Endovascular therapy for popliteal and infrapopliteal artery disease in patients with critical limb ischemia (CLI) remains challenging, given the high risk of adverse events. Favorable results for coronary balloon-expandable drug-eluting stents (DESs) in this arterial district have been reported in selected studies, but uncertainty persists on their risk-benefit balance in real-world patients. We, thus, sought to appraise our outcomes with DES implantation for distal popliteal or infrapopliteal lesions.
Our institutional databases were retrospectively queried to identify patients undergoing DES implantation for distal popliteal or infrapopliteal artery disease. Baseline, lesion, procedural, and outcome data were systematically collected.
A total of 25 patients were treated with coronary DES, 12 (48.0%) for distal popliteal and 13 (52.0%) for infrapopliteal lesions. Four (16.0%) patients received two stents, whereas the others only one. Breakdown of DES was as follows: biolimus-eluting, everolimus-eluting, paclitaxel-eluting, and sirolimus-eluting stents in, respectively, two (8.0%), one (4.0%), one (4.0%), and 21 (84.0%), with an average stent length of 33.6 ± 13.1 mm. Improvement in Fontaine stage was achieved in 23 (92.0%) patients at 1 month and in 22 (88.0%) patients at long-term (28.8 ± 20.6 months). In this highly selected case series, no repeat revascularizations or unplanned amputations were recorded, whereas two (8.0%) patients died, the first 15.5 months and the second 19.5 months after the procedure.
Implantation of coronary balloon-expandable DES appears feasible, safe, and effective in selected patients with focal lesions in the distal popliteal and infrapopliteal arteries.