Technological advancements in peripheral vascular stents are revolutionizing the management of Peripheral Arterial Disease (PAD), providing safer, more effective solutions for patients. Among the primary options are bare metal stents (BMS) and covered stents, each offering distinct benefits and limitations. This article offers a detailed comparison of these devices, covering design, clinical applications, advantages, limitations, and evidence-based outcomes, while exploring the future of stent technologies in vascular treatment.
What Are Peripheral Vascular Stents? Types & Applications
Peripheral vascular stents are self-expanding devices designed to keep blood vessels open and prevent restenosis.
They are commonly used in:
Peripheral Arterial Disease (PAD): Treating atherosclerotic blockages in iliac, femoral, or popliteal arteries.
Aneurysms: Providing structural support to weakened vessel walls.
Vessel Occlusions: Managing blockages in smaller peripheral arteries.
Types of Peripheral Vascular Stents
Bare Metal Stents (BMS): Made from nitinol or stainless steel, relying on natural endothelialization for vessel healing.
Covered Stents: Combine a metallic framework with a polymeric or fabric coating (e.g., ePTFE, Dacron) to improve sealing and reduce complications.
Hybrid Stents: Merge the features of BMS and covered stents, offering specialized solutions for complex lesions.
For more detailed information, check our guide on ePTFE-coated stents.
Covered vs. Bare Metal Stents: A Comparative Review
Bare Metal Stents (BMS)
BMS are commonly used for short lesions in large arteries, valued for their simplicity and flexibility.
Advantages:
Superior trackability in tortuous anatomy
Cost-effective compared to covered stents
Smaller delivery systems for challenging anatomies
Limitations:
Higher restenosis rates (20–40%) due to intimal hyperplasia
Lack of sealing properties, unsuitable for aneurysms or vessel perforations
Covered Stents
Covered stents combine a metallic scaffold with a coating for enhanced sealing and protective functions.
Advantages:
Improved occlusion rates for complex lesions
Sealing capacity for aneurysms and perforations
Lower risk of thrombosis compared to BMS
Limitations:
Reduced flexibility, challenging deployment in tortuous vessels
Higher cost
Requires larger sheath sizes
Key Benefits with Advanced Coatings:
Faster endothelialization and healing
Improved biocompatibility, reducing inflammation
Increased complete occlusion rates in long lesions and aneurysms
Lower perioperative risks, such as thrombosis and infection
Challenges and Considerations
Despite their advantages, covered stents face some challenges:
Material biocompatibility concerns may lead to inflammation or tissue growth
Reduced flexibility may limit use in tortuous or calcified vessels
Long-term durability and material degradation
Regulatory approval requires extensive clinical testing
The Future of Peripheral Vascular Stents
Covered and hybrid stents are shaping the future of PAD treatment. With advances in material science, drug-eluting coatings, and bioactive surfaces, these stents are expected to overcome current limitations and enhance patient outcomes. They will likely become central to the management of complex vascular conditions.
Explore our peripheral vascular stent portfolio to learn more about our products and innovative coatings.
