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Related Experiment Video

Updated: Sep 17, 2025

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

What Have We Learned From Explanted Peripheral Stents Analysis?

Salomé H Kuntz^1,2,3, Arielle Bellissard^1,2,3, Aloke V Finn^1,4

¹CVPath Institute, Gaithersburg, MD, USA.

Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists

|July 3, 2025

Summary

Analysis of explanted peripheral stents in humans reveals minimal data on their in vivo behavior. Delayed healing is a common cause of stent failure across different arterial beds, emphasizing the need for more pathological data.

Keywords:

pathology stent stent thrombosis stent-graft surgery systematic review

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Last Updated: Sep 17, 2025

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Area of Science:

Vascular Surgery
Cardiovascular Pathology
Biomaterials Science

Background:

Current in vitro and animal models for endovascular devices do not accurately predict human performance.
Direct in vivo analysis of peripheral stents is challenging, necessitating the study of explanted devices.
Understanding explanted stent behavior is crucial for identifying long-term complications and improving device design.

Purpose of the Study:

To review and summarize existing knowledge on the pathological analysis of peripheral stents explanted from human patients with peripheral artery obstructive disease (PAOD).
To identify common failure modes and healing characteristics of peripheral stents in vivo.

Main Methods:

A descriptive literature review was conducted using MEDLINE and EMBASE databases.
Search strategy combined MeSH terms: "peripheral stenting," "histology," "stents," "pathology," "neoatherosclerosis," and "explants."
No time limitation was imposed on the search.

Main Results:

Eighteen publications were identified, focusing on femoral (9), iliac (4), and carotid (5) stents; no reports on subclavian, vertebral, or renal stents were found.
Analysis of 58 devices in 42 cases revealed high failure rates: 74.1% in femoral, 82% restenosis in iliac, and 50% in carotid stents.
Common failure mechanisms included delayed healing (all beds), intimal calcifications and stent integrity (femoral), and lipid-rich necrotic cores causing ulceration (carotid).

Conclusions:

There is a significant lack of pathological data on the in vivo performance of peripheral stents in humans.
Delayed healing is a prevalent factor in peripheral stent failure, irrespective of the arterial location.
Larger-scale analysis of explanted peripheral stents is essential to improve device design and patient outcomes, with plaque characterization being key for treatment selection.