Limitations of percutaneous transluminal angioplasty with stenting for femoropopliteal arterial occlusive disease.
OBJECTIVE
To review the results of intravascular stents used to treat superficial femoral artery (SFA) occlusive disease and to assist in patient selection for this procedure.


RESULTS
We evaluated 55 patients who underwent balloon angioplasty and stenting of SFA long-segment disease and compared the results with those in the current literature. In our patient group, the SFA mean lesion length was 16.5 cm with the resting ankle-brachial index of 0.48 +/- 0.19. Hemodynamic improvement to an ABI of 0.71 +/- 0.23 (P = .001) and clinical benefit (56%) were maintained at 13.8 months. Primary and secondary patency rates were 22% and 46%, respectively, at 12 months. The literature reports patency rates of 29% to 81% primarily and 43% to 96% secondarily. However, the mean lesion length in these reports varied from 3.7 cm to 13.5 cm, and most of these patients had claudication (50% to 92%). Other variable factors determining long-term success may include the number and type of stent, artery occlusion versus stenoses, presence of diabetes mellitus, and smoking status.


CONCLUSIONS
Stenting of short-segment SFA disease remains patent more frequently than for long-segment disease, and may be applicable in patients with disabling claudication or critical limb ischemia. Surgical revascularization is preferred for long-segment disease, with stenting reserved for patients with limb-threatening ischemia and no surgical alternative.
Gray
B H
BH
Department of Vascular Medicine, Cleveland Clinic Foundation, OH 44195, USA.
Olin
J W
JW
D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D018579:Patient Selection; D016491:Peripheral Vascular Diseases / Q000601:surgery; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency