Transluminal stenting for femoropopliteal occlusive disease: analysis of restenosis by serial arteriography.
Our objective was to evaluate restenosis after stenting of femoropopliteal occlusions and the impact of percutaneous transluminal angioplasty (PTA) on recurrent stenosis. We used a retrospective analysis of contrast angiograms obtained during follow-up of stented limbs. Subjects included 27 claudicants (34 limbs) who had complete superficial femoral artery occlusion treated with PTA and Wallstents at the Veterans Adminstration Medical Center. During follow-up, 31 PTAs, three thrombolytic treatments, and one additional stenting were performed. Outcome was measured by contrast angiography. Primary patency at 1 and 3 years was 38% and 8% after stenting, and secondary patency (PTA required at least once in 21/34 limbs) was 89% and 55%, respectively. PTA performed during follow-up reduced within-stent restenosis on average from 48.3 +/- 13.6% to 22.8 +/- 18.0%. Recurrent stenosis after PTA measured 14.9 +/- 10.9 months later was 46.8 +/- 16.7%, showing little permanent impact of PTA on stenosis. Severe within-stent stenosis develops commonly after initial stenting of complete femoropopliteal occlusions. Supplemental PTA performed during follow-up provides immediate improvement in lumen diameter, but severe restenosis is still likely to recur.
Department of Vascular Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA 92868, USA.
Trung D
TD
Bui
Ian L
IL
Gordon
Thang
T
Nguyen
Roy M
RM
Fujitani
Samuel E
SE
Wilson
Robert C
RC
Conroy
D000792:Angiography; D000800:Angioplasty, Balloon; D001157:Arterial Occlusive Diseases / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D005263:Femoral Artery / Q000473:pathology*; D006083:Graft Occlusion, Vascular; D006801:Humans; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000473:pathology / Q000517:prevention & control / Q000628:therapy*; D011150:Popliteal Artery / Q000473:pathology*; D012086:Reoperation; D012189:Retrospective Studies; D055502:Secondary Prevention; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency