significant step in managing peripheral artery disease, and ongoing care is important for long-term success. Regular follow-up appointments with a healthcare provider monitor the stent’s function and overall vascular health. These check-ups often include non-invasive tests like duplex ultrasound to assess blood flow and detect any signs of re-narrowing early.
Adhering to prescribed medications is another important aspect of post-stent care. Antiplatelet medications, such as aspirin and clopidogrel, are commonly prescribed to prevent blood clots from forming inside the stent, which could lead to re-blockage. Consistent medication use helps maintain stent patency and reduces complication risks.
Lifestyle modifications are also important to support the stent’s longevity and prevent PAD progression. Quitting smoking is important, as it significantly harms blood vessels and can compromise stent function. Managing chronic conditions like diabetes, high blood pressure, and high cholesterol through diet and medication, along with regular exercise, helps improve overall circulation and artery health. Patients should also be aware of potential recurring symptoms, such as leg pain, numbness, or changes in skin color or temperature, and report these promptly to their doctor.