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Comparison of Spot versus Long Stenting for Femoropopliteal Artery Disease

Authors
 Young-Guk Ko  ;  Chul-Min Ahn  ;  Seung-Woon Rha  ;  Cheol Woong Yu  ;  Sang Ho Park  ;  Seung Jin Lee  ;  Jae-Hwan Lee  ;  Sung-Ho Her  ;  Woong Chol Kang  ;  Young-Seok Cho  ;  Jae-Bin Seo  ;  Yun Hyeong Cho  ;  Donghoon Choi 
Citation
 ANNALS OF VASCULAR SURGERY, Vol.58 : 101-107, 2019 
Journal Title
 ANNALS OF VASCULAR SURGERY 
ISSN
 0890-5096 
Issue Date
2019
MeSH
Aged ; Alloys ; Angioplasty, Balloon/adverse effects ; Angioplasty, Balloon/instrumentation* ; Angioplasty, Balloon/methods ; Constriction, Pathologic ; Female ; Femoral Artery*/physiopathology ; Humans ; Male ; Middle Aged ; Peripheral Arterial Disease/diagnosis ; Peripheral Arterial Disease/physiopathology ; Peripheral Arterial Disease/therapy* ; Popliteal Artery*/physiopathology ; Progression-Free Survival ; Prosthesis Design ; Recurrence ; Republic of Korea ; Risk Factors ; Self Expandable Metallic Stents* ; Time Factors ; Vascular Patency
Abstract
BACKGROUND: Optimal stenting strategy for long femoropopliteal artery lesions still remains undefined. Longer stent length has been shown to be associated with increased risk of restenosis. We sought to compare the efficacy of spot versus long stenting in the treatment of femoropopliteal artery disease. METHODS: This study was designed as a multicenter randomized controlled trial to compare immediate and mid-term outcomes of spot versus long primary stenting for femoropopliteal arterial lesions. A total of 125 patients were randomized 1:1 to spot stenting group (n = 59) or long stenting group (n = 66). RESULTS: All lesions were treated with self-expanding bare nitinol stents. Baseline clinical and lesion characteristics were similar between the 2 groups except for male gender and current smoker. The mean lesion length was 24.1 ± 8.8 cm. Technical success was achieved in all patients. The 1-year primary patency and TLR-free (target lesion revascularization) survival did not differ significantly between the 2 groups. However, the spot stenting group showed a trend toward higher primary patency (86.1% vs. 72.7%, P = 0.158) and TLR-free survival (94.2% vs. 82.5%, P = 0.120). The total stented length (hazard ratio [HR] 1.01, 95% confidence interval [CI] 1.00-1.01, P = 0.011) and age (HR 0.94, 95% CI 0.90-1.00, P = 0.035) were independent predictors of restenosis. CONCLUSIONS: The spot stenting appears to be more favorable than the long stenting in terms of primary patency and TLR-free survival, although the difference was not statistically significant. The stented length was an independent predictor of restenosis.
Full Text
https://www.sciencedirect.com/science/article/pii/S0890509619301311
DOI
10.1016/j.avsg.2018.11.023
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/173352
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