Comparative 2-year outcomes of the Misago stent versus other self-expandable nitinol stents for the endovascular treatment of aortoiliac disease

J Cardiovasc Surg (Torino). 2023 Aug;64(4):422-429. doi: 10.23736/S0021-9509.23.12500-6. Epub 2023 Mar 10.

Abstract

Background: The Misago iliac stent has not been compared with other stents. This study aimed to evaluate the 2-year clinical outcomes between the Misago stent and other self-expandable nitinol stents for symptomatic chronic aortoiliac disease.

Methods: This retrospective, single-center observational study enrolled 138 patients (180 limbs; Rutherford classification, between categories 2 and 6) treated with a Misago stent (N.=41) or self-expandable nitinol stent (N.=97) between January 2019 and December 2019. The primary endpoint was patency for up to 2 years. The secondary endpoints were technical success, procedure-related complications, freedom from target lesion revascularization, overall survival, and freedom from major adverse limb events. Multivariate Cox proportional hazards analysis was used to investigate predictors of restenosis.

Results: The mean follow-up duration was 710±201 days. The 2-year primary patency rate was comparable between the groups (Misago, 89.6% and self-expandable nitinol stent, 91.0%, P=0.883). The technical success rate was 100% in both groups, and procedure-related complications were equivalent between the groups (1.7% and 2.4%, respectively; P=0.773). Freedom from target lesion revascularization was not significantly different between the groups (97.6% and 94.4%, respectively; P=0.890). The overall survival rate and freedom from major adverse limb events were not significantly different between the groups (77.2% and 70.8%, respectively, P=0.209; 66.9% and 58.4%, respectively, P=0.149). Statin therapy was positively associated with primary patency.

Conclusions: The Misago stent for aortoiliac lesions demonstrated comparable and acceptable clinical results of safety and efficacy for up to 2 years compared with other self-expandable stents. Statin use predicted the prevention of patency loss.

Publication types

  • Observational Study

MeSH terms

  • Alloys
  • Atherosclerosis*
  • Femoral Artery
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors*
  • Peripheral Arterial Disease* / therapy
  • Popliteal Artery
  • Prosthesis Design
  • Retrospective Studies
  • Stents
  • Time Factors
  • Treatment Outcome
  • Vascular Patency

Substances

  • nitinol
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Alloys