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Evidence summaries

Angioplasty Versus Stenting for Superficial Femoral Artery Lesions

There appears to be a small short-term patency benefit for percutaneous transluminal angioplasty (PTA) with stenting over PTA alone for treating lesions of the superficial femoral artery, but no sustained benefit. Level of evidence: "B"

The quality of evidence is downgraded by inconsistency (variability in results across studies).

Summary

A Cochrane review [Abstract] 1 included 11 studies with a total of 1 387 subjects. Participants were followed for up to two years. There was an improvement in primary duplex patency at 6 (OR 2.90, 95% CI 1.17 to 7.18, statistical heterogeneity I2 =77%; 6 studies, n=578) and 12 months (OR 1.78, 95% CI 1.02 to 3.10, statistical heterogeneity I2 =68%; 9 studies, n=858) in participants treated with percutaneous transluminal angioplasty (PTA) plus stent over lesions treated with PTA alone. This was lost by 24 months (P = 0.06). There was a significant angiographic patency benefit at 6 months (OR 2.49, 95% CI 1.49 to 4.17; 4 studies, n=329) which was lost by 12 months (OR 1.30, 95% CI 0.84 to 2.00; 5 studies, n=384). Ankle brachial index (ABI) and treadmill walking distance showed no improvement at 12 months (P=0.49 and P=0.57 respectively) between participants treated with PTA alone or PTA with stent insertion. Three studies (n=660) reported quality of life, which showed no significant difference at any time interval. Antiplatelet therapy protocols and inclusion criteria regarding affected arteries between trials showed marked heterogeneity.

    References

    • Chowdhury MM, McLain AD, Twine CP. Angioplasty versus bare metal stenting for superficial femoral artery lesions. Cochrane Database Syst Rev 2014;(6):CD006767. [PubMed]

Primary/Secondary Keywords