%0 Journal Article
%T Adjunctive stent use during endovascular intervention to the femoropopliteal artery with drug coated balloons: Insights from the XLPAD registry
%A Damianos G Kokkinidis
%A Ehrin J Armstrong
%A Emmanouil S Brilakis
%A Haekyung Jeon-Slaughter
%A Houman Khalili
%A Nicolas W Shammas
%A Subhash Banerjee
%J Vascular Medicine
%@ 1477-0377
%D 2018
%R 10.1177/1358863X18775593
%X With growing use of drug-coated balloons (DCB) for femoropopliteal (FP) artery interventions, there is limited information on rates of real-world adjunctive stent use and its association with short and long-term outcomes. We report on 225 DCB treated FP lesions in 224 patients from the Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) between 2014 and 2016. Cochran¨CMantel¨CHaenszel and Wilcoxon rank sum statistics were used to compare stented (planned or ¡®bail-out¡¯) versus non-stented DCB treated lesions. Stents were implanted in 31% of FP DCB interventions. Among the 70 stents implanted, 46% were for ¡®bail-out¡¯ indications and 54% were planned. Lesions treated with stents were longer (mean 150 mm vs 100 mm; p < 0.001) and less likely to be in-stent restenosis lesions (10% vs 28%; p=0.003). Stenting was significantly more frequent in complex FP lesions, including chronic total occlusions (66% vs 34%; p < 0.001). For bail-out stenting, interwoven nitinol stents were the most common type (50%) followed by drug-eluting stents (34%) and bare-metal stents (22%). There were no differences in peri-procedural complication rates or 12-month target limb revascularization rates (18.6% vs 11.6%; p=0.162) or 12-month amputation rates (11.4% vs 11%; p=0.92) between lesions where adjunctive stenting was used versus lesions without adjunctive stenting, respectively. In conclusion, in a contemporary ¡®real-world¡¯ adjudicated multicenter US registry, adjunctive stenting was necessary in nearly a third of the lesions, primarily for the treatment of more complex FP lesions, with similar short and intermediate-term clinical outcomes compared with non-stented lesions. ClinicalTrials.gov Identifier: NCT0190485
%K adjunctive stenting
%K drug-coating balloons
%K drug-eluting balloons
%K femoropopliteal disease
%K peripheral interventions
%K peripheral artery disease (PAD)
%K endovascular therapy
%U https://journals.sagepub.com/doi/full/10.1177/1358863X18775593