Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions
- 7 May 2009
- journal article
- research article
- Published by Wiley in Catheterization and Cardiovascular Interventions
- Vol. 74 (7), 1090-1095
- https://doi.org/10.1002/ccd.22128
Abstract
Background: Recent randomized trials investigating stent implantation compared with balloon angioplasty for treatment of superficial femoral artery (SFA) disease have given divergent results in short (mean 5 cm) and intermediate (mean 10 cm) lesions. We reinvestigated whether primary nitinol stenting is associated with a morphologic and clinical benefit when compared with percutaneous transluminal angioplasty with optional stenting (PTA) in intermediate‐length lesions. Methods: We randomly assigned 73 patients with severe claudication or chronic limb ischemia and average 8 cm long (range 3–20 cm) SFA stenosis or occlusion to primary stent implantation (n = 34) or PTA (n = 39). Restenosis >50% and clinical outcome were assessed at 3, 6, and 12 months postintervention. Results: Average length of the treated segments was 98 ± 54 mm and 71 ± 43 mm in the stent and PTA groups (P = 0.011), respectively. In the PTA group, secondary stenting was performed in 10 of 39 patients (26%) due to a suboptimal result after balloon dilation. Restenosis rates in the stent and PTA groups were 21.9% versus 55.6% (P = 0.005) at 6 months by CT‐angiography, and 2.9% versus 18.9% (P = 0.033), 18.2% versus 50.0% (P = 0.006), and 34.4% versus 61.1% (P = 0.028) at 3, 6, and 12 months by sonography, respectively. Clinically, patients in the stent group reported a significantly higher maximum walking capacity compared with the PTA group at 6 and 12 months. Conclusion: In this randomized multicenter trial, primary stenting with a self‐expanding nitinol stent for treatment of intermediate length SFA disease resulted morphologically and clinically superior midterm results compared with balloon angioplasty with optional secondary stenting.Keywords
This publication has 22 references indexed in Scilit:
- Conventional Balloon Angioplasty versus Peripheral Cutting Balloon Angioplasty for Treatment of Femoropopliteal Artery In-Stent Restenosis: Initial ExperienceRadiology, 2008
- Randomized, Multicenter Study Comparing Expanded Polytetrafluoroethylene–covered Endoprosthesis Placement with Percutaneous Transluminal Angioplasty in the Treatment of Superficial Femoral Artery Occlusive DiseaseJournal of Vascular and Interventional Radiology, 2008
- Nitinol Stent Implantation Versus Percutaneous Transluminal Angioplasty in Superficial Femoral Artery Lesions up to 10 cm in LengthCirculation, 2007
- Sustained Benefit at 2 Years of Primary Femoropopliteal Stenting Compared With Balloon Angioplasty With Optional StentingCirculation, 2007
- Balloon Angioplasty versus Implantation of Nitinol Stents in the Superficial Femoral ArteryThe New England Journal of Medicine, 2006
- Efficacious use of nitinol stents in the femoral and popliteal arteriesJournal of Vascular Surgery, 2003
- Randomized Study to Compare PTA Alone versus PTA with Palmaz Stent Placement for Femoropopliteal LesionsJournal of Vascular and Interventional Radiology, 2001
- Percutaneous transluminal angioplasty of the femoropopliteal arteries in limbs with chronic critical lower limb ischemiaJournal of Vascular Surgery, 2001
- PTA versus Palmaz Stent Placement in Femoropopliteal Artery Obstructions: A Multicenter Prospective Randomized StudyJournal of Vascular and Interventional Radiology, 2001
- Clinical Experience with a New Nitinol Self-Expanding Stent in Peripheral ArteriesJournal of Endovascular Surgery, 1996