Randomized, Multicenter Study Comparing Expanded Polytetrafluoroethylene–covered Endoprosthesis Placement with Percutaneous Transluminal Angioplasty in the Treatment of Superficial Femoral Artery Occlusive Disease

• Published in: Journal of vascular and interventional radiology Vol. 19; no. 6; pp. 823 - 832
• Main Authors: Saxon, Richard R., MD, Dake, Michael D., MD, Volgelzang, Robert L., MD, Katzen, Barry T., MD, Becker, Gary J., MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.2008
• Subjects: Adult; Aged; Aged, 80 and over; Alloys; Angioplasty, Balloon - methods; Arterial Occlusive Diseases - therapy; Blood Vessel Prosthesis; Coated Materials, Biocompatible; Female; Femoral Artery; Humans; Male; Middle Aged; Polytetrafluoroethylene; Prospective Studies; Prosthesis Design; Radiology; Stents; Treatment Outcome; Vascular Patency; PAD; percutaneous transluminal angioplasty; Transatlantic Inter-Society Consensus I; femoropopliteal artery; FPA; superficial femoral artery; TASC I; ABI; peripheral arterial disease; PTA; ankle-brachial index; SFA
• ISSN: 1051-0443; 1535-7732
• DOI: 10.1016/j.jvir.2008.02.008

Purpose To compare the safety and effectiveness of the Viabahn endoprosthesis with that of percutaneous transluminal angioplasty (PTA) alone in the treatment of symptomatic peripheral arterial disease (PAD) affecting the superficial femoral artery (SFA). Materials and Methods From 1998 to 1999, patients with symptomatic SFA PAD were enrolled in a prospective, multicenter randomized study and underwent either PTA alone ( n = 100) or PTA followed by stent-graft placement (expanded polytetrafluoroethylene/nitinol self-expanding stent-graft) ( n = 97) for stenoses or occlusions of the SFA that were 13 cm long or shorter. At baseline, there were no significant differences between the PTA and stent-graft treatment groups, including chronic limb ischemia status and treated lesion length. Results The stent-graft group had a significantly higher technical success rate (95% vs 66%, P < .0001) and 1-year primary vessel patency rate at duplex ultrasonography (65% vs 40%, P = .0003). A patency benefit was seen for lesions at least 3 cm long. At 12 months, chronic limb ischemia status was 15% further improved for the stent-graft group ( P = .003). There were no significant differences between treatment groups with regard to the occurrence of early or late major adverse events. Conclusions In this multicenter study, the patency, technical success, and clinical status results obtained with stent-grafts were superior to those obtained with PTA alone.