Outcomes of covered stents versus bare-metal stents for subclavian artery occlusive disease

OBJECTIVE: To compare the clinical efficacy of covered stents and bare-metal stents in the endovascular treatment of subclavian artery occlusive disease. METHODS: Between January 2014 and December 2020, 161 patients (112 males) underwent stenting of left subclavian arteries; CSs were implanted in 55 patients (34.2%) and BMSs in 106 (65.8%). Thirty-day outcomes, mid-term patency, and follow-up results were analyzed with Kaplan-Meier curves. Relevant clinical, anatomical, and procedural factors were evaluated for their association with patency in the two groups using Cox proportional hazards regression. RESULTS: Mean follow-up was 45 ± 18 months. The primary patency was 93.8% (95% CI, 81.9%–98.0%) in the covered stent group and 73.7% (95% CI, 63.2%–81.6%; P = 0.010) in the bare-metal stent group. The primary patency in the total occlusion subcategory was significant in favor of CS (93.3%, 95% CI, 61.26%–99.0%) compared with BMS (42.3%, 95% CI, 22.9%–60.5%; P = 0.005). Cox proportional hazards regression indicated that the use of BMSs [hazard ratio (HR), 4.90; 95% CI, 1.47–16.31; P = 0.010] and total occlusive lesions (HR, 7.03; 95% CI, 3.02–16.34; P < 0.001) were negative predictors of patency, and the vessel diameter (HR, 3.17; 95% CI, 1.04–9.71; P = 0.043)) was a positive predictor of patency. CONCLUSION: Compared with bare stents, covered stents have a higher midterm primary patency in the treatment of subclavian artery occlusive disease.