Clinical outcomes of balloon angioplasty alone versus nitinol stent implantation in patients with small femoropopliteal artery disease: Observations from the Retrospective Multicenter Analysis for Femoropopliteal Stenting (REAL‐FP). Issue 5 (19th July 2017)

• Record Type: Journal Article
• Authors: Kamioka, Norihiko; Soga, Yoshimitsu; Kuramitsu, Shoichi; Iida, Osamu; Hirano, Keisuke; Suzuki, Kenji; Kawasaki, Daizo; Yamaoka, Terutoshi; Suematsu, Nobuhiro; Shintani, Yoshiaki; Miyashita, Yusuke; Takahashi, Hiroki; Tsuchiya, Taketsugu; Shinozaki, Norihiko; Okazaki, Shinya; Ando, Kenji
• Is Part Of: Catheterization and cardiovascular interventions. Volume 90:Issue 5(2017)
• Page Start: 790
• Page End: 797
• Publication Date: 2017-07-19
• Subjects: balloon angioplasty -- endovascular therapy -- femoropopliteal disease -- small vessel diameter -- stent implantation; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.27192
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: We sought to assess whether balloon angioplasty (BA) alone for small femoropopliteal disease improved the outcome following endovascular therapy as compared with stent implantation. Background: The optimal strategy of endovascular therapy for small vessel arteries in femoropopliteal disease remains unclear. Methods: We performed a multicenter retrospective analysis of 337 consecutive patients (371 limbs) with femoropopliteal arteries 4.0 mm or less in diameter and 150 mm or less in length. Results: Cumulative 3‐year incidence of primary patency was significantly higher in the BA group than in the stent group (53.8% vs. 34.2%, P = 0.002). While assisted‐primary patency and freedom from any major adverse limb events were also significantly higher in the BA group than in the stent group (70.9% vs. 44.2%, P < 0.001 and 60.6% vs. 36.4%, P = 0.001, respectively), secondary patency did not significantly differ between the two groups (86.9% vs. 86.9%, P = 0.67). Predictors of restenosis were diabetes mellitus (hazard ratio [HR], 1.61; 95% confidence interval [CI], 1.14–2.31; P = 0.01), no administration of cilostazol (HR, 1.50; 95% CI, 1.07–2.13; P = 0.02), stent implantation (HR, 1.68; 95% CI, 1.15–2.41; P = 0.01), and lesion length >75.0 mm(HR, 2.09; 95% CI, 1.50–2.92; P < 0.001). Conclusions: Lesions in small (<4.0 mm diameter) FP vessels demonstrated better primary patency at 3 years when successfully treated with balloon angioplasty alone as opposed to routine or bailout stenting. This difference was especially pronounced for lesions 75 to 150 mm in length.