Interwoven Nitinol Stents versus Drug Eluting Stents in the Femoro-Popliteal Segment: A Propensity Matched Analysis

• DOI: 10.1016/j.ejvs.2019.06.012
• Publication Date: 2019-09-06T21:23:01Z
• Authors: Athanasios Saratzis; Nung Rudarakanchana; Sanjay Patel; Athanasios Diaman...; Talia Lea; Ben Corbo; George Gradinariu; Konstantinos Kats...; Hany Zayed; Prakash Saha; Said Abisi; Lukla Biasi; Bijan Modarai; Tommaso Donati; Morad Sallam; Ashish Patel; Rachel Bell; Rebecca Sandford; Michael Dialynas; Irfan Ahmad; Mark Tyrrell; Tarun Shabharwal
• Keywords: Critical limb ischemia; Target lesion; Popliteal artery

BackgroundPercutaneous transluminal angioplasty (PTA) is a common procedure in patients with peripheral arterial disease (PAD) affecting the femoropopliteal segment (F-P). Biomimetic nitinol stents (Supera stent, SPS) and drug eluting (DES) were designed to improve longevity of F-P PTA; however, their performance has not been compared pragmatic setting, taking atherosclerotic plaque characteristics into account.MethodsOverall, 296 consecutive (mean age: 73 y, SD: 11 65% male, 68% chronic limb threatening ischaemia) who underwent PTA using SPS or DES between 2013 2018 identified from prospectively maintained institutional database. Patient characteristics, including characterisation based on computed tomography, collected; 121 case matched pairs created propensity score patient data.ResultsDuring median two year follow up, 28% cohort (32% vs. 24% DES, p = .07) developed target lesion restenosis (TLR) > 50%. Among patients, those significantly more likely develop TLR >50% (31% 27%, .34), stent occlusion (13% 12%, .85 – secondary patency rate 87% 88%), have major amputation (10% 6%, .16), require re-intervention (14% 9%, .12), die (7% vs.4%, .31). Plaque calcification did predict either group, both non populations. Multivariable analysis adjusted for revealed that main predictors at years female sex [odds ratio (OR): 2.05, .01], hypertension (OR: 2.10, .04) previous 1.35, .04).ConclusionMedium term results following are comparable, regardless characteristics.