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• W3093743655 abstract "Popliteal artery stenting in patients with peripheral artery disease remains controversial because of perceived risks of stent fracture and occlusion. Drug-coated balloons (DCBs) have been introduced as a better no-stent alternative, whereas dedicated novel stents (NSs) are increasingly used for treatment of popliteal lesions. Our aim was to compare midterm outcomes of stents with those of DCBs in the popliteal segment. A retrospective chart review of peripheral artery disease patients who underwent an endovascular intervention of the popliteal segment at our institution between 2011 and 2019 was performed. Patients treated with drug-eluting stents, covered stents, or plain balloon were excluded. Demographics, comorbidities, perioperative details, and follow-up data were reviewed. The studied outcome was primary patency. Survival analysis was used with P values < .05 indicating significance. There were 408 patients (age, 72.7 ± 11.8 years; 57.6% male) who underwent endovascular popliteal intervention for claudication (27.0%), rest pain (20.6%), or tissue loss (54.8%). Stenting was performed in 54.7% of patients (45.3% DCB angioplasty). The two groups were similar in baseline comorbidities and anatomic characteristics except for lower rates of hyperlipidemia (46.6% vs 71.4%; P < .001), end-stage renal disease (12.3% vs 21.4%; P = .014), and previous intervention in the stent group (34.3% vs 56.7%; P < .001). DCB patients were more likely to be claudicants (32.1% vs 22.7%; P = .034). Stented patients had significantly higher 2-year primary patency (61.0% vs 46.1%; P = .028; Fig). Secondary patency at 2 years was higher for popliteal stents but was without significance (76.0% vs 70.0%; P = .161). Multivariate analysis demonstrated wounds as a predictor of patency loss (hazard ratio, 1.57; 95% confidence interval, 1.09-2.24; P = .014), whereas stenting improved patency by 1.5 times (hazard ratio, 0.67; 95% confidence interval, 0.47-0.96; P = .028). Major adverse limb events did not differ at 2 years (13.6% DCB vs 14.3% stent; P = .357). Subanalysis of 117 NSs (75 Supera [Abbott Vascular, Abbott Park, Ill], 42 Tigris [W. L. Gore & Associates, Flagstaff, Ariz]) vs 109 standard stents revealed lower 2-year primary patency for the NSs (51.4% vs 69.6%; P = .041) without significant difference in secondary patency (74.9% vs 76.5%; P = .548). Standard stents were more likely to be landed in the above-knee segment (68.8% vs 32.5%; P < .001). Stenting of the popliteal segment can achieve superior primary patency against DCBs. Stent type does not appear to affect this patency." @default.
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• W3093743655 date "2020-11-01" @default.
• W3093743655 modified "2023-09-30" @default.
• W3093743655 title "Stenting of Popliteal Lesions Performs Superior to Drug-Coated Balloon Angioplasty" @default.
• W3093743655 doi "https://doi.org/10.1016/j.jvs.2020.08.074" @default.
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