Largest Diameter of Cardiovascular Stents
The largest cardiovascular stents reach diameters of 40-45 mm for aortic applications, with stent grafts for aortic dissection averaging 35 mm (range 24-45 mm) in diameter. 1
Stent Diameter by Anatomical Location
Aortic Stents (Largest)
- Aortic stent grafts for dissection repair are individually produced with diameters of 20-40 mm, with average stent grafts measuring 35 mm (range 24-45 mm) in diameter 1
- These represent the largest diameter cardiovascular stents used in clinical practice, designed to exclude entry tears in aortic dissections 1
- The delivery systems for these large aortic stent grafts require 22-27 French sheaths 1
Iliac Vein Stents
- Optimal iliac vein stent sizing reaches 16 mm diameter for the common iliac vein, 14 mm for the external iliac vein, and 12 mm for the common femoral vein 2
- These sizes are based on normal vessel caliber measurements and should restore the lumen to minimum recommended caliber 2
Peripheral Arterial Stents
- Iliac artery stents typically range from 5-8 mm in diameter 3
- Larger diameter renal arteries have lower restenosis rates than smaller diameter vessels, with final stent diameter being a critical factor in long-term patency 1
- For renal artery stenting, larger post-stent minimal lumen diameter correlates with better late stent patency 1
Branch Vessel Stents
- Wallstents of 14 mm diameter are used for branch vessel applications in aortic dissection 1
- Pulmonary vein stents dilated to 8-10 mm diameter show improved freedom from restenosis, with 10 mm being optimal in adults 1
Clinical Considerations for Stent Sizing
Oversizing Risks
- Discordant planning with diameter differences >1 mm significantly predicts restenosis (odds ratio 0.115,95% CI 0.02-0.674) 4
- Oversizing in the external iliac artery is associated with most restenoses in iliac lesions 4
- Stent configuration and geometric design may be more important than post-placement diameter in determining neointimal hyperplasia and thrombosis 5
Undersizing Consequences
- Inadequate stent diameter leads to higher restenosis rates across all vascular territories 1, 4
- For pulmonary veins, 6 mm is considered the "critical diameter" below which low-flow states develop 1
The key principle is that stent diameter should match or slightly exceed the normal vessel caliber at that anatomic location, with aortic applications requiring the largest diameters (up to 45 mm) and peripheral vessels requiring progressively smaller sizes based on native vessel anatomy. 1, 2