Abstract 13911: Predictors of Restenosis Differ From Subacute to Chronic Phases Following Nitinol Stenting in the Femoropopliteal Artery
Background: Restenosis following endovascular therapy (EVT) by nitinol stenting in the femoropopliteal artery (FPA) lesions remains a clinical challenge. Predictors of restenosis from subacute to chronic phases are unclear.
Methods: We performed a retrospective analysis using a multicenter database of 3,471 limbs in 2,737 consecutive patients (age: 72 ± 9 years; 69% male) who underwent EVT for FPA lesions between 2004 and 2011. Outcome measures were primary patency (Kaplan-Meier estimated) and predictors of restenosis (Cox hazard regression model) at different times after EVT with provisional stenting. Restenosis was evaluated by duplex ultrasonography (peak systolic velocity ratio >2.4), or angiography (>50%). Restenosis timing was defined as the subacute phase (<91days), the mid phase (91-365 days) and the chronic phase (>365 days).
Results: Sixty-one percent (n = 2117) of patients had diabetes mellitus and 26% (n = 902) were on regular dialysis. Thirty percent (n = 1041) of limbs were classified as critical limb ischemia. Restenosis was observed in 1047 limbs during a mean follow-up period of 27 ± 22 months. At 12, 24, and 36 months, overall primary patency rate was 78%, 68%, and 61%, respectively. Critical limb ischemia and stent used were the predictors of restenosis in the subacute phase, whereas male gender, diabetes, dialysis, TASC C/D lesions, and cilostazol administration were the predictors of restenosis in the later phases (Table).
Conclusion: Predictors of restenosis following nitinol stenting for FPA lesions differed from subacute to chronic phases. Mechanisms of the restenosis may vary depending on the phases after EVT.
- © 2013 by American Heart Association, Inc.