Carotid intima-media thickness, carotid wall shear stress and restenosis after femoro-popliteal percutaneous transluminal angioplasty (PTA).
OBJECTIVE
To determine the relationship between carotid intima-media thickness (IMT), carotid wall shear stress (WSS) and restenosis after femoro-popliteal percutaneous transluminal angioplasty (PTA).


METHODS
Thirty-one subjects (18 men, 13 women, median age 69 years) treated with femoro-popliteal PTA for symptomatic peripheral arterial occlusive disease were enrolled. On admission, IMT, internal diameter and blood velocity of the common carotid artery (CCA) were assessed by high-resolution ultrasonography. Blood viscosity was measured and carotid WSS was calculated. Patients were followed up for 6 months for the occurrence of significant restenosis (>50%) as documented by duplex ultrasonography. Two patients were lost to follow-up.


RESULTS
Fourteen patients (48%) developed restenosis at 6 months. IMT and WSS were not different in patients without and with restenosis (IMT: 0.90 (0.85-0.97) vs. 0.89 (0.84-0.93) mm, p = 0.51; WSS: 14.1 (11.9-19.2) vs. 15.9 (12.8-21.5) dyne/cm2, p = 0.48). The hazard ratio of incident restenosis as estimated by Cox regression analysis was 0.04 for IMT (p = 0.23; 95% CI 0.0001-8.22) and 1.07 for WSS (p = 0.10; 95% CI 0.98-1.17).


CONCLUSIONS
In this pilot study involving a limited number of patients, carotid IMT and carotid WSS are not significantly related to restenosis at 6 months after femoro-popliteal PTA. This might be the result of different underlying pathophysiology for atherosclerosis and restenosis.
van der Loo
B
B
Division of Angiology, Department of Medicine, University Hospital Zurich, Zurich, Switzerland.
Krieger
E
E
Katavic
J
J
Spring
S
S
Rousson
V
V
Amann-Vesti
B
B
Koppensteiner
R
R
D000368:Aged; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D017536:Carotid Artery, Common / Q000473:pathology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010976:Platelet Count; D011150:Popliteal Artery; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*; D018616:Ultrasonography, Doppler, Duplex