Impact of Implantation Defects on Intermediate Outcome of Supera Stent for Popliteal Artery Stenosis

Abstract

This study reports our experience during the first 50 cases of use of Supera stent for popliteal atherosclerotic lesions treatment. This prospective single-arm trial enrolled the first 50 limbs (46 patients) treated in our center with a Supera stent for symptomatic atherosclerotic disease of the popliteal artery and a follow-up longer than 12months. Tissue loss (43.5%) was the most common primary indication for intervention, followed by claudication (37.0%) and rest pain (19.5%). Stent implantation was successful in all patients. The majority of lesions were Trans-Atlantic Inter-Society Consensus (TASC) II type D lesions (64%). The lesions treated were localized in P3 zone in 64%, P2 zone in 28%, and P1 zone in 8%. One runoff vessel was the most common situation (42%). Mean follow-up was 16.5months (range 12-46). The mean preoperative ankle-brachial index increased from 0.38+0.37 before intervention to 0.63+0.86 postoperatively at 12 months (P=0.014). Primary patency rates at 3, 6, 9, and 12months were 95.9%, 91.7%, 89.6%, and 89.6%, and primary assisted patency rates were 95.9%, 93.8%, 93.8%, and 93.8%, respectively. In-stent restenosis was associated with the following: patient <75years (P=0.023), female sex (P=0.032), and TASC-II D lesions (P=0.041). Implantation defects did not constitute a risk factor for stent restenosis. The implantation of the interwoven nitinol stents in patients with popliteal occlusive disease is safe and effective, with encouraging patency rates and clinical results after a 12-month follow-up. In our experience, we have not seen significant differences in patency at 1-year follow-up in patients with implantation defects.