title: Predictors of primary patency failure in Wallstent self-expanding endovascular prostheses for iliofemoral occlusive disease.
abstract: We studied the factors that affected the primary patency and the clinical and procedural success of WALLSTENTS (stents) that were used at our institution from 1 March 1994 to 30 October 1995 for the treatment of iliac and femoral artery occlusive disease. This prospective study comprised 63 patients with 82 lesions. Follow-up was performed for a mean duration of 18.7 months. Pre- and post-procedural duplex ultrasonography, together with estimation of ankle-brachial index scores, was performed on all patients, and additional studies were performed at clinical follow-up if indicated. The technical success rate was 100%. Ankle-brachial index scores improved considerably from 0.52 +/- 0.21 before the procedure to 0.73 +/- 0.27 after the procedure. The significant predictors by univariate analysis of primary patency failure were: Fontaine class III or IV (P = 0.044); femoral location (P = 0.004); lesion length > 100 mm (P = 0.010); poor or moderate outflow (P = 0.026); and number of stents > or = 3 (P = 0.012). Cox regression analysis showed that > or = 3 stents (risk ratio = 5.61), poor or moderate outflow (risk ratio = 6.05), and femoral location (risk ratio = 5.18) were the significant predictors of primary patency failure. Femoral lesions required more stents than did iliac lesions (2.2 +/- 0.8 vs 1.3 +/- 0.5). Primary patency rates for iliac and femoral stents were 86% and 49%, respectively, at 12 months, and 82% and 41% at 24 months.
authors.affiliation: Department of Cardiology, Texas Heart Institute, Houston 77030, USA.
authors.forename: S
authors.initials: S
authors.lastname: Damaraju
authors.forename: L
authors.initials: L
authors.lastname: Cuasay
authors.forename: D
authors.initials: D
authors.lastname: Le
authors.forename: N
authors.initials: N
authors.lastname: Strickman
authors.forename: Z
authors.initials: Z
authors.lastname: Krajcer
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000628:therapy*; D004868:Equipment Failure; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D007511:Ischemia / Q000000981:diagnostic imaging / Q000628:therapy; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency / Q000502:physiology*