EXTENSIVE TREATMENT OF LONG FEMOROPOPLITEAL LESIONS WITH BARE STENTS.
Recent controversies on the use of active devices in the arteries of the lower extremities renewed the focus on the evaluation of more conventional techniques. The results of the stenting of short and/or intermediate femoro-popliteal lesions are well known, but little data relate to the extensive stenting of long lesions with bare stents (ESLLBS). The objective of this study was to report our results of ESLLBS.Between January 2014 and December 2017, 1233 patients had infrainguinal angioplasty in our center. The files of patients treated for femoropopliteal lesions longer than 250 mm by extensive stenting with bare metal stents were reviewed and analyzed. The primary outcome was the 12-month primary patency, defined by the absence of restenosis (≥50%) and/or reintervention on the target lesion. Continuous data were expressed as mean and standard deviation. Survival analysis was carried out according to Kaplan-Meier.Overall, 64 patients with a mean age of 80±11 years were included, including 49 (76.6%) presenting with critical ischemia. Lesions were classified as TASC D in 54.7% of the cases. The length of the lesions was 295±64 mm and 3±1 stents were implanted. The 30-day mortality was null but two patients (3.1%) presented nonvascular major complications. With a follow-up of 27±17 months, 22 patients (34.3%) died including three of vascular causes. The healing of the trophic disorder was obtained in 77.5% of the cases. The rate of amputation was 10.9%. The 6-, 12-, and 24-month primary patency rates were 79.7%, 66.6%, and 60.9%, respectively. The 6-, 12-, and 24-month rates of freedom from target lesion revascularization (FfTLR) were 96.3%, 73.9%, and 71.9%, respectively. The 6-, 12-, and 24-month survival rates were 90.3%, 83.6%, and 65.6%, respectively.The 12-month primary patency rate of ESLLBS of long femoropopliteal lesions is acceptable. This strategy constitutes an acceptable alternative in patients presenting with critical ischemia and a limited life expectancy.
Authors: Paul Labed, Florian Gonzalez, Jérémie Jayet, Isabelle Javerliat, Marc Coggia, Raphael Coscas