PMC8207276_01
CT, angiographic, and IVUS findings of the right SFA. (a) CT and angiographic findings of the right SFA: (1) baseline CT, (2) baseline angiography, (3) after the first procedure, (4) 6 months after the first procedure, (5) after the second procedure, and (6) 6 months after the second procedure. (b) IVUS findings of the right SFA. Blue text: stent area (mm2) (short diameter (mm) x long diameter (mm)); orange text: lumen area (mm2) (short diameter (mm) x long diameter (mm)); and yellow text: % stenosis (calculated as 100 - lumen area/stent area x 100).. CT: computed tomography; IVUS: intravascular ultrasound; IW-NS: interwoven nitinol stent; PC-PES: polymer-coated paclitaxel-eluting stent; SFA: superficial femoral artery.
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Computed tomography revealed long, calcified, and diffused lesions in bilateral SFA (Figures 1(a1) and 2(a1)). Pre-procedure angiographic findings are shown in Figures 1(a2) and 2(a2). Moreover, a 5.5 x 80-mm IW-NS, 6.0 x 80-mm PC-PES, 6.0 x 80-mm IW-NS, and 7.0 x 80-mm PC-PES were implanted from the distal to the proximal site to cover all SFA lesions after ballooning (Figure 1(a3)). IW-NSs were deployed (Figures 1(a4) and 2(a4)). IVUS findings are shown in Figures 1(b) and 2(b). IW-NSs were relatively well expanded based on the reference diameter of each stent; however, significant lumen loss was observed. The stent area (stent diameter), lumen area (lumen diameter), and % stenosis of each lesion where IW-NSs were implanted are also shown in Figures 1(b) and 2(b). Thereafter, a 6.0 x 120-mm PC-PES was implanted to the distal ISR site, and a 6.0 x 80-mm PC-PES was implanted to the proximal ISR site (Figure 1(a5)). Then, IVUS imaging showed that the newly implanted PC-PESs were relatively well expanded (Figures 1(b) and 2(b)). Restenosis was not observed in the stent implantation sites of the bilateral SFA lesions (Figures 1(a6) and 2(a6)). PC-PESs that were implanted 6 months ago in the implantation site of IW-NSs also had well-maintained expansion, and the lumen area was kept sufficiently (Figures 1(b) and 2(b)).
CT, angiographic, and IVUS findings of the left SFA. (a) CT and angiographic findings of the left SFA: (1) baseline CT, (2) baseline angiography, (3) after the first procedure, (4) 6 months after the first procedure, (5) after the second procedure, and (6) 6 months after the second procedure. (b) IVUS findings of the left SFA. Blue text: stent area (mm2) (short diameter (mm) x long diameter (mm)); orange text: lumen area (mm2) (short diameter (mm) x long diameter (mm)); and yellow text: % stenosis (calculated as 100 - lumen area/stent area x 100).. CT: computed tomography; IVUS: intravascular ultrasound; IW-NS: interwoven nitinol stent; PC-PES: polymer-coated paclitaxel-eluting stent; SFA: superficial femoral artery.
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Moreover, a 5.5 x 120-mm IW-NS, 7.0 x 120-mm PC-PES, and 7.0 x 80-mm PC-PES were implanted from the distal to the proximal site to cover all SFA lesions after ballooning (Figure 2(a3)). ISR site (Figure 2(a5)). Implanted stents were post-dilated by a 6-mm non-compliant balloon.
OCT findings of the right SFA: (a) 7 x 80-mm PC-PES, (b) 6 x 80-mm PC-PES in 6 x 80-mm IW-NS, (c) 6 x 80-mm PC-PES, and (d) 6 x 120-mm PC-PES in 5.5 x 80-mm IW-NS.. OCT: optical coherence tomography; IW-NS: interwoven nitinol stent; PC-PES: polymer-coated paclitaxel-eluting stent.
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The axial resolution of OCT is 10 times higher than that of IVUS; therefore, OCT imaging provides a much clearer view of the area between the lumen and plaque/neointima surface.   Representative OCT images of each stent are shown in Figure 3.