title: Predictors of medium-term patency in percutaneous endovascular therapy of femoro-popliteal lesions.
abstract: BACKGROUND
  The objective is to study the medium-term results of angioplasty and stenting in the femoro-popliteal sector in patients with critical limb ischemia (CLI), and identify angiographic predictive factors of primary patency.
  
  
  METHODS
  Retrospective review of 98 patients with critical ischemia and angiographic lesions characterized as TASC A=13 (14%), B=38 (40%), C=24 (25%) or D=20 (21%). A total of 106 angioplasties and primary self-expanding stents (mean length of stent coverage of 19cm) were performed between January 2006 and January 2011.
  
  
  RESULTS
  The immediate results of patency, limb salvage and survival were 95, 96 and 96%, respectively. Primary patency at 1 and 2 years was 54 and 38%, respectively. Twenty-seven cases (25%) required endovascular iterative procedures, providing an assisted patency at 1 and 2 years of 72 and 60%, and a secondary patency of 80 and 67%. A lower primary patency was observed (log rank) when stent length was >20cm (P<.001), popliteal artery was invloved (P=.004), and in TASC C and D lesions (P=.04). In multivariate analysis (Cox), only stent length>20cm was an independent negative predictor for primary patency (HR=5.7, P<.001). The limb salvage at 1 and 2 years was 83 and 81%, respectively.
  
  
  CONCLUSIONS
  Angioplasty with stent in the femoro-popliteal sector is a safe technique, but with significantly lower permeability results in injuries that require stent coverage of more than 20cm. In these cases, vein bypass surgery should be the procedure of choice.
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España. Electronic address: avelescu@parcdesalutmar.cat.
authors.forename: Alina
authors.initials: A
authors.lastname: Velescu
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mateos Torres
authors.affiliation: Servicio de Angiología y Cirugía Vascular, Hospital del Mar, Barcelona, España; Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, España.
authors.forename: Albert
authors.initials: A
authors.lastname: Clará Velasco
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D057510:Endovascular Procedures; D005260:Female; D005263:Femoral Artery / Q000502:physiology / Q000601:surgery*; D006801:Humans; D008297:Male; D011150:Popliteal Artery / Q000502:physiology / Q000601:surgery*; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D014654:Vascular Patency
keywords: Angioplastia; Angioplasty; Arteria femoral; Arteria poplítea; Critical limb ischaemia; Femoral artery; Isquemia crítica de extremidades inferiores; Popliteal artery