Keisha Kellham
Introduction
The treatment of femoro-popliteal peripheral arterial disease (FP-PAD) often involves endovascular stenting. Interwoven nitinol stents (Supera Peripheral Stent, SPS) and drug-eluting stents (DES) are commonly used devices, but long term comparative outcomes remain unclear.
Objective
This study aimed to compare long-term outcomes, including mortality and re-intervention, between SPS and DES in a single tertiary vascular centre.
Methods: A retrospective analysis of patients with Chronic limb threatening ischaemia (CLTI) who underwent femoro-popliteal stenting with either SPS or DES from 2013 to 2018 was performed. Data were extracted from a prospectively maintained institutional database. Outcomes were analysed over a median follow-up of 10 years.
Results
From the analysed cohort, the median overall survival was 81 months. SPS cohort reported 62 months and DES cohort 91 months (log rank, p=0.0055). Forty-one patients (13%) had undergone a major amputation. The overall amputation free survival is 28% with no significant difference between SPS 21% versus DES (paclitaxel) 33% (p=). Re-intervention rates remain the same between SPS vs DES 24% and 27%, respectively (p=).
Conclusion
At 10 years, follow-up mortality was higher after deploying bare nitinol stents (SPS) to treat femoropopliteal occlusive disease. The amputation and re-intervention rates did not significantly differ between the cohorts. Further extensive prospective studies are recommended to determine if a significant difference in mortality, amputation-free survival, and re-intervention rates exists.
Authors
Keisha Kellman, Vickna Balarajah, Angel Jose
Guy's and St. Thomas' NHS Foundation Trust, London, United Kingdom