Short Spot Versus Long Lesion Stenting as Best Treatment for Extensive Occlusive SFA Disease

Short Spot Versus Long Lesion Stenting as Best Treatment for Extensive Occlusive SFA Disease; a Pilot Study

Since the length of lesion seems to be negatively associated with stent patency due to restenosis, it is thought that the efficacy of treatment in patients with multiple (> 1) short (focal; > 1 and < 5 cm) SFA lesions can be improved by spot stenting as compared to the use of one long stent. This study proposes to evaluate the endovascular treatment for patients with SFA lesions by comparing two strategies for patients with extensive occlusive SFA disease; 1) short spot (SS) stenting or 2) long lesion (LL) stenting.

Inclusion Criteria:

• PAOD (ABI <0.90 and/or a decline of >0.15 after exercise test), Rutherford category 2, 3 or 4
• Multiple (>1) short (focal; >1 and < 5 cm) significant stenoses (≥ 50%) and/or occlusions in the superficial femoral artery
• Eligible for endovascular treatment via short spot stenting and via long lesion stenting according to international guidelines
• Unilateral occlusive disease
• Age ≥ 18

Exclusion Criteria:

• Patients with PAOD Rutherford category 5 and 6
• Impaired inflow due to significant lesions in the arteries proximal to the SFA intended to treat
• Bilateral lesions with treatment indication
• Contra-indication for anticoagulant therapy
• Renal insufficiency (MDRD < 50 ml/min)
• Life expectancy < 6 months
• Known contrast allergy
• Pregnancy
• Unable to complete a questionnaire in the home language