Ktenopoulos N, Milaras N, Apostolos A, Tsioufis K, Toutouzas K, Sideris S. Letter to the Editor: Bare metal stents in upper extremity arterial trauma - rethinking an underused solution for complex injuries. World J Cardiol 2026; 18(6): 117035 [DOI: 10.4330/wjc.117035]
Corresponding Author of This Article
Nikias Milaras, Department of Cardiology, Hippokration General Hospital, Vasilisis Sofias 14, Athens 11527, Greece. nikiasmilaras@gmail.com
Research Domain of This Article
Peripheral Vascular Disease
Article-Type of This Article
letter
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Ktenopoulos N, Milaras N, Apostolos A, Tsioufis K, Toutouzas K, Sideris S. Letter to the Editor: Bare metal stents in upper extremity arterial trauma - rethinking an underused solution for complex injuries. World J Cardiol 2026; 18(6): 117035 [DOI: 10.4330/wjc.117035]
Nikolaos Ktenopoulos, Anastasios Apostolos, Konstantinos Tsioufis, Konstantinos Toutouzas, First Department of Cardiology, National and Kapodistrian University of Athens, Hippokration General Hospital of Athens, Athens 11527, Greece
Nikias Milaras, Skevos Sideris, Department of Cardiology, Hippokration General Hospital, Athens 11527, Greece
Author contributions: Author contributions: Ktenopoulos N and Milaras N conceived the concept and developed the manuscript framework; Ktenopoulos N drafted the initial version of the manuscript; Milaras N, Apostolos A, Tsioufis K, Toutouzas K, and Sideris S critically revised the manuscript for intellectual content and clinical accuracy. All authors reviewed and approved the final version of the manuscript and agree to be accountable for the content of the work.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Nikias Milaras, Department of Cardiology, Hippokration General Hospital, Vasilisis Sofias 14, Athens 11527, Greece. nikiasmilaras@gmail.com
Received: November 26, 2025 Revised: January 5, 2026 Accepted: April 8, 2026 Published online: June 26, 2026 Processing time: 204 Days and 0.5 Hours
Abstract
Upper extremity arterial trauma remains a challenging clinical entity, often complicated by concomitant orthopedic, neurologic and soft-tissue injuries. In this issue, Chen et al published in World Journal of Cardiology present a decade-long retrospective analysis evaluating the clinical performance of bare metal stent (BMS)-assisted endovascular repair for upper limb arterial injuries, offering compelling evidence that BMS may play a more significant role than previously appreciated. They describe a refined “working track” technique to restore luminal continuity across traumatic arterial disruption, followed by overlapping BMS placement. In their cohort, BMS-assisted repair demonstrated durable patency over long-term follow-up. Importantly, the BMS group achieved better functional recovery, reflected by significantly lower Disabilities of the Arm, Shoulder and Hand scores than controls. These findings highlight not only the mechanical resilience of modern stent platforms in anatomically mobile segments but also the potential of BMS to minimize thrombosis risk, challenging the traditional bias favoring graft interposition or covered stents in trauma settings. Despite limitations inherent to retrospective and incomplete follow-up data, this study adds important real-world insights to an underexplored domain of endovascular trauma management. The work by Chen et al underscores the need for prospective, randomized controlled studies to clarify the optimal role of BMS in upper extremity revascularization and invites the interventional community to reconsider long-standing paradigms in limb-salvage strategies.
Core Tip: Long-term outcomes of bare metal stent (BMS)-assisted repair for upper limb arterial trauma using a “working track” end-to-end technique with strategic stent overlap. Their BMS cohort achieved 100% patency and better functional recovery by Disabilities of the Arm, Shoulder and Hand score compared with non-BMS repairs. By preserving branches and demonstrating durability in mobile arterial segments, BMS may be an underused, limb-salvaging option in selected traumatic injuries. Prospective studies are needed to define patient selection, antithrombotic regimens and comparative effectiveness.
