Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/S1677-54492008000400010
Jornal Vascular Brasileiro
Review Article

Atualização sobre endopróteses vasculares (stents): dos estudos experimentais à prática clínica

Update on vascular endoprostheses (stents): from experimental studies to clinical practice

Luís Henrique Gil França; Adamastor Humberto Pereira

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Resumo

Atualmente, o tratamento das doenças vasculares periféricas é uma das áreas da medicina de maior expansão. O número de intervenções vasculares aumenta e os resultados das novas técnicas endovasculares estão muito próximos aos das tradicionais cirurgias vasculares. Embora a angioplastia ofereça bons resultados em curto prazo, o implante de stents procura melhorar o sucesso do procedimento e estender o seu uso a um número maior de pacientes com doença vascular periférica. Entretanto, a sua utilização ainda é controversa. O implante de stents no sistema aorto-ilíaco tem bons resultados; porém, a sua indicação para as lesões femoro-poplíteas ainda é discutida. Além disso, o rápido desenvolvimento de stents e sua escolha para uso no sistema vascular periférico têm sido uma difícil tarefa para o cirurgião endovascular. Muitos fatores influenciam a escolha do stent, e um amplo conhecimento desse material é essencial. Tal escolha depende da avaliação pré-operatória, da localização e das características da lesão e também do uso do stent primário ou seletivo. Nesse trabalho, são realizadas revisão do histórico do desenvolvimento dos stents, desde os estudos experimentais até os ensaios clínicos e também discussão sobre a sua aplicação no tratamento das doenças vasculares periféricas.

Palavras-chave

Artéria, prótese vascular, doenças vasculares periféricas

Abstract

The treatment of peripheral vascular diseases is one of the most rapidly expanding fields of medicine today. The number of peripheral interventions increased and innovative endovascular techniques are close to the results of traditional vascular surgeries. Although balloon angioplasty alone offers good immediate results, implantation of stents has been proposed to improve the procedural success and extend its application to more patients with peripheral vascular disease. However, stenting is controversial. Use of stents has good results in aortoiliac vessels, but its use in femoropopliteal vessels is still in dispute. Moreover, the rapid development of endovascular stents for peripheral applications and their choice have been a complicated task for endovascular surgeons. Many factors influence choice of stent, therefore, knowledge of available stents is mandatory. Appropriate selection depends on adequate preprocedural evaluation of the lesion, choice of primary vs. selective stent placement, and location and characteristics of the lesion. In this article the history of stent development is reviewed, from studies with experimental models to clinical practice, and its application in the treatment of peripheral vascular diseases is discussed.

Keywords

Artery, vascular graft, peripheral vascular diseases

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