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Long coverage with drug-eluting stents is superior to spot coverage for long femoropopliteal artery disease: PARADE II study

Authors
 Jong-Il Park  ;  Young-Guk Ko  ;  Yong-Joon Lee  ;  Seung-Jun Lee  ;  Sung-Jin Hong  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Myeong-Ki Hong  ;  Cheol-Woong Yu  ;  Seung-Woon Rha  ;  Jong-Kwan Park  ;  Pil-Ki Min  ;  Chang-Hwan Yoon  ;  Sang-Rok Lee  ;  Sang-Ho Park  ;  Dong-Hoon Choi 
Citation
 FRONTIERS IN CARDIOVASCULAR MEDICINE, Vol.9 : 1022071, 2022-10 
Journal Title
FRONTIERS IN CARDIOVASCULAR MEDICINE
Issue Date
2022-10
Keywords
drug-eluting stent ; femoropopliteal artery ; patency ; peripheral artery disease ; restenosis
Abstract
Background: The efficacy of spot stenting using drug-eluting stents (DES) for the treatment of long femoropopliteal (FP) lesion is unknown. This study aimed to compare clinical outcomes of long full coverage vs. spot coverage with DES for long FP artery disease.

Methods: This multicenter randomized trial compared long DES vs. spot DES for FP lesions longer than 150 mm. All lesions were treated with paclitaxel-eluting stents (Zilver PTX). The primary endpoint was primary patency at 12 months.

Results: The study was terminated early after an interim analysis. A total of 103 patients (55 in the long DES group; 48 in the spot DES group) were eligible for analysis. There were no significant differences in baseline and lesion characteristics between groups. Total stent length was longer in the long DES group than in the spot DES group (225.6 ± 67.2 vs. 131.3 ± 48.7 mm, p < 0.001). Technical success was achieved in all patients. There was a trend toward a higher primary patency rate at 12 months in the long DES group than in the spot DES group (87.5% vs. 67.5%, p = 0.120). The rate of survival free from target lesion revascularization was significantly higher in the long DES group than in the spot DES group (91.7% vs. 72.0%, p = 0.044). In multivariate Cox regression analysis, spot DES [hazard ratio (HR) 2.42, 95% confidence interval (CI) 1.14-5.12, p = 0.021] and postdilation (HR 0.27, 95% CI 0.09-0.79, p = 0.018) were identified as independent predictors for loss of patency at 12 months post-procedure.

Conclusions: Long DES were more effective than spot DES for treating long FP lesions.

Clinical trial registration: Clinicaltrials.gov, identifier: NCT02701881.
Files in This Item:
T202205586.pdf Download
DOI
10.3389/fcvm.2022.1022071
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
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Min, Pil Ki(민필기) ORCID logo https://orcid.org/0000-0001-7033-7651
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Lee, Seung-Jun(이승준) ORCID logo https://orcid.org/0000-0002-9201-4818
Lee, Yong Joon(이용준)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/192197
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