Impact of stent placement compared with balloon angioplasty in small vessel of femoropopliteal disease

Purpose: The aim of this study was to evaluate the efficacy of stent placement versus balloon angioplasty (BA) in less than 4.5 mm diameter femoropopliteal (FP) lesions. Methods: This study was a multicenter retrospective analysis. A total of 2742 consecutive patients (3471limbs) with FP disease were enrolled and 196 limbs below 4.5 mm diameter FP lesions were analyzed in current study; 122 (31.2%) were implanted the self-expanding nitinol stent, 269 (68.8%) were balloon angioplasty alone. Results: The mean reference vessel diameter was 3.8±0.4 mm and the mean lesion length was 55.0±33.8 mm. There was no significant difference in overall freedom from restenosis between BA group and stent group (62.7% vs 54.9% at 2-year, respectively; P=0.27), nor were there significant differences with freedom from repeated revascularization (91.8% vs 90.2% at 2-year; P=0.99) and reocclusion (79.4% vs 69.9% at 2-year, respectively; P=0.22). The independent predictors of primary patency were female gender, diabetes mellitus, history of cerebrovascular disease and lesion length. Freedom from restenosis Conclusions: In small vessels, implantation of the self-expanding nitinol stent for FP lesions does not improves freedom from restenosis, repeated revascularization and reocclusion compared with balloon angioplasty.