SUPERA Stenting in the Common Femoral Artery: Extended Early Experience and Practical Considerations

Endovascular management of de novo common femoral artery (CFA) disease remains controversial. Considerable interest has been generated in recent years since the Endovascular Versus Open Repair of the Common Femoral Artery (TECCO) trial and due to advancements in vascular stent designs. In particular, SUPERA (Abbot Vascular Inc, Santa Clara USA) stents are designed to offer increased flexibility and less adverse interactions with the arterial wall thus making it potentially better suited for CFA lesions. However, despite such theoretical benefits, there is lack of data in its use in clinical practice. This study provides illustrative examples of SUPERA stents in different clinical settings and contributes to important clinical data for the overall efficacy and safety profile of endovascular interventions in CFA disease.

Materials and Methods:

Retrospective analysis of all endovascular CFA procedures between January 1, 2011 and December 31, 2019. Eligible patients were identified using the Vascular Quality Initiative database, a clinical registry which prospectively collects data from patients treated by vascular specialists in hospitals across North America. Data collected included demographics, clinical symptoms, medical comorbidities, procedural details, and complications. Detailed sub-analysis was performed on the stenting cohort.

Results:

During our study period, 69 patients underwent CFA endovascular interventions of which 16 patients had stenting procedures for a total of 18 stent insertions. Technical success was achieved in 98.6% of cases and 100% success was achieved in stenting procedures. Ankle-brachial index increased to 0.78 from 0.59 (p< 0.001) post-intervention. A total of 15 SUPERA stents were placed in 13 patients. Overall primary patency rate defined as lack of re-stenosis or re-intervention of SUPERA stents was 100% in patients who had a follow-up assessment at 12 months (n=12 stents) and 24 months (n=6 stents). Five patients deceased between the 12 and 24 month interval. No stent fractures were observed up to 24 months.

Conclusion:

Endovascular CFA intervention is an evolving topic in the vascular and interventional radiology community. Newer generation of devices such as SUPERA stents offer potential benefits given its inherent design. Despite the theoretically promising design of the SUPERA, there is a lack of data to support its use in CFA lesions. This study contributes important patient level data for SUPERA stents in the CFA.