title: Timing of the restenosis following nitinol stenting in the superficial femoral artery and the factors associated with early and late restenoses.
abstract: OBJECTIVE
  We sought to investigate the timing of restenosis and the restenosis factors following nitinol stenting in the superficial femoral artery (SFA).
  
  
  BACKGROUND
  Restenosis following nitinol stenting in the SFA remains unsolved.
  
  
  METHODS
  We analyzed 742 limbs in consecutive 585 patients who underwent successful endovascular therapy for de novo SFA lesions. Patency was assessed by duplex ultrasonography. Primary patency was defined as treated vessels without restenosis and secondary patency was defined as target vessels reopened by repeat revascularization. Receiver-operating characteristic (ROC) analysis was performed to delineate the timing of restenosis. Patients were subsequently classified into three groups: no restenosis, early restenosis, and late restenosis. Cox proportional hazard regression analyses were performed to explore the determinants of restenosis in each restenosis group.
  
  
  RESULTS
  Primary and secondary patency was 67 and 86% at 6 years, respectively. ROC curves indicated the 369th day was the best cutoff point distinguishing the early (144 limbs) and the late (42 limbs) restenoses. Sustained patency was observed in 556 limbs. After multivariate analysis, cilostazol (P = 0.0007) was negatively associated; female gender (P = 0.0071), diabetes mellitus (P = 0.0428), critical limb ischemia (P = 0.0435), and stent fracture (P = 0.0004) were positively associated with the early restenosis. Trans Atlantic Inter-Society Consensus II C/D was positively associated with both the early (P = 0.0017) and the late (P = 0.0359) restenoses.
  
  
  CONCLUSIONS
  Restenosis predominantly occurred within a year following nitinol stenting in the SFA, and the factors associated with the early restenosis were different from those with the late restenosis.
authors.affiliation: Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan. iida.osa@gmail.com
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hirano
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Naoto
authors.initials: N
authors.lastname: Inoue
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Seiki
authors.initials: S
authors.lastname: Nagata
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D016009:Chi-Square Distribution; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D014654:Vascular Patency
chemical_list: D000497:Alloys; C013616:nitinol