Stenting Superior to Angioplasty for Peripheral Artery Disease

Among patients with atherosclerotic popliteal artery stenosis, primary stenting with a nitinol stent may be superior to balloon angioplasty, according to a new study.

Researchers at the Albert-Ludwigs-University (Freiburg, Germany) and Heart Center Bad Krozingen (Freiburg, Germany) enrolled 246 patients in the prospective, multicenter, randomized Endovascular Treatment of Atherosclerotic Popliteal Artery Lesions (ETAP) trial, assigning 119 patients to receive the Bard Peripheral Vascular (Tempe, AZ, USA) Lifestent and 127 to balloon angioplasty; the average lesion length was 41 mm in the stent group and 43 mm in controls. The mean stenosis diameter of the popliteal artery was 93% among those patients assigned to stenting, and 92% among those who were treated with the balloon.


The results showed that a year after treatment, 67.4% of the patients who received the stent had patent popliteal arteries, compared with 44.9% of patients treated with balloon angioplasty. Stent fractures occurred twice during the study. Other outcomes at 12 months were similar for death, heart attack, amputation, and ankle brachial index, but 49 of the patients undergoing angioplasty required repeat treatment compared with 15 of those getting stents. Absolute walking distances reflected an increase of 70 meters in the balloon group and 116 meters among the stented patients. The study was presented at the Transcatheter Cardiovascular Therapeutics (TCT) annual meeting, held during October 2012 in Miami (FL, USA).

“The popliteal artery is considered as a 'no stent' zone due to potential excessive external forces applied to the stent in the popliteal fossa,” said lead author and study presenter associate Prof. Thomas Zeller, MD, chief physician at the Heart Center Bad Krozingen. “Results from this trial indicate that treatment of popliteal artery obstructive lesions with a nitinol self-expanding stent is safe. Additionally, one-year primary patency and target lesion revascularization rates were substantially better with the nitinol stent than with balloon angioplasty.”

The Lifestent vascular stent system uses advanced helical struts and angled bridges to withstand high bending, compression, and torsion forces, thus allowing dynamic vessel conformity and a low fracture rate.

Related Links:
Albert-Ludwigs-University
Heart Center Bad Krozingen
Bard Peripheral Vascular