title: Angiographic restenosis and its clinical impact after infrapopliteal angioplasty.
abstract: OBJECTIVE
  To assess 3- and 12-month angiographic restenosis rates and their clinical impact after infrapopliteal angioplasty.
  
  
  METHODS
  Prospective multicenter study.
  
  
  METHODS
  We analyzed 68 critical ischemic limbs (tissue loss: 58 limbs) from 63 consecutive patients due to isolated infrapopliteal lesions who underwent angioplasty alone. Primary endpoint was 3-month angiographic restenosis rate; secondary endpoints were 12-month angiographic restenosis rate, and 3- and 12-month rates of mortality, major amputation and reintervention. Three- and 12-month frequency of ambulatory status and of freedom from ischemic symptoms, and time to wound healing in the ischemic wound group, were compared between restenotic and non-restenotic groups. Angiographic restenosis predictors were assessed by multivariable analysis.
  
  
  RESULTS
  95% of cases had 3-month angiography; restenosis rate was 73%: 40% restenosis and 33% re-occlusion. Twelve-month follow-up angiography was conducted for the patients without 3-month angiographic restenosis, and restenosis rate at 12 months was 82%. Non-administration of cilostazol and statin, and chronic total occlusion were 3-month angiographic restenosis predictors. Three- and 12-month mortality was 5% and 12%, respectively. Despite no patients having undergone amputation, 15% had persistent ischemic symptoms, and 48% of limbs underwent reintervention within 12 months. During the same study period, ambulatory status and limbs with complete healing were more frequently observed in the non-restenosis group than in the restenosis group. In the tissue loss group, time to wound healing in the restenosis group was longer than in the non-restenosis group (127 days vs. 66 days, p = 0.02).
  
  
  CONCLUSIONS
  The extremely high angiographic restenosis rate after infrapopliteal angioplasty may adversely impact clinical status improvement.
authors.affiliation: Kansai Rosai Hospital Cardiovascular Center, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan. iida.osa@gmail.com
authors.forename: O
authors.initials: O
authors.lastname: Iida
authors.forename: Y
authors.initials: Y
authors.lastname: Soga
authors.forename: D
authors.initials: D
authors.lastname: Kawasaki
authors.forename: K
authors.initials: K
authors.lastname: Hirano
authors.forename: T
authors.initials: T
authors.lastname: Yamaoka
authors.forename: K
authors.initials: K
authors.lastname: Suzuki
authors.forename: Y
authors.initials: Y
authors.lastname: Miyashita
authors.forename: H
authors.initials: H
authors.lastname: Yokoi
authors.forename: M
authors.initials: M
authors.lastname: Takahara
authors.forename: M
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D000368:Aged; D000671:Amputation, Surgical / Q000706:statistics & numerical data; D000792:Angiography; D017130:Angioplasty / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D015994:Incidence; D007511:Ischemia / Q000000981:diagnostic imaging / Q000601:surgery; D007564:Japan / Q000453:epidemiology; D007866:Leg / Q000098:blood supply; D008297:Male; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D011379:Prognosis; D011446:Prospective Studies; D011475:Prosthesis Failure; D012086:Reoperation / Q000706:statistics & numerical data; D015996:Survival Rate; D013997:Time Factors