Introduction: The optimal sizing of self-expanding drug-eluting stents (DES) in the treatment for superficial femoral artery (SFA) lesions is unclear.
Hypothesis: This study sought to investigate whether stent diameter of self-expanding DES influence the patency in SFA lesions, using optical coherence tomography (OCT).
Methods: De novo SFA lesions in patients who underwent self-expanding paclitaxel-eluting stents (PES) implantation, were enrolled. Follow-up angiography and OCT was conducted to assess stent patency six months after stent implantation, and volumetric OCT analysis was performed to evaluate vascular response to the stents. Volume index (VI) was defined as the volume divided by the stent length. The primary end point was lumen VI at the 6-month follow-up. Secondary end point was minimum lumen area (MLA) at the follow-up.
Results: A total of 40 SFA lesions treated with self-expanding PES (6-mm diameter stents in 18 lesions, 7-mm diameter stents in 12 lesions, and 8-mm diameter stents in 10 lesions) were analyzed. Mean stent length was 85.3 ± 32.7 mm. Baseline characteristics and angiographic data were similar among the three different stent diameter (6-mm, 7-mm, and 8-mm) groups. MLA at the 6-month follow-up was 9.7 ± 2.7 mm2 in the 6-mm group, 12.2 ± 3.9 mm2 in the 7-mm group, and 13.9 ± 6.4 mm2 in the 8-mm group (p<0.05 for one-way ANOVA, p<0.05 for trend). Volumetric OCT parameters at the follow-up are presented in Figure. Stent VI was greater in the larger stent diameter groups (p<0.01 for one-way ANOVA, p<0.01 for trend). Neointimal VI was similar among the three groups (p=0.19 for one-way ANOVA, p=0.43 for trend). As a result, lumen VI was greater in the larger stent diameter groups (p<0.05 for one-way ANOVA, p<0.05 for trend).
Conclusions: Chronic stent enlargement resulted in greater lumen area after implantation of self-expanding DES with a larger diameter. The sizing of DES diameter might be important for stent patency in SFA lesions.