Long coverage with drug-eluting stents is superior to spot coverage for long femoropopliteal artery disease: PARADE II study

Jong Il Park, Young Guk Ko, Yong Joon Lee, Seung Jun Lee, Sung Jin Hong, Chul Min Ahn, Jung Sun Kim, Byeong Keuk Kim, Myeong Ki Hong, Cheol Woong Yu, Seung Woon Rha, Jong Kwan Park, Pil Ki Min, Chang Hwan Yoon, Sang Rok Lee, Sang Ho Park, Dong Hoon Choi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The efficacy of spot stenting using drug-eluting stents (DES) for the treatment of long femoropopliteal (FP) lesion is unknown. This study aimed to compare clinical outcomes of long full coverage vs. spot coverage with DES for long FP artery disease. Methods: This multicenter randomized trial compared long DES vs. spot DES for FP lesions longer than 150 mm. All lesions were treated with paclitaxel-eluting stents (Zilver PTX). The primary endpoint was primary patency at 12 months. Results: The study was terminated early after an interim analysis. A total of 103 patients (55 in the long DES group; 48 in the spot DES group) were eligible for analysis. There were no significant differences in baseline and lesion characteristics between groups. Total stent length was longer in the long DES group than in the spot DES group (225.6 ± 67.2 vs. 131.3 ± 48.7 mm, p < 0.001). Technical success was achieved in all patients. There was a trend toward a higher primary patency rate at 12 months in the long DES group than in the spot DES group (87.5% vs. 67.5%, p = 0.120). The rate of survival free from target lesion revascularization was significantly higher in the long DES group than in the spot DES group (91.7% vs. 72.0%, p = 0.044). In multivariate Cox regression analysis, spot DES [hazard ratio (HR) 2.42, 95% confidence interval (CI) 1.14–5.12, p = 0.021] and postdilation (HR 0.27, 95% CI 0.09–0.79, p = 0.018) were identified as independent predictors for loss of patency at 12 months post-procedure. Conclusions: Long DES were more effective than spot DES for treating long FP lesions. Clinical trial registration: Clinicaltrials.gov, identifier: NCT02701881.

Original languageEnglish
Article number1022071
JournalFrontiers in Cardiovascular Medicine
Volume9
DOIs
Publication statusPublished - 2022 Oct 19
Externally publishedYes

Keywords

  • drug-eluting stent
  • femoropopliteal artery
  • patency
  • peripheral artery disease
  • restenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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