Abstract 17943: Clinical Factors That Determine the Superiority of Femoropopliteal Stenting Compared With Balloon Angioplasty

Abstract

Background: It has reported that femoropopliteal stenting is superior to balloon angioplasty. However, it remains unclear that what factors affect the superiority of stent compared with balloon angioplasty. Purpose: To investigate the efficacy of stent in femoropopliteal lesions and clinical factors that affect the superiority of femoropopliteal stenting compared with balloon angiography. Methods: We analyzed consecutive 1523 de novo femoropopliteal lesions performing endovascular therapy between January 2004 and December 2013 by means of propensity score matching. We assessed the efficacy of stent for femoropopliteal lesion on primary patency and assisted-primary patency, and clinical factors that determine the superiority of stent compared with balloon angioplasty. Results: 265 lesions in each group were selected by propensity score matching model for comparison. No difference was found in primary patency at 3 year between stent group and non-stent group (58.7% vs 49.3%, p=.06) and in assisted- primary patency at 3 year (63.8% vs 61.6%, p=.89). For the subgroup analysis, hazard ratio for primary patency in non-hemodialytic (hazard ratio [HR], 0.69; 95% confidential interval [CI], 0.50-0.96; p=.03) or ambulatory patients (HR, 0.69; 95% CI, 0.52-0.92; p=.01), or occlusive (HR, 0.58; 95% CI, 0.37-0.91; p=.02), non-calcified (HR, 0.63; 95% CI, 0.39-0.99; p=.04), TASCII non type A (HR, 0.65; 95% CI, 0.46-0.91; adjusted p=.01), or long (>100mm) (HR, 0.57; 95% CI, 0.32-0.98; p=.04) lesions showed the superiority of stent compared with balloon angioplasty. Conclusions: Our data suggests that femoropopliteal stenting is not necessarily recommended for all femoropopliteal lesions. However, it seems that femoropopliteal stenting is effective in non-hemodialytic or ambulatory patients, or lesions such as occlusive, non-calcified, TASC II non type A, or lesion length > 100mm compared with balloon angioplasty.