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The Journal of Cardiovascular Surgery 2022 Jan 10

DOI: 10.23736/S0021-9509.22.12129-4

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

A systematic review and meta-analysis of Supera interwoven nitinol stents for the treatment of infrainguinal peripheral arterial disease

Vangelis BONTINIS 1 , Constantine N. ANTONOPOULOS 2, Alkis BONTINIS 1, Andreas KOUTSOUMPELIS 1, Argirios GIANNOPOULOS 1, Kiriakos KTENIDIS 1

1 Department of Vascular Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece; 2 Department of Vascular Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Athens, Greece


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BACKGROUND: Stenting of infrainguinal lesions can be rather challenging due to the mechanical stress applied on the arteries during motion. We assessed the short-term and midterm safety and efficacy of Supera interwoven nitinol stent for the treatment of infrainguinal arterial disease.
EVIDENCE ACQUISITION: We conducted a systematic review for articles published from December 2011 up to May 2021 regarding studies assessing the safety and efficacy of Supera interwoven nitinol stents for the treatment of infra-inguinal peripheral arterial disease. Studies that involved synchronous application of the Supera stent and drug delivering devices, or any alternative endoprosthesis were excluded. Pooled Kaplan-Meier survival curves and smoothed hazard estimates were generated. Data were meta-analyzed using a random effects model. Primary endpoints included primary patency and freedom from clinically driven target lesion revascularization (TRL). Secondary endpoints included technical success and major amputation at 1 year post intervention.
EVIDENCE SYNTHESIS: Seventeen studies with 2,015 patients (65.3% males) and a mean lesion length of 137.2 mm were included. Of the total treated lesions, 44.9% involved femoropopliteal artery and 37.4% the popliteal artery. Chronic total occlusions made up 49% of the treated lesions. There were no stent fractures reported. The pooled technical success rate is 99.84% (95% CI: 99.26-100). Pooled major amputation rate at 1 year is 1.48% (95% CI: 0.47-2.87). Pooled primary patency and freedom from TLR rates at 1 year are 83.5% (95% CI: 80.24-86.54) and 90.32% (95% CI: 88.75-91.79), respectively. Pooling of individual patient data produced primary patency and freedom from TLR rates of 84.48% (95% CI: 82.66-86.11) and 90.81% (95% CI: 88.64-92.58) respectively. According to the smoothed hazard ratio estimate the risk for losing primary patency peaked between four and five months while the risk for TLR peaked between seven and eight months after the intervention.
CONCLUSIONS: This review and meta-analysis indicated the safety and efficacy of Supera stents for the treatment of challenging infrainguinal lesions in the short-term and mid-term periods, with acceptable primary patency and freedom from TLR rates. Clinicians should be aware that between four and five months patients face a higher risk for event occurrence.


KEY WORDS: Peripheral arterial disease; Endovascular procedures; Self-expanding stent; Superficial femoral artery; Popliteal artery

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