Evolution of patency rates of self-expandable bare metal stents for endovascular treatment of femoro-popliteal arterial occlusive disease: Does stent design matter?

Abstract

OBJECTIVE:

To analyse the patency rates of femoro-popliteal stenting with different self-expandable Nitinol stent-designs.

METHODS:

Two hundred and twenty-two patients (142 (64%) male; age 72.4 ± 11.6 years) with symptomatic femoro-popliteal peripheral arterial occlusive disease (PAOD) underwent percutaneous transluminal angioplasty (PTA) and stenting with three different Nitinol stents (interwoven IW: n = 70; closed-cell CC: n = 85; open-cell OC: n = 67). One-year post-procedural target lesion revascularization (TLR_12M) rates were investigated with regard to co-morbidities: diabetes (DBM), hyperlipidaemia (HLP), hypertension (RR), coronary artery disease (CAD) and degree of calcification.

RESULTS:

Twelve-month follow-up data were available for 60, 69 and 50 patients in the IW, OC and CC groups (179 patients in total). The cumulative patency (IW: 52 (86.7%); OC: 50 (72.5%); CC: 23 (46.0%); P < 0.001) and the TLR_12M rates (IW: 8 (13.3%); OC: 19 (27.5%); CC: 27 (54.0%); P < 0.001) differed significantly, as did the subgroup analyses (DBM: P = 0.05; RR: P = 0.003; HLP: P = 0.005; CAD: P = 0.02; localization: P < 0.001; calcification: P < 0.001), with the best patency for the IW stent and the highest TLR_12M for the CC stent.

CONCLUSION:

The interwoven stent-design was superior to the standard open- and closed-cell stent-designs in endovascular treatment of femoro-popliteal PAOD in a follow-up period of 12 months.

KEY POINTS:

• Results of femoro-popliteal stenting are still unsatisfactory. • Comparative studies for currently available different Nitinol stent-designs are lacking. • This is a first comparative study on long-term patency of different Nitinol stent-designs. • Interwoven stent-design leads to improved long-term patency. • Interwoven stent-design leads to lower TLR than other stent-designs.

• Authors: Karla Maria Treitl, Benedikt Woerner, Regina Schinner, Michael Czihal, Susan Notohamiprodjo, Ulrich Hoffmann, Marcus Treitl
• Journal: European radiology (Eur Radiol) Vol. 27 Issue 9 Pg. 3947-3955 (Sep 2017) ISSN: 1432-1084 [Electronic] Germany
• PMID: 28168366 (Publication Type: Comparative Study, Evaluation Study, Journal Article)

Chemical References

• Alloys
• nitinol

Topics

• Aged
• Alloys (therapeutic use)
• Angioplasty (instrumentation, methods)
• Angioplasty, Balloon (methods)
• Arterial Occlusive Diseases (pathology, surgery)
• Coronary Artery Disease (physiopathology)
• Female
• Femoral Artery (surgery)
• Humans
• Male
• Peripheral Arterial Disease (pathology, surgery)
• Popliteal Artery (surgery)
• Prosthesis Design
• Reperfusion (methods)
• Stents
• Treatment Outcome
• Vascular Patency (physiology)