An Audit of Ultrasound Surveillance Following Deployment of Arterial Stents in the Lower Limb

Background: There has been an increase in the number of stents deployed in the iliac, femoral and popliteal arteries following endovascular management of peripheral arterial disease. Excessive neointimal hyperplasia can lead to the development of in-stent stenoses following insertion and so most endovascular surgeons advocate the use of a formal stent surveillance program to identify clinically quiescent stenoses which can then undergo re-intervention to maintain stent patency. This audit aims to assess the number of patients who are undergoing stent surveillance as well as the timeframes related to the scans. Method(s): Retrospective audit of all patients who have had deployment of iliac, femoral and popliteal stents in the past five years and documentation of commencement onto the stent surveillance programme. A 100% enrolment was set as the standard. Result(s): Lower limb arterial stents were deployed in 106 patients. The average age was 71 years with an overwhelming male predominance (75%). Approximately half of the stents were inserted for category two and three patients (Rutherford classification for peripheral arterial disease) whilst 34% were inserted for category four and five patients. Only 69% of patients had been enrolled onto the stent surveillance programme with a median time of 85 days for the initial post-procedural duplex. Conclusion(s): A formal, consistent stent surveillance programme is essential to identify subclinical in-stent stenoses. Early recognition allows for speedy re-intervention in those patients who are deemed clinically appropriate ultimately leading to stent patency. Enrolment onto stent surveillance programmes should be managed by a dedicated member of the team with regular auditing.

Publication History

Article published online:
11 May 2021