Abstract 4424: Factors Differ Between Early and Late Restenoses Following Nitinol Stent Implantation in the Superficial Femoral Artery
Background: Restenosis following nitinol stent implantation in the superficial femoral artery (SFA) predominantly occurs within a year, but continues to occur with lower rates afterwards. However, factors associated with restenosis remain unclear. We sought to investigate the factors associated with restenosis within a year and beyond in this study.
Methods: We studied 431 limbs in consecutive 309 patients with peripheral artery disease (74±9 years, male 72%, claudicator 70%) who underwent successful endovascular therapy (EVT) for de novo SFA lesions. Nitinol stents (Luminexx in 93 limbs; Smart in 338 limbs) were provisionally deployed from April 2004 to December 2008. We classified the limbs as: early restenosis group = restenosis occurred within a year, 68 limbs; late restensosis group = restensosis occurred beyond a year, 24limbs; no-restenosis group, 339 limbs. Restenosis was detected by duplex ultrasound and stent fracture was identified by X-ray. A multiple logistic analysis was performed to explore the determinants of restensosis in each group.
Results: Average lesion length was 138±92 mm and 43% (185/431) lesions was TASC II C/D. Primary patency was 81, 69, 67% at 1, 3, 5 years, respectively. Stent fracture was observed in 16% (71/431) lesions. A multiple logistic analysis showed use of cilostazol, limb severity and stent fracture were the strong independent factors associated with the early restenosis. Lesion severity (TASC II C/D) was the strongest independent factor associated with late restenosis.
Conclusion: Factors associated with early restenosis differ from those with late restenosis following nitinol stent implantation in the superficial femoral artery.