Abstract 11418: Clinical Predictors of Endovascular Therapy for Small Vessels of Femoropopliteal Lesion
Purpose: The outcome of EVT for small vessels of femoropopliteal (FP) lesion is not good. However, little is known about the predictors of clinical outcome.
Methods: REAL-FP is retrospective multicenter analysis of EVT for FP lesions at 13 Japanese medical centers from January 2004 to December 2011. 2742 patients, 3471 limbs were registered. We defined small vessel as less than 4 mm in diameter and excluded vessels over 4mm. Finally, we analyzed 463 patients, 530 limbs and investigated the predictors of primary patency of EVT for small vessels.
Results: The mean follow interval was 27 ± 21 months. Mean age was 71.5 ± 9.5 years and 58% was male. Mean lesion length 104.9 ± 83.1mm and the rate of stent use was 46%. In univariate analysis, age (HR 1.02 [95%CI:1.00-1.03]), female (1.37[1.06-1.76]), diabetes (1.32[1.01-1.75]), CLI (1.34[1.03-1.74]), TASCII classification (2.47[1.91-3.19]), stent use (1.77[1.37-2.28]), total stent length (1.00[1.00-1.01]), cilostazole (0.65 [0.49-0.85]), vessel diameter (0.68[0.51-0.93]) were significant risk factors. After adjustment for age, female, diabetes, CLI, TASCII classification, stent use, cilostazole, and vessel diameter, age (HR 1.01[95% CI:1.00-1.03]), TASCII classification (2.00[1.50-2.67]), stent use (1.39[1.05-1.85]) and cilostazole (0.69[0.52-0.90]) were still significant risk factors. We assigned one point to age (>70 years), TASCII classification, stent use and cilostazole, and calculated total mark (maximum 4, minimum 0. However, there was no 0 point case.). We took those initials and named it CAST score. At 2 years, primary patency rate of CAST score 4 group was significant lower than other groups (67%, 54%, 40%, and 17% for score 1, 2, 3, 4, respectively, log-rank p<.0001).
Conclusions: Cilostazole, age, stent use and TASCII classification were independent predictors of primary patency. And CAST score is the useful tool that we can predict primary patency of EVT for small vessels of FP lesion.
- © 2013 by American Heart Association, Inc.