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Ann Vasc Surg. 2019 Jul;58:101-107. doi: 10.1016/j.avsg.2018.11.023. Epub 2019 Feb 13.

Comparison of Spot versus Long Stenting for Femoropopliteal Artery Disease.

Author information

1
Division of Cardiology and Cardiovascular Research Institute, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea.
2
Korea University Guro Hospital, Seoul, South Korea.
3
Korea University Anam Hospital, Seoul, South Korea; Sejong General Hospital, Bucheon-si, Gyeonggi-do, South Korea.
4
Soonchunhyang University Cheonan Hospital, Cheonan-si, Chungcheongnam-do, South Korea.
5
Chungnam National University Hospital, Daejeon, South Korea.
6
Daejeon St. Mary's Hospital, Catholic University of Korea, Daejeon, South Korea.
7
Gachon University Gil Hospital, Incheon, South Korea.
8
Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do, South Korea.
9
Seoul National University Boramae Medical Center, Seoul, South Korea.
10
Myongji Hospital, Goyang-si, Gyeonggi-do, South Korea.
11
Division of Cardiology and Cardiovascular Research Institute, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: cdhlyj@yuhs.ac.

Abstract

BACKGROUND:

Optimal stenting strategy for long femoropopliteal artery lesions still remains undefined. Longer stent length has been shown to be associated with increased risk of restenosis. We sought to compare the efficacy of spot versus long stenting in the treatment of femoropopliteal artery disease.

METHODS:

This study was designed as a multicenter randomized controlled trial to compare immediate and mid-term outcomes of spot versus long primary stenting for femoropopliteal arterial lesions. A total of 125 patients were randomized 1:1 to spot stenting group (n = 59) or long stenting group (n = 66).

RESULTS:

All lesions were treated with self-expanding bare nitinol stents. Baseline clinical and lesion characteristics were similar between the 2 groups except for male gender and current smoker. The mean lesion length was 24.1 ± 8.8 cm. Technical success was achieved in all patients. The 1-year primary patency and TLR-free (target lesion revascularization) survival did not differ significantly between the 2 groups. However, the spot stenting group showed a trend toward higher primary patency (86.1% vs. 72.7%, P = 0.158) and TLR-free survival (94.2% vs. 82.5%, P = 0.120). The total stented length (hazard ratio [HR] 1.01, 95% confidence interval [CI] 1.00-1.01, P = 0.011) and age (HR 0.94, 95% CI 0.90-1.00, P = 0.035) were independent predictors of restenosis.

CONCLUSIONS:

The spot stenting appears to be more favorable than the long stenting in terms of primary patency and TLR-free survival, although the difference was not statistically significant. The stented length was an independent predictor of restenosis.

PMID:
30769056
DOI:
10.1016/j.avsg.2018.11.023

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