title: Long-term clinical outcome after endovascular treatment in patients with intermittent claudication due to iliofemoral artery disease.
abstract: BACKGROUND
  The natural history of patients with intermittent claudication (IC) has been reported, but little is known about that of claudicant patients after endovascular therapy (EVT).
  
  
  RESULTS
  A total of 271 consecutive patients (mean age, 68+/-6 years, 82% men) with IC were treated with EVT for a de novo iliofemoral lesion. Primary patency was defined as treated vessel without re-stenosis and repeat revascularization. Major adverse cardiovascular event (MACE) included death, myocardial infarction and stroke. Median follow-up interval was 11.7+/-2.9 years. During the follow-up period, 132 patients died (cardiovascular death; 66%). Major amputation was performed in 4 patients. Primary patency rate was 82%, 79%, and 78% at 5, 10 and 15 years, respectively. Freedom from all-cause death (MACE) was 73% (69%), 58% (49%), and 43% (34%) at 5, 10 and 15 years. On multivariate Cox regression, Trans-Atlantic Inter-society Consensus grade C/D, and involvement of femoropopliteal lesion were independent predictors of primary patency. Independent predictors for overall survival were age, left ventricular dysfunction (ejection fraction <40%), coronary artery disease, diabetes, chronic kidney disease and below-the-knee disease.
  
  
  CONCLUSIONS
  Regardless of good clinical patency of treated vessel in patients with IC, survival was poor. Independent predictors were different between long-term patency and late mortality.
authors.affiliation: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu 802-8555, Japan. sogacchy@yahoo.co.jp
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Tomoko
authors.initials: T
authors.lastname: Urakawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tosaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Iwabuchi
authors.forename: Masakiyo
authors.initials: M
authors.lastname: Nobuyoshi
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease; D057510:Endovascular Procedures; D005263:Femoral Artery / Q000473:pathology*; D006801:Humans; D007383:Intermittent Claudication / Q000209:etiology / Q000401:mortality / Q000628:therapy*; D008875:Middle Aged; D013318:Stroke Volume; D015996:Survival Rate; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000150:complications*; D014654:Vascular Patency