Purpose: The effectiveness of continued exercise therapy after vascular reconstruction for lower limb peripheral artery disease has been demonstrated. However, there are no data on the extent to which the hip and knee joints can safely be permitted to bend after lower limb artery stent placement. The purpose of this study was to observe, evaluate, and obtain visual images of the effects of the external forces generated by knee and hip flexion on stents placed in the arteries of the lower extremities of patients with lower limb peripheral artery disease, in order to identify movements of the lower limb joints that require caution postoperatively. Methods: This retrospective observational study included 144 patients (200 limbs) that underwent endovascular treatment with stent placement. The limbs were divided into two groups according to the stenting site: the iliac artery region (150 limbs) and the femoropopliteal artery region (50 limbs). Changes in stent shape during hip and knee joint flexion were evaluated using two-dimensional images obtained using lateral radiography. Results: In the iliac artery region, 92 limbs exhibited changes in stent shape during maximum hip flexion. These changes were largely characterized by further enhancement of the host vesselʼs flexion. In the femoropopliteal artery region, stent flexion as a result of knee flexion alone was observed in 17 limbs and, when hip flexion was combined with knee flexion, stent flexion was observed in a total of 30 limbs. Conclusion: Imaging the impact of lower limb joint movements on implanted stents could potentially contribute to safe and more effective exercise therapy tailored to individual patients.
Tetsu Horaguchi (2024) studied this question.