IVUS Improves Outcomes with SUPERA Stents for the Treatment of Superficial Femoral-popliteal Artery Disease

Objectives To determine the effect of intravenous ultrasound (IVUS) when used adjunctively with nitinol interwoven bare metal stents in the management of femoropopliteal lesions. Background Nitinol interwoven bare metal stents represent an advancement in stent technology; however nominal deployment remains an area of focus. Intravascular Ultrasound (IVUS) has been shown to improve outcomes in both the coronary and peripheral vasculature by providing the operator with greater vessel detail. The use of adjunctive IVUS with Nitinol bare metal stents has not been widely studied. Methods This study included a cohort of 200 consecutive patients with peripheral artery disease. All patients were treated with ≥1 Supera bare metal stent, and 91 received adjunctive IVUS imaging prior to stent deployment. Deployment conditions of nominal, compressed, and elongated were measured and the primary clinical outcomes included target lesion reintervention, major and minor, below the knee amputation, and mortality. Results The patients who received IVUS had a significantly greater number of nominally deployed stents (p<0.001). Patients who had IVUS imaging also had significantly lower reintervention rates compared to those who did not receive IVUS imaging (p=0.047). Conclusion IVUS and angiography decreases clinically driven target lesion reintervention and increases nominal deployment compared to angiography alone in femoropopliteal lesions treated with interwoven bare metal nitinol stents. Condensed Abstract This retrospective study was done to examine the utility of intravenous ultrasound when used adjunctively for visualization in the management of femoropopliteal lesions in peripheral artery disease patients. There was total of 200 subjects and all were treated using the Supera nitinol self-expanding stent. By the end of the study, the group of subjects treated with intravenous ultrasound had significantly fewer reinterventions and had a greater rate of nominally deployed stents. These findings suggest the beneficial role intravenous ultrasound has compared to angiography alone in the management of femoropopliteal lesions with Supera stents.