What is the average life span of a peripheral stent?

Lifespan of Peripheral Stents

Peripheral arterial stents demonstrate moderate long-term durability, with primary patency rates of approximately 66% at 5 years and 46% at 10 years for iliac artery stents, though patency varies significantly by anatomic location and lesion characteristics. 1

Iliac Artery Stent Longevity

The most robust long-term data comes from iliac arterial stenting:

• Primary patency rates: 66% at 5 years and 46% at 10 years 1
• Secondary patency rates (after reintervention): 79% at 5 years and 55% at 10 years 1
• Approximately 16% of patients required surgical bypass involving the stented segment within 10 years, primarily due to stent restenosis 1

Femoral-Popliteal Stent Durability

Femoral-popliteal stents have historically shown inferior longevity compared to iliac stents:

• No advantage over angioplasty alone in randomized trials for patency, ankle-brachial index, or clinical improvement 2
• Stenting may be reserved for salvage of immediate angioplasty failure or treatment of recurrent stenosis after angioplasty 2
• Long-segment superficial femoral artery disease with poor runoff demonstrates particularly poor outcomes with endovascular therapy 2

Factors Affecting Stent Longevity

Anatomic Considerations

• Iliac location: Superior patency compared to femoral-popliteal segments 2
• Lesion length: Longer lesions associated with worse outcomes 2
• Runoff quality: Poor tibial runoff significantly decreases intervention durability 2

Patient-Specific Factors

• Female gender and hormone replacement therapy: Reported to decrease iliac stent patency 3, 4
• Severity of disease: Critical limb ischemia versus claudication affects outcomes 2
• Lesion type: Stenoses perform better than occlusions in femoral-popliteal territory 2

Plastic vs. Metal Stents (Non-Arterial Applications)

For biliary applications, which provide insight into stent behavior:

• Plastic stents: Average patency approximately 4 months 2
• Self-expanding metal stents: Average patency approximately 8 months (twice that of plastic stents) 2
• Cost-effectiveness analysis favors metal stents for patients with estimated survival exceeding 6 months 2

Surveillance and Reintervention Requirements

Regular follow-up is mandatory to maintain long-term patency:

• Approximately 62% of patients with venous stents required reintervention for recurrent symptoms in one multi-institutional series 5
• Only 32% of interventions resulted in sustained symptomatic improvement without additional procedures 5
• Annual duplex ultrasound monitoring recommended to detect restenosis before symptom recurrence 6

Clinical Implications

The decision to use peripheral stents must account for expected patient survival and ability to comply with surveillance:

• Patients with reasonable life expectancy unable to return for subsequent procedures should be considered for alternative therapy 5
• For iliac lesions, provisional stenting (stenting only for angioplasty failure) is more cost-effective than primary stenting, though primary stenting is now routine clinical practice 2
• Endovascular brachytherapy may reduce restenosis rates in femoral-popliteal arteries, though this remains investigational 2

Common Pitfalls

• Overestimating durability: Primary patency drops substantially after the first year, particularly in femoral-popliteal segments 1
• Inadequate surveillance: Late stent failure can occur progressively beyond 4 years, requiring ongoing monitoring 7
• Poor patient selection: Patients with extensive disease, poor runoff, or limited life expectancy may not benefit from stenting 2, 5
• Ignoring anatomic location: Iliac stents perform substantially better than femoral-popliteal stents 2, 1