A Real-World Experience With the Supera Interwoven Nitinol Stent in Femoropopliteal Arteries

Autor: Olaf Schouten, Victor C. Bourke, Shannon D. Thomas, Ramon L. Varcoe, Andrew F. Lennox, Michael Myint
Rok vydání: 2016
Předmět:
Male
Time Factors
medicine.medical_treatment
Constriction
Pathologic
Kaplan-Meier Estimate
Femoral artery
030204 cardiovascular system & hematology
0302 clinical medicine
Risk Factors
Popliteal Artery
Treatment Failure
030212 general & internal medicine
Aged
80 and over
education.field_of_study
Endovascular Procedures
Middle Aged
Limb Salvage
Femoral Artery
Female
Stents
Radiology
New South Wales
medicine.symptom
Cardiology and Cardiovascular Medicine
Adult
medicine.medical_specialty
Population
Prosthesis Design
Amputation
Surgical
Disease-Free Survival
Peripheral Arterial Disease
03 medical and health sciences
medicine.artery
Angioplasty
Alloys
medicine
Humans
Vascular Patency
Radiology
Nuclear Medicine and imaging
education
Aged
Retrospective Studies
business.industry
Angiography
Digital Subtraction
Intermittent Claudication
Intermittent claudication
Popliteal artery
Surgery
Amputation
business
Claudication
Zdroj: Journal of Endovascular Therapy. 23:433-441
ISSN: 1545-1550
1526-6028
DOI: 10.1177/1526602816639543
Popis: Purpose: To evaluate the safety and midterm patency of the Supera interwoven nitinol stent in a real-world population and determine deployment and patient-related factors that may predispose to loss of patency. Methods: A retrospective analysis was conducted of 111 consecutive limbs from 97 patients (mean age 75.3 years; 68 men) with severe atherosclerotic disease of the superficial femoral and popliteal arteries that were treated with Supera stents between June 2012 and October 2014. Half the patients had claudication (56%); the remainder had rest pain (19%) and tissue loss (26%). Forty-eight (43%) lesions were chronic total occlusions, and more than half were classified as TransAtlantic Inter-Society Consensus C (22%) or D (30%). Results: All 146 Supera stents (1.32 stents per limb) were deployed successfully, extending over a mean length of 175.5±130.5 mm to treat lesions averaging 151.5±127.1 mm long. At 30 days, Kaplan-Meier estimated freedom from death, target lesion revascularization, and amputation was 97.3%. Primary patency and freedom from clinically driven target lesion revascularization rates were 87.1% and 95.0% at 6 months, respectively, and 78.9% and 87.6% at 12 months, respectively. Four distinct mechanisms for failure were identified in the 13 limbs in which patency was lost; stent intussusception (n=4), compromised inflow or outflow (n=2), gross oversizing (n=1), and neoplastic thrombophilia (n=1); the cause of 5 occlusions could not be identified. Conclusion: In this heterogeneous group that included long and complex atheromatous femoropopliteal lesions, the Supera stent achieved excellent clinical and patency results at 1 year. Further improvement may be achieved through careful patient selection and the avoidance of deployment pitfalls.
Databáze: OpenAIRE
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