title: Impact of post-procedural intravascular ultrasound findings on long-term results following self-expanding nitinol stenting in superficial femoral artery lesions.
abstract: BACKGROUND
  Previous intravascular ultrasound (IVUS) studies have reported that a tiny reference cross-sectional area (CSA), stent under-expansion, stent asymmetry, stent edge dissection, and tissue protrusion are associated with target lesion revascularization (TLR) after coronary intervention. In the lower limb, however, it has not been reported that these findings correlate with TLR after endovascular therapy (EVT).
  
  
  RESULTS
  A total of 236 consecutive superficial femoral artery (SFA) lesions in patients who underwent IVUS after self-expanding nitinol stent implantation, were analyzed. Stent expansion ratio was calculated as minimum stent CSA/reference lumen CSA, radial stent symmetry index as minimum/maximum stent diameter, and axial stent symmetry index as minimum/maximum stent CSA. TLR was defined as clinically driven revascularization with ≥75% restenosis of the target lesion. The mean follow-up period was 34±15 months. TLR were performed in 42 lesions (17.8%). There were no significant differences in stent expansion ratio, stent symmetry indices, and tissue protrusion between the TLR and no-TLR groups. Multivariate analysis indicated that total stent length (odds ratio [OR], 1.004; P<0.05), distal reference CSA (OR, 0.91; P<0.01), and stent edge dissection (OR, 3.51; P<0.01) were independent predictors of TLR.
  
  
  CONCLUSIONS
  Stent implantation in tiny vessels and stent edge dissection in SFA lesions are indicators of high risk of TLR. Post-procedural stent under-expansion and stent asymmetry, however, were not associated with TLR.
authors.affiliation: Cardiovascular Division, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Kojiro
authors.initials: K
authors.lastname: Miki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Fujii
authors.forename: Masashi
authors.initials: M
authors.lastname: Fukunaga
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shibuya
authors.forename: Takahiro
authors.initials: T
authors.lastname: Imanaka
authors.forename: Hiroto
authors.initials: H
authors.lastname: Tamaru
authors.forename: Motomaru
authors.initials: M
authors.lastname: Masutani
authors.forename: Mitsumasa
authors.initials: M
authors.lastname: Ohyanagi
authors.forename: Tohru
authors.initials: T
authors.lastname: Masuyama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure / Q000009:adverse effects*; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects*; D018084:Ultrasonography, Interventional
chemical_list: D000497:Alloys; C013616:nitinol