Angioplasty in Long Femoropopliteal Lesions Offers Reasonable Results

Courtesy of Dr. Carlos Fava.

Around half the treated lesions in peripheral disease are femoropopliteal lesions. Long lesions are among the challenges faced: they are associated with higher mortality and morbidity, and revascularization in that setting always entails some degree of difficulty.

Nuevas estrategias en el territorio femoropoplíteo

Nowadays, with the development of nitinol stents and more operator experience, angioplasty is becoming a treatment option for them, but there are few randomized studies offering robust information on that.

Researchers randomized 103 patients with TASC II C and D lesions. Among them, 50 underwent angioplasty with a self-expanding nitinol stent and 53 underwent femoropopliteal bypass.

The groups were similar; mean patient age was 69 years old and most subjects were male. Coronary disease was more frequent in the angioplasty group.


Read also: DES and DCB with Similar Results in Femoropopliteal Artery Disease.


There were no differences in lesion type and length, or in Rutherford classification. About 49% of patients experienced critical ischemia.

Technical success was higher among patients who underwent surgery (87% vs. 100%; p = 0.006). In 13% of patients in the angioplasty group, the lesion could not be crossed.

At 24 months, there were no differences in the rates of limb salvage, survival, or complications. Primary and secondary patency rates were 60% and 72%, respectively, in the stent group, compared with 56% and 73%, respectively, in the surgery group. There were no differences in target lesion revascularization, either.


Read also: FDA Alert on Drug-Coated Balloons and Stents in Femoropopliteal Artery Disease.


Additionally, both groups showed improvement as regards the ankle brachial index (ABI) and wound healing time, with no difference between them.

Clinical improvement was greater among patients who underwent surgery.

Conclusion

There were no significant differences regarding patency rates, limb salvage, or complications at two years. Technical success and clinical improvement were significantly better among patients who underwent femoropopliteal bypass. The results of patients who underwent angioplasty for femoropopliteal lesions up to 30 cm may be reasonable. We may have to wait for mid- and long-term follow-up results.

Original Title: Nitinol Stent Versus Bypass in Long Femoropopliteal Lesions.  2-Year Results of a Randomized Controlled Trial.

Reference: Florian K. Enzmann, et al J Am Coll Cardiol Intv 2019 Article in press.


Subscribe to our weekly newsletter

Get the latest scientific articles on interventional cardiology

We are interested in your opinion. Please, leave your comments, thoughts, questions, etc., below. They will be most welcome.

More articles by this author

TCT 2024 | SIRONA: Randomized Study Comparing Sirolimus-Coated vs Paclitaxel-Coated Balloon Angioplasty in Femoropopliteal Disease

This prospective, randomized, multicenter, investigator-initiated non-inferiority study compared the use of sirolimus-coated balloon (MagicTouch) vs paclitaxel-coated balloon in endovascular treatment.  The primary objective was to...

TCT 2024 | PEERLESS: Mechanical Thrombectomy with FlowTriever vs Catheter-Directed Thrombolysis in Intermediate Risk PTE

Pulmonary embolism (PE) continues to be the third cause of cardiovascular mortality. The current clinical guidelines recommend anticoagulation in intermediate risk patients presenting right...

Atherosclerotic Renal Artery Stenosis: To Revascularize or Not

At long term, atherosclerotic renal artery stenosis (RAS) can lead to hypertension, chronic kidney disease, and cardiac failure. Historically, these patients have been referred...

Endovascular Management of Chronic TEPH: Is Coronary Management Extrapolatable in This Scenario?

Chronic thromboembolic pulmonary hypertension (CTEPH) is a condition that causes significant functional limitation. Its surgical treatment, known as pulmonary endarterectomy (PEA), has improved the...

LEAVE A REPLY

Please enter your comment!
Please enter your name here

Related Articles

SOLACI Sessionsspot_img

Recent Articles

TCT 2024 | FAVOR III EUROPA

The study FAVOR III EUROPA, a randomized trial, included 2,000 patients with chronic coronary syndrome, or stabilized acute coronary syndrome, and intermediate lesions. 1,008...

TCT 2024 | TRISCEND II

This randomized study included 400 patients; 267 were treated with EVOQUE valve and 133 with optimal medical treatment (OMT). After one-year follow-up, there were no...

TCT 2024 – ACCESS-TAVI: Comparing Percutaneous Access Closure Strategies After TAVI

Vascular access complications following transcatheter aortic valve implantation (TAVI) remain common. However, few studies compare vascular access closure methods.  Based on the CHOICE-CLOSURE and MASH...