Results:

In the majority (78%) of cases, stents were used in conjunction with their specific, corresponding US Food and Drug Administration–approved EPD. The Xact/Emboshield (n = 3,507, 28.9%) was most commonly used, followed by Precise/Angioguard (n = 2,696, 22.2%) and the Acculink/Accunet (n = 2,617, 21.6%) stent/EPD combination. The Protégé/SpiderFx (ev3 Endovascular Inc., Plymouth, MN) (n = 453, 3.7%) and Wallstent/Filterwire (Boston Scientific, Natick, MA) (n = 213, 1.8%) were infrequently used. There was a borderline difference in the primary endpoint of death/stroke in patients treated with the Precise/Angioguard system compared with the Acculink/Accunet (2.5% vs. 1.8%; p = 0.058) and similar results when compared with the Xact/Emboshield (2.5% vs. 1.9%; p = 0.14). In adjusted analyses, there was no significant difference between Precise/Angioguard and Accunet/Acculink (odds ratio [OR], 1.48; 95% confidence interval [CI], 0.89-2.47; p = 0.065), Precise/Angioguard and Xact/Emboshield (OR, 1.16; 95% CI, 0.77-1.76; p = 0.38), and Xact/Emboshield and Accunet/Acculink (OR, 1.28; 95% CI, 0.82-1.97; p = 0.18). The Precise/Angioguard system was associated with a significantly higher rate of stroke compared with the Xact/Emboshield system (2.3% vs. 1.7%; p = 0.02) and with a trend toward a higher stroke rate than the Accunet/Acculink system (2.3% vs. 1.6%; p = 0.06). There was no difference in the stroke rate between the Accunet/Acculink and Xact/Emboshield systems (1.6% vs. 1.7%; p = 0.84).