Outcomes of covered stents versus bare-metal stents for subclavian artery occlusive disease

Libing Wei; Xixiang Gao; Zhu Tong; Shijun Cui; Lianrui Guo; Yongquan Gu

doi:10.3389/fcvm.2023.1194043

Outcomes of covered stents versus bare-metal stents for subclavian artery occlusive disease

Front Cardiovasc Med. 2023 Jul 7:10:1194043. doi: 10.3389/fcvm.2023.1194043. eCollection 2023.

Authors

Libing Wei^#¹, Xixiang Gao^#¹, Zhu Tong¹, Shijun Cui¹, Lianrui Guo¹, Yongquan Gu¹

Affiliation

¹ Department of Vascular Surgery, Xuanwu Hospital and Institute of Vascular Surgery, Capital Medical University, Beijing, China.

^# Contributed equally.

Abstract

Objective: To compare the clinical efficacy of covered stents and bare-metal stents in the endovascular treatment of subclavian artery occlusive disease.

Methods: Between January 2014 and December 2020, 161 patients (112 males) underwent stenting of left subclavian arteries; CSs were implanted in 55 patients (34.2%) and BMSs in 106 (65.8%). Thirty-day outcomes, mid-term patency, and follow-up results were analyzed with Kaplan-Meier curves. Relevant clinical, anatomical, and procedural factors were evaluated for their association with patency in the two groups using Cox proportional hazards regression.

Results: Mean follow-up was 45 ± 18 months. The primary patency was 93.8% (95% CI, 81.9%-98.0%) in the covered stent group and 73.7% (95% CI, 63.2%-81.6%; P = 0.010) in the bare-metal stent group. The primary patency in the total occlusion subcategory was significant in favor of CS (93.3%, 95% CI, 61.26%-99.0%) compared with BMS (42.3%, 95% CI, 22.9%-60.5%; P = 0.005). Cox proportional hazards regression indicated that the use of BMSs [hazard ratio (HR), 4.90; 95% CI, 1.47-16.31; P = 0.010] and total occlusive lesions (HR, 7.03; 95% CI, 3.02-16.34; P < 0.001) were negative predictors of patency, and the vessel diameter (HR, 3.17; 95% CI, 1.04-9.71; P = 0.043)) was a positive predictor of patency.

Conclusion: Compared with bare stents, covered stents have a higher midterm primary patency in the treatment of subclavian artery occlusive disease.

Keywords: bare-metal stent; covered stent; primary patency; subclavian artery occlusive disease; subclavian steal syndrome.

Grants and funding

This work was supported by the National Key Research and Development Projects of China (2021YFC2500500, 2021YFC2500504) and (2022YFC3602400, 2022YFC3602404).