title: Bare Metal Versus Paclitaxel-Eluting Stents for Long Femoropopliteal Lesions: Prospective Cohorts Comparison Using a Propensity Score-Matched Analysis.
abstract: BACKGROUND
  The study aims to compare outcomes of primary stenting of long femoropopliteal (FP) lesions with bare metal stent (BMS) versus paclitaxel eluting stent (PES).
  
  
  METHODS
  In a single centre study, we established 2 consecutive and prospective cohorts with TASC C/D FP de novo lesions. The inclusion and exclusion criteria were similar. Bare metal stent (LifeStent®, Bard Peripheral) and PES (Zilver®PTX®, Cook Peripheral Vascular) were implanted. Prospective clinical and morphological follow-ups were carried out at 1, 3, 6, 12, and 18 months. Propensity score (inverse probability of treatment weighted method) stratification was used to minimize bias.
  
  
  RESULTS
  In total, 110 limbs were treated (STELLA: n = 62; STELLA PTX: n = 48). We noted some difference between both cohorts regarding type 2 diabetes (P = 0.05), vitamin K antagonist use (P = 0.05), and angiotensin II receptor blocker use (P = 0.002). More stents were implanted in the STELLA PTX cohort (P < 0.0013). At 12 months, in univariate analysis, freedom from target lesion revascularization (TLR) was higher in the STELLA cohort (P = 0.005). No differences were found between both cohorts in terms of primary sustained clinical improvement (P = 0.25), primary patency (P = 0.07), and survival (P = 0.79). With the propensity score, no difference was observed in terms of primary sustained clinical improvement (P = 0.79), freedom from TLR (P = 0.59), and primary patency (P = 0.69). With Cox logistic regression, the number of implanted stents influenced the primary sustained clinical improvement, the freedom from TLR, and the primary patency.
  
  
  CONCLUSIONS
  Paclitaxel-eluting stents do not seem to provide benefits in terms of clinical and morphological outcomes for TASC C/D lesions compared to BMS.
authors.affiliation: Department of Vascular Surgery, CHU (University Hospital Centre) Nantes, l'institut du thorax, service de chirurgie vasculaire (Institut du Thorax), Nantes, France.
authors.forename: Pierre-Alexandre
authors.initials: PA
authors.lastname: Vent
authors.affiliation: Department of Cardiothoracic and Vascular Surgery, CHU de Rennes, Rennes, France.
authors.forename: Adrien
authors.initials: A
authors.lastname: Kaladji
authors.affiliation: Department of Vascular Surgery, CHU (University Hospital Centre) Nantes, l'institut du thorax, service de chirurgie vasculaire (Institut du Thorax), Nantes, France.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Davaine
authors.affiliation: CHU Nantes, l'institut du thorax, centre d'investigation clinique (Clinical Investigation Centre), Nantes, France; Inserm UMR1087, l'institut du thorax, Nantes, France; CNRS, UMR 6291, Nantes, France; Université de Nantes, Nantes, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Guyomarch
authors.affiliation: Department of Vascular Surgery, CHU (University Hospital Centre) Nantes, l'institut du thorax, service de chirurgie vasculaire (Institut du Thorax), Nantes, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Chaillou
authors.affiliation: Department of Vascular Surgery, CHU (University Hospital Centre) Nantes, l'institut du thorax, service de chirurgie vasculaire (Institut du Thorax), Nantes, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Costargent
authors.affiliation: Laboratory of Bone Resorption Physiopathology, Inserm UMR-957, Nantes, France.
authors.forename: Thibaut
authors.initials: T
authors.lastname: Quillard
authors.affiliation: Department of Vascular Surgery, CHU (University Hospital Centre) Nantes, l'institut du thorax, service de chirurgie vasculaire (Institut du Thorax), Nantes, France; Université de Nantes, Nantes, France; Laboratory of Bone Resorption Physiopathology, Inserm UMR-957, Nantes, France. Electronic address: yann.goueffic@chu-nantes.fr.
authors.forename: Yann
authors.initials: Y
authors.lastname: Gouëffic
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D005602:France; D006801:Humans; D057194:Intention to Treat Analysis; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D016555:Matched-Pair Analysis; D008670:Metals; D008875:Middle Aged; D015999:Multivariate Analysis; D017239:Paclitaxel / Q000008:administration & dosage* / Q000009:adverse effects; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D057216:Propensity Score; D016016:Proportional Hazards Models; D011446:Prospective Studies; D011474:Prosthesis Design; D012042:Registries; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D017239:Paclitaxel