Angioplasty and elective stenting of de novo versus recurrent femoropopliteal lesions: 1-year follow-up.
OBJECTIVE
To investigate patency rates after percutaneous transluminal angioplasty (PTA) and PTA plus elective stenting in de novo versus recurrent femoropopliteal lesions.


METHODS
The data were collected from a prospective registry including 533 consecutive patients (284 men; median age 71 years, interquartile range [IQR] 72-78) with severe claudication (n=387) or critical limb ischemia (n=146) who underwent femoropopliteal percutaneous interventions during a 36-month period. PTA was used to treat 357 de novo and 99 recurrent lesions; PTA plus elective stent implantation was performed in 58 de novo and 19 recurrent lesions. Patients were followed for a median 12 months (IQR 7-14) using color duplex sonography. Rates of restenosis (>/=50%) were compared by multivariate analysis.


RESULTS
Overall primary technical success was achieved in 517 (97%) patients; 31 (6%) periprocedural complications were encountered. Restenosis occurred in 213 (40%) patients after a median 6 months (IQR 4-7). Twelve-month patency after PTA was 61% in de novo and 33% in recurrent lesions (p<0.0001). Patients with recurrent lesions had a 2.3-fold increased adjusted risk for restenosis after PTA (95% confidence interval 1.7 to 3.2). Twelve-month patency after stenting was 58% in de novo and 52% in recurrent lesions (p=0.9). In patients with de novo lesions, patency rates after PTA and stent were similar (p=0.8); however, in patients with recurrent lesions, elective stenting performed better (p=0.05).


CONCLUSIONS
Recurrent stenosis after prior femoropopliteal balloon angioplasty is an independent risk factor for restenosis; these lesions exhibit disappointing patency after repeated PTA. Stent implantation may improve intermediate-term results in these patients.
Schillinger
Martin
M
Department of Angiology, University of Vienna, Medical School, Vienna, Austria. martin.schillinger@akh-wien.ac.at
Mlekusch
Wolfgang
W
Haumer
Markus
M
Sabeti
Schila
S
Ahmadi
Ramazanali
R
Minar
Erich
E
D000368:Aged; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D019917:Blood Vessel Prosthesis Implantation; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000601:surgery*; D012008:Recurrence; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome