Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion

Background The clinical outcomes of comparing covered stents (CSs) and drug‐coated balloons (DCBs) angioplasty in femoropopliteal artery occlusion remain unknown. This study aimed to evaluate the midterm efficacy of CS and DCB procedures in patients with FPO. Methods All 194 patients were divided in...

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Main Authors: Yuhao Lin, Yaowen Chang, Jing Wang, Huijun Yuan, Feng Zhang, Ruipeng Zhang, Jianjun Quan, Jian Dong, Yang Han, Longlong Cong, Lin Yang
Format: Article
Language:English
Published: Wiley 2025-07-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.039384
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author Yuhao Lin
Yaowen Chang
Jing Wang
Huijun Yuan
Feng Zhang
Ruipeng Zhang
Jianjun Quan
Jian Dong
Yang Han
Longlong Cong
Lin Yang
author_facet Yuhao Lin
Yaowen Chang
Jing Wang
Huijun Yuan
Feng Zhang
Ruipeng Zhang
Jianjun Quan
Jian Dong
Yang Han
Longlong Cong
Lin Yang
author_sort Yuhao Lin
collection DOAJ
description Background The clinical outcomes of comparing covered stents (CSs) and drug‐coated balloons (DCBs) angioplasty in femoropopliteal artery occlusion remain unknown. This study aimed to evaluate the midterm efficacy of CS and DCB procedures in patients with FPO. Methods All 194 patients were divided into CS (94 patients) and DCB (100 patients) groups in this multicenter retrospective study. The primary end point was primary patency at 24 months, and the secondary end points included freedom from clinically driven target lesion revascularization, limb salvage, major adverse events, and overall survival rates. Propensity score matching analysis was performed to reconfirm the main end points. Results Compared with the patients in the DCB group, those in the CS group had a lower prevalence of smoking (54.3% versus 74.0%, P=0.004) and diabetes (38.3% versus 66.0%, P<0.001) before propensity score matching. Compared with the DCB procedure, the CS procedure resulted in a significantly greater primary patency at 24 months (74.4% versus 55.8%, P=0.019), with comparable primary patency at 12 months; similar results were obtained after matching. However, there was no difference in terms of clinically driven target lesion revascularization, limb salvage, major adverse events, or overall survival rates. Subgroup analyses confirmed the superior clinical patency of CS in patients with diabetes (P=0.010) and proximal reference vessel diameter ≥5.0 mm (P=0.038). A baseline ankle brachial index <0.40 was likely to be an independent risk factor for restenosis, and a postprocedural ankle brachial index ≥0.80 and the CS used (hazard ratio [HR], 0.54 [95% CI, 0.32–0.91], P=0.021) were potential protective factors for restenosis after multivariate analysis. Conclusions Compared with the DCB procedure, the CS procedure resulted in greater primary patency at 24 months in complicated femoropopliteal artery occlusion lesions.
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spelling doaj-art-a55bbc928f5541ea866cdf016df4e4142025-08-20T02:46:24ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141310.1161/JAHA.124.039384Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery OcclusionYuhao Lin0Yaowen Chang1Jing Wang2Huijun Yuan3Feng Zhang4Ruipeng Zhang5Jianjun Quan6Jian Dong7Yang Han8Longlong Cong9Lin Yang10Department of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an ChinaDepartment of Interventional Vascular Surgery The First Affiliated Hospital of Lanzhou University Lanzhou ChinaDepartment of Interventional Vascular Surgery Xianyang Central Hospital Xianyang ChinaDepartment of Interventional Vascular Surgery Xi’an Red Cross Hospital of Xi’an Jiaotong University Xi’an ChinaDepartment of Vascular Surgery 215 Hospital of Shaanxi Nuclear Industry Xianyang ChinaDepartment of Vascular Surgery Shaanxi Provincial People’s Hospital Xi’an ChinaDepartment of Interventional Vascular Surgery Hanzhong Central Hospital Hanzhong ChinaDepartment of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an ChinaDepartment of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an ChinaDepartment of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an ChinaDepartment of Vascular Surgery The First Affiliated Hospital of Xi’an Jiaotong University Xi’an ChinaBackground The clinical outcomes of comparing covered stents (CSs) and drug‐coated balloons (DCBs) angioplasty in femoropopliteal artery occlusion remain unknown. This study aimed to evaluate the midterm efficacy of CS and DCB procedures in patients with FPO. Methods All 194 patients were divided into CS (94 patients) and DCB (100 patients) groups in this multicenter retrospective study. The primary end point was primary patency at 24 months, and the secondary end points included freedom from clinically driven target lesion revascularization, limb salvage, major adverse events, and overall survival rates. Propensity score matching analysis was performed to reconfirm the main end points. Results Compared with the patients in the DCB group, those in the CS group had a lower prevalence of smoking (54.3% versus 74.0%, P=0.004) and diabetes (38.3% versus 66.0%, P<0.001) before propensity score matching. Compared with the DCB procedure, the CS procedure resulted in a significantly greater primary patency at 24 months (74.4% versus 55.8%, P=0.019), with comparable primary patency at 12 months; similar results were obtained after matching. However, there was no difference in terms of clinically driven target lesion revascularization, limb salvage, major adverse events, or overall survival rates. Subgroup analyses confirmed the superior clinical patency of CS in patients with diabetes (P=0.010) and proximal reference vessel diameter ≥5.0 mm (P=0.038). A baseline ankle brachial index <0.40 was likely to be an independent risk factor for restenosis, and a postprocedural ankle brachial index ≥0.80 and the CS used (hazard ratio [HR], 0.54 [95% CI, 0.32–0.91], P=0.021) were potential protective factors for restenosis after multivariate analysis. Conclusions Compared with the DCB procedure, the CS procedure resulted in greater primary patency at 24 months in complicated femoropopliteal artery occlusion lesions.https://www.ahajournals.org/doi/10.1161/JAHA.124.039384clinically driven target lesion revascularization (CD‐TLR)covered stent (CS)drug‐coated balloon (DCB)femoropopliteal lesionprimary patency
spellingShingle Yuhao Lin
Yaowen Chang
Jing Wang
Huijun Yuan
Feng Zhang
Ruipeng Zhang
Jianjun Quan
Jian Dong
Yang Han
Longlong Cong
Lin Yang
Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
clinically driven target lesion revascularization (CD‐TLR)
covered stent (CS)
drug‐coated balloon (DCB)
femoropopliteal lesion
primary patency
title Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
title_full Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
title_fullStr Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
title_full_unstemmed Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
title_short Twenty‐Four‐Month Outcomes of Heparin‐Bonded Covered Stents and Drug‐Coated Balloon Angioplasty in Femoropopliteal Artery Occlusion
title_sort twenty four month outcomes of heparin bonded covered stents and drug coated balloon angioplasty in femoropopliteal artery occlusion
topic clinically driven target lesion revascularization (CD‐TLR)
covered stent (CS)
drug‐coated balloon (DCB)
femoropopliteal lesion
primary patency
url https://www.ahajournals.org/doi/10.1161/JAHA.124.039384
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