Randomized clinical trial to compare the efficacy of self-expanding bare metal nitinol stent and balloon angioplasty alone for below-the-knee lesions following successful balloon angioplasty: 1-year clinical outcomes

PLoS One. 2023 Nov 13;18(11):e0294132. doi: 10.1371/journal.pone.0294132. eCollection 2023.

Abstract

This prospective, multicenter, randomized study aimed to compare the 1-year clinical outcomes after primary stenting with self-expanding bare metal nitinol stent (SENS) and plain old balloon angioplasty (POBA) in patients with critical limb ischemia (CLI) and below-the-knee (BTK) lesions. Overall, 119 patients with CLI and BTK lesions were randomized to POBA alone (POBA group, 61 patients) or primary stenting with SENS (stenting group, 58 patients) after achieving acceptable POBA results in target BTK lesions. Clinical outcomes including amputation and revascularization rates were prospectively compared for 1 year. After 1 year, similar incidence rates of individual clinical endpoints, including cardiac death (6.5% vs. 5.1%, p > 0.999), myocardial infarction (1.6% vs. 0.0%, p > 0.999), repeat revascularization (19.6% vs. 18.9%, p = 0.922), target lesion revascularization (13.1% vs. 17.2%, p = 0.530), and amputation (4.9% vs. 0.0%, p = 0.244), were observed. POBA appeared to have acceptable treatment outcomes compared with primary stenting with SENS after 1 year in CLI patients with BTK lesions undergoing percutaneous transluminal angioplasty (PTA).

Publication types

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

MeSH terms

  • Angioplasty, Balloon* / adverse effects
  • Angioplasty, Balloon* / methods
  • Angioplasty, Balloon, Coronary*
  • Humans
  • Peripheral Arterial Disease* / therapy
  • Popliteal Artery
  • Prospective Studies
  • Stents
  • Treatment Outcome
  • Vascular Patency

Substances

  • nitinol

Grants and funding

This study was supported by a National Research Foundation of Korea (NRF) grant funded by the Korean government (MSIT) (project number: NRF-2022R1F1A1065143) and the Department of Internal Medicine, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon 35233, Korea. This study was supported by a grant from Abbot Company, Korea. This study was supported by the Soonchunhyang University Research Fund. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.