Trends in the utilization of drug-eluting stents to treat femoropopliteal peripheral artery disease

Objective: There is a paucity of data exploring the real-world use of the two drug-eluting stents approved for use in the United States for the treatment of femoropopliteal peripheral artery disease. This study examined the use trends of Eluvia drug-eluting vascular stent and Zilver PTX drug-eluting peripheral stent between 2016 and 2022 using medical claims. Methods: Using the Truveta data platform, patients aged ≥18 years with peripheral artery disease who underwent lower extremity femoropopliteal peripheral artery endovascular revascularization with either Eluvia paclitaxel-eluting stents (introduced in 2018) or Zilver PTX paclitaxel-coated stents were identified between January 1, 2016, and December 31, 2022. The annual use overall by setting (inpatient vs outpatient) and within clinical subgroups were explored. Results: Overall, 710 patients who received paclitaxel-eluting stents and 620 who received paclitaxel-coated stents were identified. The paclitaxel-eluting stent was released during the study period; by the end of the study period, paclitaxel-eluting stents accounted for 82% of the index femoropopliteal peripheral artery procedures. The use of paclitaxel-coated stents decreased from 100% to 18% over the same period. This change occurred among patients with diabetes, chronic limb-threatening ischemia, and chronic kidney disease. There were significant differences in stent use by race and geographic region. Conclusions: The use of paclitaxel-eluting stent for the treatment of femoropopliteal peripheral artery disease in the United States has increased steadily since its introduction in 2018; by 2022, it was used in 82% of femoropopliteal peripheral artery procedures in medical centers using the Truveta platform.