Skyi Yin-Chun Pang
Current Position
Consultant in Vascular Surgery
Department of Surgery, Queen Mary Hospital, The University of Hong Kong
Peripheral Artery Session

Topic: PRESTO: the novel technique with SUPERA stent for SFA proximal lesion


Calcification and long femoropopliteal occlusion are always challenging in peripheral intervention regarding feasibility and durability. Despite different non-stent strategy, mechanical scaffold is often required for recoil or dissection. Interwoven helical stent provides better radial strength when comparing to other self-expanding nitinol stent with excellent performance in heavily calcified lesion, long lesion, and even traditional non-stent zone. It becomes an important treatment option for difficult femoropopliteal lesion especially in Hong Kong where drug devices are not yet regarded as government subsidized item.
Elongation of SUPERA stent from inadequate preparation results in inaccurate deployment at SFA ostial lesion has been tackled by PRESTO technique. This technique is to introduce SUPERA stent from distal puncture in order to deploy the stent just at the SFA ostium. This strategy now become my first choice for long and calcified femoropopliteal occlusion started from SFA ostium as provisional stenting.
In our small case series, high technical success rate is shown with no access complication reported and the early result from PRESTO strategy is promising. Longer follow up Is required to demonstrate its durability.