Drug-Eluting Stents Are the Default Strategy for Superficial Femoral Artery Intervention Now

Burket, Mark W.

doi:10.1161/circulationaha.115.018034

Cited by 8 publications

(7 citation statements)

References 66 publications

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“…6,24 CS is currently the most expensive commercially available stent for the FP segment. 12 The deployment of CS may cover the collateral vessels. An optimal outcome was achieved only when stent sizing was done accurately, 12,46 oversizing of stent grafts can cause infolding and subsequent occlusion or turbulent flow at the edge of the devices.…”

Section: Treatment Effectmentioning

confidence: 99%

“…12 The deployment of CS may cover the collateral vessels. An optimal outcome was achieved only when stent sizing was done accurately, 12,46 oversizing of stent grafts can cause infolding and subsequent occlusion or turbulent flow at the edge of the devices. These features limited its clinical use and its efficacy is not good as expected.…”

Section: Treatment Effectmentioning

confidence: 99%

“…10,11 The best percutaneous treatment strategy for FP disease remains debated. 12,13 The efficacy differences between DES and CS were estimated and various commonly used endovascular treatment modalities for the FP segment compared.…”

Section: Introductionmentioning

confidence: 99%

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Restenosis Prevention With Drug Eluting or Covered Stents in Femoropopliteal Arterial Occlusive Disease: Evidence From a Comprehensive Network Meta-analysis

et al. 2019

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS This comprehensive network meta-analysis used data from 28 randomised controlled trials of commonly used endovascular treatments for femoropopliteal lesions. It was found that drug eluting stents were significantly more effective than drug coated balloons for the treatment of short lesions. However, the overall analysis did not demonstrate any significant difference in the efficacy of drug eluting stents, covered stents, drug coated balloons, and bare metal stent. Percutaneous transluminal angioplasty alone does not constitute an effective choice. These outcomes may contribute to clinical decision making. Background/objective: Endovascular interventions for femoropopliteal (FP) arterial diseases are limited by the development of restenosis. Current drug coated devices are capable of preventing restenosis by releasing antiproliferative agents to the vessel wall. However, default strategies for the treatment of FP diseases remain controversial. The aim of this study was to investigate the efficacy differences between drug eluting stents (DES), covered stents (CS), and other commonly used endovascular treatments in FP lesions, including drug coated balloons (DCBs), bare metal stents (BMS), and percutaneous transluminal angioplasty (PTA). Methods: A comprehensive network meta-analysis was conducted using data from relevant randomised control trials published up to 16 December 2018. Primary patency and target lesion revascularisation (TLR) at 12 months were set as the primary and secondary end points, respectively. Results: Twenty-eight eligible trials including 4728 patients were selected. DES was ranked as the most effective treatment in the multidimensional analysis of primary patency; however, there was no significant difference in the efficacy of DES and that of CS, DCB, and BMS. However, in short lesions (<10 cm), DES was significantly more effective than DCB (odds ratio 0.35; 95% confidence interval 0.15e0.83). Primary patency at 12 months was significantly lower with PTA. In terms of preventing TLR, DCB was ranked first, followed by DES, CS, BMS, and PTA. TLR was significantly higher with PTA than with other treatment strategies. Conclusion: The findings of this network meta-analysis suggest that this is not the appropriate time to identify the best endovascular treatment strategy for the FP segment. DES is effective in maintaining mid-term patency, especially in short lesions, whereas DCB seems more suitable for clinical use.

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Section: Treatment Effectmentioning

confidence: 99%

Section: Treatment Effectmentioning

confidence: 99%

See 1 more Smart Citation

Restenosis Prevention With Drug Eluting or Covered Stents in Femoropopliteal Arterial Occlusive Disease: Evidence From a Comprehensive Network Meta-analysis

et al. 2019

European Journal of Vascular and Endovascular Surgery

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“…3 However, it remains unclear which is the best percutaneous treatment strategy for FP disease. 4,5 As most trials just compared the treatment efficiency between PTA and another treatment, direct comparisons between the other devices are scarce. [6][7][8] To solve this problem, network meta-analysis, which is capable of comparing different treatments with a common reference treatment, has been developed.…”

Section: Introductionmentioning

confidence: 99%

Network Analysis of Endovascular Treatment Strategies for Femoropopliteal Arterial Occlusive Disease

Zhao

Cui

2022

J Endovasc Ther

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Purpose: Endovascular treatment of femoropopliteal arterial diseases remains controversial. We conducted a Bayesian network meta-analysis of randomized controlled trials aiming to investigate the efficacy differences between paclitaxel- or sirolimus-eluting stents, covered stents, drug-coated balloons, bare metal stents, and percutaneous transluminal angioplasty. Method: MEDLINE, Embase, Ovid, and other relevant online material were searched up to October 21, 2020. Primary endpoints were primary patency and target lesion revascularization at 6, 12, and more than 24 months. Results: Thirty-eight eligible trials included 6026 patients. In terms of primary patency, drug eluting stents were ranked as the most effective treatment based on the surface under the cumulative ranking curve values at 6 (80.6), 12 (78.4), and more than 24 months (96.5) of follow-ups. In terms of target lesion revascularization, drug eluting stents were ranked as the most effective treatment based on the surface under the cumulative ranking curve values at 6 (90.3), 12 (71.3), and more than 24 months (82.1) of follow-ups. Covered stents and bare metal stents had higher ranks in target lesion revascularization than those in primary patency. Sirolimus stents had a higher rank than paclitaxel stents. Conclusion: Drug eluting stents showed encouraging results in primary patency rates and freedom from target lesion revascularization at all phases of follow-up for femoropopliteal arterial diseases. Sirolimus stents appear to be more effective in femoropopliteal segment than paclitaxel stent.

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“…In the latest years, drug-coated balloon has become a mixed approach with Nitinol stents where lesions are as long as 30-40 cm. However, stenting is now considered the gold standard in treating SFA atherosclerotic lesions with an endovascular approach [8,9].…”

Section: Introductionmentioning

confidence: 99%

Computing patient-specific hemodynamics in stented femoral artery models obtained from computed tomography using a validated 3D reconstruction method

Colombo

Bologna

Garbey

et al. 2020

Medical Engineering & Physics

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Drug-Eluting Stents Are the Default Strategy for Superficial Femoral Artery Intervention Now

Cited by 8 publications

References 66 publications

Restenosis Prevention With Drug Eluting or Covered Stents in Femoropopliteal Arterial Occlusive Disease: Evidence From a Comprehensive Network Meta-analysis

Restenosis Prevention With Drug Eluting or Covered Stents in Femoropopliteal Arterial Occlusive Disease: Evidence From a Comprehensive Network Meta-analysis

Network Analysis of Endovascular Treatment Strategies for Femoropopliteal Arterial Occlusive Disease

Computing patient-specific hemodynamics in stented femoral artery models obtained from computed tomography using a validated 3D reconstruction method

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