Spot Stenting Compared to Full Coverage Stenting in Femoropopliteal Lesions

October 15, 2019—A study published by Yusuke Tomoi, MD, et al in Journal of Vascular Surgery sought to determine whether spot stenting or full coverage stenting resulted in better outcomes after endovascular therapy for femoropopliteal artery lesions in real-world clinical settings (2019;70;1166–1176).

The multicenter, retrospective study examined data from a clinical database of 1,554 consecutive patients who had undergone femoropopliteal endovascular therapy for symptomatic peripheral artery disease from January 2010 to December 2016. Of these patients, 1,151 underwent femoropopliteal stenting.

The outcome measures were primary patency and primary assisted patency obtained using propensity-score matching. Interaction analysis was also performed to explore the effects of the baseline characteristics on the association between spot stenting and primary patency.

As summarized in Journal of Vascular Surgery, spot stenting for femoropopliteal lesions demonstrated a significantly lower primary patency rate compared with full coverage stenting at 3 years (29% vs 53%; P = .011). Additionally, primary assisted patency at 3 years was significantly lower in the group with spot stenting than in the full coverage stenting group (53% vs 72%; P = .014). Interaction analysis showed that chronic total occlusion lesions, lesion location A (proximal superficial femoral artery portion), and lesion length ≥ 138 mm were associated with the noninferiority of spot stenting compared with full coverage stenting for primary patency.

The investigators concluded that the propensity-matched analysis demonstrated that primary patency and primary assisted patency at 3 years were significantly lower with spot stenting compared with full coverage stenting for femoropopliteal lesions in real-world clinical settings. The interaction analysis suggested that spot stenting might be suited to more complex femoropopliteal lesions (ie, chronic total occlusion lesions, proximal superficial femoral artery lesion, lesion length ≥ 138 mm), noted the investigators in Journal of Vascular Surgery.