Interwoven nitinol stents for the treatment of infrainguinal peripheral arterial disease

Endovascular treatment of peripheral arterial disease has emerged as a minimally-invasive alternative to surgical intervention and has often become the first-line therapy. The patency of these interventions has shown promise but has remained variable depending upon the location, length of lesion and device used for a particular treatment. Specifically, one of the most common locations that is treated with endovascular means for chronic-limb threatening ischemia is the femoropopliteal region. This area of the arterial tree is highly exposed to movements such as flexion, extension, and rotational torque; as such, placing metallic stents can result in kinking and damage to the stent, and subsequently the artery, over time. Stent characteristics are defined according to the metal property that composes them. Nitinol has been experimented with for use in the arterial tree since the 1980s namely because of its uniquely elastic mechanical properties, which were ideal for sustaining its shape within an anatomic area prone to positional variability. More recently, nitinol stents were introduced in an interwoven fashion, the design of which creates a scaffold of structure for the elastic property of the metal to remain reinforced within highly flexible arteries. This review article discusses the available literature and evidence behind the use of these interwoven nitinol stents in lower extremity peripheral arterial interventions.