Combined Therapy of Stent-Grafts With Other Scaffolds in Femoro-Popliteal Artery

With endovascular treatment (EVT) becoming the preferred approach for long femoro-popliteal (FP) lesions, stent-grafts (SGs) have seen increased use in practice.

This study assessed the efficacy of combining SGs with other scaffold devices in treating long FP lesions in patients with symptomatic lower extremity arterial disease.

This study retrospectively reviewed 3132 patients treated with EVT for FP lesions at seven cardiovascular centers in eastern Japan between January 2017 and February 2021. Acute limb ischemia treatments were excluded from this analysis. We performed propensity score matching to compare patency rates between cases treated with SGs combined with other scaffold devices and those treated with SGs alone.

This study enrolled 291 participants. We assigned 81 cases to the combined-use group and 210 to the SG-alone group. Propensity score matching yielded 41 matched pairs exhibiting no significant differences in baseline characteristics, including lesion length (28.4 ± 10.3 vs. 27.7 ± 9.3 cm). The 1-year rate of freedom from restenosis was 71.6% in the combined-use group compared with 84.6% in the SG-alone group; the corresponding 3-year rate was 64.4% versus 72.6% (p = 0.83). No statistically significant differences were observed between the two groups in terms of freedom from target lesion revascularization, occlusive restenosis, or acute limb ischemia (p = 0.99, 0.72, and 0.11, respectively).

Both treatment strategies yielded acceptable outcomes in the management of complex FP lesions. Although the combined-use group experienced an earlier decline in patency than the SG-alone group, this difference was not statistically significant.

Since this study is a retrospective analysis from a multicenter registry, trial registration is unnecessary.