Stents With Torsional Strength for Superficial Femoral Artery Disease: The Prospective Q3-Registry

2022 ◽  
pp. 152660282110677
Author(s):  
Marcus Thieme ◽  
Jarwed Arjumand ◽  
Markus Spanagel ◽  
Gunnar Tepe ◽  
Erwin Blessing ◽  
...  

Purpose: This postmarketing surveillance study aimed to assess effectiveness and safety of a peripheral self-expanding stent with high torsional strength (POLARIS stent) for the treatment of de novo superficial femoral artery (SFA) lesions in the routine clinical practice. Materials and Methods: Consecutive patients with symptomatic de novo SFA occlusive disease who underwent POLARIS stent implantation were enrolled into the prospective, multicenter, observational postmarket surveillance study. Primary outcome measure was freedom from clinically driven target lesion revascularization (cdTLR) at 12 months. Main secondary outcomes were procedural success, primary clinical improvement, and freedom from major adverse cardiovascular and limb events (MACLE) throughout 24 months. Results: A total of 199 participants (70±11 years, 70.4% men) were included in the study at 9 German sites from December 2014 to August 2018. Half of them (52.6%) were current smokers, 37.6% had diabetes, and 25.0% were obese. Most participants suffered from intermittent claudication (88.4%). Mean lesion length was 98±83 mm, 43.5% of lesions were occluded, and 27.3% were severely calcified. Freedom from 12 months cdTLR was 94.4% (95% confidence interval [CI], 90.6–98.2). At 24 months, freedom from cdTLR was 88.7% (95% CI, 83.0–94.4). Procedural success was achieved in 96.2% of participants. Primary clinical improvement occurred in 87.5% and 85.4% of participants at 12 and 24 months, respectively. Freedom from MACLE was 94.8% (95% CI, 91.4–98.1) and 93.8% (95% CI, 89.9–97.6) at 12 and 24 months, respectively. Conclusions: Treatment of SFA occlusive disease in a real-world setting using the POLARIS stent with high bidirectional torsional strength is efficacious and does not raise any safety concern in the medium term. The study is registered with ClinicalTrials.gov (Identifier: NCT02307292).

2020 ◽  
pp. 152660282095026
Author(s):  
Nobuhiro Ito ◽  
Mitsuyoshi Takahara ◽  
Yoshimitsu Soga ◽  
Seiichi Hiramori ◽  
Kaoru Hirose ◽  
...  

Purpose To investigate lumen loss (LL) at 1 year after bare nitinol stent (BNS) implantation for de novo superficial femoral artery (SFA) lesions. Materials and Methods The subjects were 701 consecutive patients (mean age 74±9 years; 492 men) with 817 de novo SFA lesions treated with BNS implantation between January 2004 and September 2015. The mean lesion length was 141±88 mm and the mean vessel diameter was 5.4±0.9 mm. The endpoint was LL at 1 year after BNS implantation. Secondary outcomes were restenosis and target lesion revascularization (TLR) estimated using the Kaplan-Meier method; estimates are reported with the 95% confidence interval (CI). LL was defined as the minimum lumen diameter immediately after BNS implantation minus that at 1 year measured by angiographic quantitative vessel analysis. The distribution of LL in the overall population was estimated using an accelerated failure time model. Results Mean LL at 1 year was estimated to be 1.74±1.28 mm (95% CI 1.63 to 1.84). Current smoking was positively associated with LL (p=0.015), whereas lack of cilostazol use was correlated with an increase in LL (p=0.001). Reference vessel diameter and lesion length did not have any significant association with LL at 1 year. The 1-year cumulative estimate of restenosis was 25% (95% CI 22% to 28%); the corresponding value for TLR was 18% (95% CI 15% to 21%). Conclusion Mean LL progressed by at least 1.6 mm at 1 year after BNS implantation. The risk factors for increased LL were current smoker and lack of cilostazol use.


2018 ◽  
Vol 25 (3) ◽  
pp. 313-319 ◽  
Author(s):  
Ting-Chao Lin ◽  
Chun-Yang Huang ◽  
Po-Lin Chen ◽  
Chiu-Yang Lee ◽  
Chun-Che Shih ◽  
...  

Purpose: To report a retrospective analysis of risk factors for edge restenosis after Viabahn stent-graft treatment of superficial femoral artery (SFA) occlusive disease and determine any protective effect of drug-coated balloons (DCBs) used at the time of stent-graft implantation. Methods: Between October 2011 and July 2016, 110 patients (mean age 73.3±7.6 years; 78 men) were treated with the Viabahn stent-graft for long SFA occlusions. Thirty-eight (34.5%) patients had DCB reinforcement at the distal edge of the stent-graft. For analysis, the population was divided into groups of no edge stenosis patients (n=88; mean lesion length 22.4±4.2 cm) and edge stenosis patients (n=22; mean lesion length 23.5±5.7 cm). The clinical outcomes, ankle-brachial indices, computed tomography angiography findings, and patency were compared at a minimum of 12 months. Logistic regression analysis was employed to determine risk factors for edge stenosis; the results are presented as the odds ratio (OR) and 95% confidence interval. Results: No differences in clinical or procedural characteristics were identified except the higher incidence of diabetes (p=0.008) and greater need for retrograde access (p=0.033) in the edge stenosis group. DCB reinforcement reduced the incidence of edge stenosis (p=0.021) and target lesion revascularization (TLR; p=0.010) and resulted in a significantly higher 1-year primary patency rate (92.1% vs 76.4%, p=0.042). However, multivariate analysis revealed only poor distal runoff (OR 0.31, 95% CI 0.11 to 0.83, p=0.020) as a predictor of edge stenosis. Conclusion: The risk of edge stenosis after Viabahn implantation was higher in patients with poor distal runoff. DCB reinforcement over the distal edge reduced edge stenosis, decreased 1-year TLR, and improved 1-year primary patency.


Vascular ◽  
2010 ◽  
Vol 18 (2) ◽  
pp. 82-92 ◽  
Author(s):  
S. Perrio ◽  
P. J. E. Holt ◽  
B. O. Patterson ◽  
R. J. Hinchliffe ◽  
I. M. Loftus ◽  
...  

2013 ◽  
Vol 20 (6) ◽  
pp. 836-843 ◽  
Author(s):  
Bahar Golchehr ◽  
Mare M.A. Lensvelt ◽  
Wilbert M. Fritschy ◽  
Suzanne Holewijn ◽  
Laurens A. van Walraven ◽  
...  

1999 ◽  
Vol 6 (3) ◽  
pp. 270-277 ◽  
Author(s):  
Julio A. Rodriguez-Lopez ◽  
Liliana Soler ◽  
Alan Werner ◽  
Edgar Martinez ◽  
Konstantine Papazoglou ◽  
...  

2012 ◽  
Vol 56 (3) ◽  
pp. 880-881
Author(s):  
Javier E. Anaya-Ayala ◽  
Christopher J. Smolock ◽  
Matthew K. Adams ◽  
Mitul S. Patel ◽  
Cassidy Duran ◽  
...  

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