Performance of stenting in femoropopliteal disease: a systematic literature review and meta-analysis of proportions
Publication: Journal of Comparative Effectiveness Research
Abstract
Aim: To evaluate the performance of four stent types (BMS, bare metal stents; Eluvia, a polymer-based paclitaxel-eluting stent; Viabahn, a covered stent; and Zilver PTX, a polymer-free paclitaxel-coated stent) in femoropopliteal lesions at 12 and 24 months using a meta-analysis of proportions. Materials & methods: This systematic review (PROSPERO CRD42024528559) used PubMed to identify relevant single-arm and comparative studies (with ≥50 patients/study) published between 1 January 2009 and 1 July 2024. Data on patient/lesion characteristics and outcomes were extracted. Subgroup analyses were based on lesion length (<150 mm vs ≥150 mm) and study quality. A random-intercept logistic regression model was used to pool the data. The 95% CI around the pooled effect was calculated using Knapp–Hartung adjustments. Results: Data were extracted from 141 of the 870 screened studies, corresponding to 35,897 patients. The mean patient age was 70.9 (range: 63.3–80.0) years; 69.6% were male. The overall mean lesion length was 153.1 (range: 37–330) mm. Although all stent types performed well in the main analysis, Eluvia exhibited consistently high primary patency and low target lesion revascularization rates at both timepoints and across lesion lengths. Mortality rates for all stent types were stable for short lesions but more variable for long lesions. Conclusion: All stents used in short lesions performed well; however, Eluvia also demonstrated reliable performance in long lesions.
Plain language summary: How well do stents work for blocked arteries between the hip & the knee: an overview of published evidence
What is this article about?
Stenting is one of the treatments available for narrowed or blocked leg arteries. This study focused on four different stent types that are used in the artery that runs between the hip and the knee. We reviewed the available scientific literature on these stents and then combined the results from different studies to find out how often stenting is successful at keeping the artery open for 1 year and for 2 years. We also looked at the success of stents used in long or short sections of closed off artery.
What were the results?
We combined the results from 141 studies that looked at 35,897 patients overall. The average performance and a range where 95% of the results would fall (the 95% CI) was calculated. Although all stents performed well, one stent infused with a drug had a range that did not overlap with the other stents, this could mean that this stent has a better performance.
Why is this important?
The results of this analysis provide a summary of the performance of the different stent types which can help physicians understand the options available to them.
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References
Papers of special note have been highlighted as: • of interest
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Received: 19 September 2025
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Performance of stenting in femoropopliteal disease: a systematic literature review and meta-analysis of proportions. (2026) Journal of Comparative Effectiveness Research. DOI: 10.57264/cer-2025-0152
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