Self-expanding stents outperform balloon-expandable stents for iliac artery disease

Self-expanding (SE) stents proved more effective than balloon-expandable (BE) stents for the treatment of atherosclerosis of the iliac arteries and are thus recommended for affected patients, according to researchers who recently compared the two versions among a large group of patients being treated in northern Europe.  

The study was published online Aug. 21 in the Journal of the American College of Cardiology.

Although the endovascular approach has been preferred to surgery as a treatment of aortoiliac lesions and iliac artery stenting compared favorably with balloon angioplasty, there has been a lack of information about the best type of stent to use.

“The treatment of iliac artery occlusive disease with SE led to a decreased incidence of restenosis at 12 months and thus provided superior primary patency than the treatment with BE,” wrote the group. The team was led by Hans Krankenberg with the department of angiology at Asklepios Klinikum Harburg in Hamburg, Germany.

The findings were based on data from 660 patients enrolled into a cohort between August 2010 and June 2013 at 18 German and Swiss centers. All patients had peripheral artery disease of Rutherford state 1 to 4 due to a single significant common or external iliac artery lesion of 10 to 200 mm in length, which did not extend into the aorta or common femoral artery. The two treatment groups were well matched in terms of the nature of the targeted lesions as well as for their morbidities and coexisting conditions.

The key finding was that restenosis occurred in 6.1 percent of the SE patients as compared to 14.9 percent of the BE patients. The researchers found no between-group differences in walking impairment, hemodynamic success, amputation rate, all-cause death or periprocedural complications.