Abstract 17276: Impact of Runoff on Endovascular Treatment for Femoropopliteal Lesions
PURPOSE: To investigate the impact of runoff on endovascular treatment for femoropopliteal lesions.
METHODS: From January 2003 to January 2012, 859 consecutive patients (1084 limbs ; mean age 73 years ; 68% male) who underwent endovascular treatment for femoropopliteal de novo lesions were retrospectively selected and analyzed. We imitated Thrombolysis in Myocardial Infarction flow grade and classified postoperative runoff into the category 0 to 3. Restenosis was defined as >2.4 of peak systolic velocity ratio by duplex or >50% stenosis by angiogram. Primary patency was defined as treated vessels without restenosis and repeat revascularization. Secondary patency was defined as target vessels that become totally occluded and are reopened by repeat revascularization. We investigated the impact of runoff on primary and secondary patency.
RESULTS: Mean lesion length was 91±85mm. 50.9% patients were underwent stenting. A quarter (25%) of the patients had critical limb ischemia. At 3 years, vessels with poor runoff had significant worse cumulative primary patency (36±7%, 52±4%, 54±3%, 61%±4% for category 0, 1, 2 ,3, respectively, log-rank test p=0.0002) and secondary patency (73±7%, 85±3%, 88±2%, 88%±2%, respectively, log-rank test p=0.0199). The relative risk of primary patency associated with runoff category 0 was 1.77 (95% CI 1.19-2.57; p=0.0055), 1.81 (1.22-2.61; p=0.0038), 2.46 (1.62-3.67; p<0.0001) for category 1, 2, 3, respectively. Adjustment for gender, diabetes, Rutherford classification, and Trans-Atlantic Inter-Society Consensus type did not significantly change the relative risk (2.10 [1.37-3.11], p=0.0009, 1.70[1.12-2.50], p=0.0145, 2.13[1.36-3.26], p=0.0012, for category 1, 2, 3, respectively).
CONCLUSION: In patients who are treated for femoropopliteal lesions, runoff is very important to obtain good patency. These findings suggest that to prevent poor runoff and additional treatment for poor runoff are crucial.
- © 2012 by American Heart Association, Inc.