Stent May Be Best for Peripheral Arterial Disease

Restenosis of the superficial-femoral artery was lower at six and 12 months compared to angioplasty alone

WEDNESDAY, May 3 (HealthDay News) -- Primary implantation of a self-expanding, nitinol stent may be more effective in treating atherosclerosis of the superficial-femoral artery than standard balloon angioplasty with optional secondary stenting, at least in the intermediate term, according to a report in the May 4 issue of the New England Journal of Medicine.

Martin Schillinger, M.D., and colleagues from the Medical University of Vienna in Austria, randomly assigned 104 patients with severe claudication or chronic limb ischemia caused by femoral artery stenosis or occlusion to receive either a primary stent or angioplasty with optional secondary stenting.

Restenosis at six months, measured by angiography, was 24 percent in the stent group compared with 43 percent in the angioplasty group; at 12 months the rates measured by ultrasonography were 37 percent and 63 percent, respectively. Primary stent patients also fared better on treadmill tests during both follow-ups. Overall, 32 percent of the angioplasty group received a secondary stent because of suboptimal results.

In an accompanying editorial, Alan T. Hirsch, M.D., writes that while the study is a potentially important therapeutic advance for peripheral arterial disease management, limitations include a lack of a usual-care group, long-term follow-up, and the use of medical management.

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