Functional and clinical outcomes of nitinol stenting with and without abciximab for complex superficial femoral artery disease: a randomized trial

Catheter Cardiovasc Interv. 2006 Feb;67(2):288-97. doi: 10.1002/ccd.20593.

Abstract

Objective: To evaluate the effect of glycoprotein IIb/IIIa inhibition during nitinol stenting, of superficial femoral occlusive disease.

Background: Stent implantation in the superficial femoral artery has been associated with suboptimal results while Glycoprotein IIb/IIIa inhibitors have shown improved procedural results during coronary intervention. We evaluated abciximab infusion during (Smart Stent) implantation in superficial femoral obstructions.

Methods: We conducted a randomized placebo controlled trial. The two primary end points include: (1) 9-month restenosis defined as a decrease in ankle brachial index and in-stent duplex ultrasound restenosis: (2) adverse events defined as death (30 days) or repeat revascularization within 9 months.

Results: Twenty-seven patients were randomized to abciximab and 24 patients to control (placebo). The primary end point of cumulative restenosis occurred in 15.4% of patients administered abciximab and in 12% administered placebo (P = 0.873). The primary restenosis endpoint in diabetics and total occlusions were similar at 14.3% and 15.4% respectively. The composite end point of 30-day mortality and 9-month revascularization occurred in 5.8% abciximab and 0% (P = 0.274) placebo with no 30-day deaths. Graded treadmill time and Rutherford class were all significantly improved in both groups, but the abciximab group did not appear to demonstrate any identifiable effect.

Conclusion: (Smart Stent) nitinol stenting of the superficial femoral artery was associated with favorable functional outcomes at 9 months. Adjunctive abciximab did not appear to demonstrate any identifiable effect.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abciximab
  • Aged
  • Aged, 80 and over
  • Alloys
  • Angiography
  • Angioplasty, Balloon
  • Antibodies, Monoclonal / administration & dosage*
  • Arterial Occlusive Diseases / therapy*
  • Chi-Square Distribution
  • Female
  • Femoral Artery*
  • Humans
  • Immunoglobulin Fab Fragments / administration & dosage*
  • Male
  • Middle Aged
  • Peripheral Vascular Diseases / therapy*
  • Platelet Glycoprotein GPIIb-IIIa Complex / antagonists & inhibitors*
  • Stents*
  • Treatment Outcome
  • Ultrasonography, Doppler, Duplex

Substances

  • Alloys
  • Antibodies, Monoclonal
  • Immunoglobulin Fab Fragments
  • Platelet Glycoprotein GPIIb-IIIa Complex
  • nitinol
  • Abciximab