Over the last decade, the number of endovascular procedures performed on the superficial femoral (SFA) and popliteal arteries (PA) has significantly increased. There is no consensus on the optimal form of intervention used in this arterial segment. While some have advocated balloon angioplasty alone, others have championed either selective or primary stenting of these lesions. It is the purpose of this study to determine the efficacy and durability of primary stenting of the superficial femoral and popliteal artery.
The Vienna Absolute study was the first randomized study to show superiority of primary stenting over balloon angioplasty for the treatment of moderate-length SFA lesions.2 In that study, patients were randomized 1:1 to a Dynalink* or Absolute* stent (Abbott Vascular) versus balloon angioplasty. At 1 year, primary patency was significantly higher for patients treated with a stent (63% vs 37%). However, other randomized studies conducted with the Luminexx stent (Bard Peripheral Vascular) failed to show a benefit of stent placement for shorter-length (mean, 40 mm) SFA lesions.3 At the same time, concerns regarding a high prevalence of stent fracture in the SFA using early generation self-expanding stents limited the broad application of stents to the femoropopliteal segment.