Drug-Eluting Stent and Drug-Coated Balloon Compared to Full-Covered Drug-Eluting Stent for Femoropopliteal Lesions: CENTAUR Study.

BACKGROUND: Several studies have documented positive clinical outcomes associated with drug-containing devices, such as drug-eluting stents (DES) and drug-coated balloons (DCB), for femoropopliteal artery (FPA) lesions. Endovascular therapy (EVT) using drug-containing devices is the primary strategy, even for complex FP lesions. However, little is known about the clinical outcomes of the hybrid of DES and DCB therapies.

AIMS: To compare the efficacy of hybrid therapy with that of a full-covered DES for FPA lesions in a real-world setting.

METHODS: This retrospective multi-center study enrolled 2105 consecutive patients (2173 de novo FPA lesions) who underwent EVT between 2018 and 2021. Among these, 99 FPA lesions treated with hybrid therapy and 369 FPA lesions treated with a full-covered DES were analyzed. Propensity score matching was performed to compare clinical outcomes between hybrid and full-covered DES groups, resulting in the analysis of 79 matched pairs. The primary outcome was patency at 1 year, with target lesion revascularization (TLR) also evaluated.

RESULTS: Primary patency and freedom from TLR at 1 year were comparable between the groups (hybrid vs. full-covered DES: 79.6% vs. 88.3%, p = 0.23; and 86.9% vs. 93.6%, respectively; p = 0.21). However, interaction analysis revealed that full-covered DES provided significantly higher primary patency than hybrid therapy in FPA lesions without popliteal artery involvement (interaction p = 0.049).

CONCLUSIONS: Hybrid therapy achieved an acceptable clinical outcome for complex FPA lesions compared with full-covered DES in a real-world setting.