Midterm Results of the Supera Stent for the Treatment of Femoropopliteal Occlusive Disease


      The Supera (Abbott Vascular, Santa Clara, CA) stent is an interwoven nitinol, shape-memory stent with high strength and flexibility characteristics which are purported to increase resistance to kinking and compression. The purpose of this study was to review single-center outcomes of the use of this stent in the femoropopliteal segment.


      We performed a single-center, retrospective analysis of patients who underwent Supera stent placement for femoropopliteal occlusive disease from 2016–2019. Data was collected on patient demographics and procedural details. Follow-up imaging data, including duplex imaging and ankle-brachial indices, and clinical data were abstracted from encounter notes.


      Sixty-two patients with 72 unique Supera stent placements were identified. Mean age was 76 and 69% were male. 56% of patients had severe calcification and 11% had moderate calcification. 48% of lesions were Trans-Atlantic Inter-Society Consensus Document C or D lesions. Primary patency rates at 12, 24, and 36 months were 85%, 82%, and 75%, respectively. Primary patency was not affected significantly by lesion length, degree of calcification, number of outflow vessels, concomitant interventions, or stent size.


      These results demonstrate sustained primary patency with the Supera stent over a 3-year interval in treatment of patients with femoropopliteal occlusive disease, including in the setting of severely calcified vessels.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Annals of Vascular Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Goodney P.P.
        • Beck A.W.
        • Nagle J.
        • et al.
        National trends in lower extremity bypass surgery, endovascular interventions, and major amputations.
        J Vasc Surg. 2009; 50: 54-60
        • Pacha H.M.
        • Al-khadra Y.
        • Darmoch F.
        • et al.
        In-hospital outcomes and trends of endovascular intervention vs surgical revascularization in octogenarians with peripheral artery disease.
        Am J Cardiol. 2021; 145: 143-150
        • Schillinger M.
        • Sabeti S.
        • Dick P.
        • et al.
        Sustained benefit at 2 years of primary femoropopliteal stenting compared with balloon angioplasty with optional stenting.
        Circulation. 2007; 115: 2745-2749
        • Duda S.H.
        • Bosiers M.
        • Lammer J.
        • et al.
        Drug-eluting and bare nitinol stents for the treatment of atherosclerotic lesions in the superficial femoral artery: long-term results from the SIROCCO trial.
        J Endovasc Ther. 2006; 13: 701-710
      1. Sidawy A.N. Perler B.A. Rutherford’s vascular surgery and endovascular therapy. 9th ed. Elsevier, Philadelphia, PA2019
        • Laird J.R.
        Limitations of percutaneous transluminal angioplasty and stenting for the treatment of disease of the superficial femoral and popliteal arteries.
        J Endovasc Ther. 2006; 13: II30-II40
        • Rosenfield K.
        • Schainfeld R.
        • Pieczek A.
        • et al.
        Restenosis of endovascular stents from stent compression.
        J Am Coll Cardiol. 1997; 29: 328-338
        • Bosiers M.
        • Torsello G.
        • Gißler H.-M.
        • et al.
        Nitinol stent implantation in long superficial femoral artery lesions: 12-month results of the DURABILITY I study.
        J Endovasc Ther. 2009; 16: 261-269
        • Scheinert D.
        • Scheinert S.
        • Sax J.
        • et al.
        Prevalence and clinical impact of stent fractures after femoropopliteal stenting.
        J Am Coll Cardiol. 2005; 45: 312-315
        • Bosiers M.
        • Deloose K.
        • Callaert J.
        • et al.
        Results of the Protégé EverFlex 200-mm-long nitinol stent (ev3) in TASC C and D femoropopliteal lesions.
        J Vasc Surg. 2011; 54: 1042-1050
        • Davaine J.-M.
        • Azéma L.
        • Guyomarch B.
        • et al.
        One-year clinical outcome after primary stenting for Trans-Atlantic Inter-Society Consensus (TASC) C and D femoropopliteal lesions (The STELLA “STEnting Long de L’Artère fémorale superficielle” Cohort).
        Eur J Vasc Endovasc Surg. 2012; 44: 432-441
        • Scheinert D.
        • Grummt L.
        • Piorkowski M.
        • et al.
        A novel self-expanding interwoven nitinol stent for complex femoropopliteal lesions: 24-month results of the SUPERA SFA registry.
        J Endovasc Ther. 2011; 18: 745-752
        • George J.C.
        • Rosen E.S.
        • Nachtigall J.
        • et al.
        SUPERA interwoven nitinol stent outcomes in above-knee IntErventions (SAKE) study.
        J Vasc Interv Radiol. 2014; 25: 954-961
        • Brescia A.A.
        • Wickers B.M.
        • Correa J.C.
        • et al.
        Stenting of femoropopliteal lesions using interwoven nitinol stents.
        J Vasc Surg. 2015; 61: 1472-1478
        • Garcia L.
        • Jaff M.R.
        • Metzger C.
        • et al.
        Wire-interwoven nitinol stent outcome in the superficial femoral and proximal popliteal arteries.
        Circ Cardiovasc Interv. 2015; 8: e000937
        • Montero-Baker M.
        • Ziomek G.J.
        • Leon L.
        • et al.
        Analysis of endovascular therapy for femoropopliteal disease with the Supera stent.
        J Vasc Surg. 2016; 64: 1002-1008
        • Palena L.M.
        • Diaz-Sandoval L.J.
        • Sultato E.
        • et al.
        Feasibility and 1-year outcomes of subintimal revascularization with supera® stenting of long femoropopliteal occlusions in critical limb ischemia.
        Catheter Cardiovasc Interv. 2017; 89: 910-920
        • San Norberto E.M.
        • Flota C.M.
        • Fidalgo-Domingos L.
        • et al.
        Real-world results of supera stent implantation for popliteal artery atherosclerotic lesions: 3-year outcome.
        Ann Vasc Surg. 2020; 62: 397-405
        • Schillinger M.
        • Sabeti S.
        • Loewe C.
        • et al.
        Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery.
        N Engl J Med. 2006; 354: 1879-1888
      2. LifeStent FlexStar and FlexStar XL. Summary of Safety and Effectiveness Data (SSED). 40.

        • Krankenberg H.
        • Schlüter M.
        • Steinkamp H.J.
        • et al.
        Nitinol stent implantation versus percutaneous transluminal angioplasty in superficial femoral artery lesions up to 10 cm in length.
        Circulation. 2007; 116: 285-292
        • Lee B.C.
        • Kim H.O.
        • Kim J.K.
        • et al.
        Endovascular removal of a detached supera stent delivery catheter tip in a patient with heavily calcified vessels associated with peripheral artery disease.
        Ann Vasc Surg. 2020; 67: 566.e1-566.e4
        • Kim H.-T.
        • Cho J.-H.
        • Lee J.-H.
        • et al.
        Early Supera stent fracture in the femoropopliteal artery.
        Cardiovasc J Afr. 2020; 31: e1-e3
        • Nakama T.
        • Obunai K.
        • Muraishi M.
        • et al.
        Angioscopy findings on 15-month follow-up for interwoven nitinol stent invagination in the femoropopliteal artery.
        JACC Cardiovasc Interv. 2020; 13: 1958-1959
        • Chan Y.C.
        • Cheng S.W.
        • Ting A.C.
        • et al.
        Primary stenting of femoropopliteal atherosclerotic lesions using new helical interwoven nitinol stents.
        J Vasc Surg. 2014; 59: 384-391
        • Dumantepe M.
        • Seren M.
        • Fazlıogullari O.
        • et al.
        Treatment of complex atherosclerotic femoropopliteal artery disease with a self-expanding interwoven nitinol stent: midterm results.
        Vascular. 2021; 29: 711-719
        • Park S.H.
        • Rha S.W.
        • Choi C.U.
        • et al.
        Efficacy of two different self-expanding nitinol stents for atherosclerotic femoropopliteal arterial disease (SENS-FP trial): study protocol for a randomized controlled trial.
        Trials. 2014; 15: 355
        • Bhatt H.
        • Kovach R.
        • Janzer S.
        • et al.
        SUPERA stent outcomes in above-the-knee IntervEntions: effects of COMPression and ELongation (SAKE-COMPEL) sub-study.
        Cardiovasc Revasc Med. 2018; 19: 512-515
        • Garcia L.A.
        • Rosenfield K.R.
        • Metzger C.D.
        • et al.
        SUPERB final 3-year outcomes using interwoven nitinol biomimetic supera stent.
        Catheter Cardiovasc Interv. 2017; 89: 1259-1267