Comparison Between Interwoven Nitinol and Drug Eluting Stents for Endovascular Treatment of Femoropopliteal Artery Disease.
Aged
Aged, 80 and over
Alloys
Angiography, Digital Subtraction
Blood Vessel Prosthesis Implantation
/ instrumentation
Drug-Eluting Stents
Endovascular Procedures
/ instrumentation
Female
Femoral Artery
/ diagnostic imaging
Humans
Male
Middle Aged
Paclitaxel
/ administration & dosage
Peripheral Arterial Disease
/ diagnosis
Popliteal Artery
/ diagnostic imaging
Prosthesis Design
Retrospective Studies
Self Expandable Metallic Stents
Treatment Outcome
Vascular Calcification
/ complications
drug eluting stents
femoropopliteal segment
lower extremity revascularisation
patency
peripheral artery disease
self expanding interwoven nitinol stent
Journal
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery
ISSN: 1532-2165
Titre abrégé: Eur J Vasc Endovasc Surg
Pays: England
ID NLM: 9512728
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
11
04
2019
revised:
26
08
2019
accepted:
03
09
2019
pubmed:
2
11
2019
medline:
10
4
2020
entrez:
1
11
2019
Statut:
ppublish
Résumé
Information on performance of different stent platforms in endovascular revascularisation of femoropopliteal lesions is controversial and scarce. Interwoven nitinol (INS, Supera) were compared with drug eluting (DES, Zilver PTx) stents with primary intervention for femoropopliteal lesions. The primary endpoint was time to clinically driven target lesion revascularisation (CD-TLR) within 12 months. Secondary endpoints were time to death, amputation and composite of death, amputation and CD-TLR. Due to the retrospective analysis, inverse probability treatment weighted (IPTW) Cox models were calculated to reach more similar patient populations with weights for the average treatment effect of the population. The two sensitivity analyses were propensity score matching and adjustment for covariates. At 12 months, the cumulative incidence of CD-TLR in the INS group (13%) and DES group (18%) did not differ (HR 1.36, 95% CI 0.56-3.31). A significant interaction between stents used and grade of calcification was observed (p = .006). HR for CD-TLR was 6.4 (95% CI 1.3-32.5) in none to mildly calcified favouring INS, and 0.3 (95% CI 0.1-1.3) for moderate to severely calcified lesions favouring DES. Stent efficiency did not differ comparing treatment of popliteal lesions (HR 0.80; 95% CI 0.21-3.13). Sensitivity analyses confirmed the primary efficacy outcome for either adjusted (HR 1.16; 95% CI 0.51-2.62) or matched analysis (HR 1.35; 95% CI 0.50-3.62)). Interaction of stents with calcification grade was lost for adjusted (HR 0.28; 95% CI 0.06-1.19) and matched analysis (HR 0.53; 95% CI 0.10-2.91). Both stents (INS and DES) showed comparable results regarding CD-TLR in femoropopliteal lesions, so that one stent could not be favoured over the other, even for calcified or popliteal artery lesions.
Identifiants
pubmed: 31668949
pii: S1078-5884(19)31465-0
doi: 10.1016/j.ejvs.2019.09.002
pii:
doi:
Substances chimiques
Alloys
0
nitinol
2EWL73IJ7F
Paclitaxel
P88XT4IS4D
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
865-873Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright © 2019 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.