title: Shared and differential factors influencing restenosis following endovascular therapy between TASC (Trans-Atlantic Inter-Society Consensus) II class A to C and D lesions in the femoropopliteal artery.
abstract: OBJECTIVE
  This study sought to investigate factors associated with restenosis after endovascular therapy comparing TASC (Trans-Atlantic Inter-Society Consensus) II classes A to C with class D femoropopliteal (FP) lesions.
  
  
  BACKGROUND
  It is unclear whether the determinants of restenosis for TASC II class D lesions are the same as those for TASC II classes A to C FP lesions.
  
  
  METHODS
  We studied 2,400 limbs from 1,889 consecutive patients (73 ± 17 years of age; 31% women; 30% critical limb ischemia) who underwent successful endovascular therapy for de novo FP lesions. Predictors for restenosis in TASC II classes A to C and class D lesions were assessed using a Cox proportional hazards model.
  
  
  RESULTS
  The 5-year primary patency rate was 50% in TASC II classes A to C and 34% in TASC II class D lesions, respectively (p < 0.001). Overall, restenosis had a significant interaction with sex and renal failure (both p < 0.01). Female sex was a significant risk factor for restenosis in TASC II class D lesions (adjusted hazard ratio [HR]: 1.80, p < 0.001) but not TASC II classes A to C lesions (adjusted HR: 1.10, p = 0.352). Conversely, renal insufficiency was a significant risk factor for restenosis in TASC II classes A to C lesions (adjusted HR: 1.43, p < 0.001) but not TASC II class D lesions (adjusted HR: 0.79, p = 0.129). Diabetes mellitus, no stent use, chronic total occlusion, and poor below-the-knee runoff were shared risk factors for restenosis between TASC II classes A to C and class D lesions (all p < 0.05).
  
  
  CONCLUSIONS
  For de novo FP lesions, diabetes, no stent use, chronic total occlusion, and poor below-the-knee runoff were shared restenosis predictors for TASC II classes A to C and class D lesions, whereas renal failure was a predictor for TASC II classes A to C lesions and female sex for TASC II class D lesions.
authors: Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan. Electronic address: iida.osa@gmail.com.
authors: Osamu
authors: O
authors: Iida
authors: Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Mitsuyoshi
authors: M
authors: Takahara
authors: Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
authors: Yoshimitsu
authors: Y
authors: Soga
authors: Department of Cardiology, Sendai Kosei Hospital, Sendai, Japan.
authors: Kenji
authors: K
authors: Suzuki
authors: Department of Cardiology, Yokohama-city Eastern Hospital, Yokohama, Japan.
authors: Keisuke
authors: K
authors: Hirano
authors: Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan.
authors: Daizo
authors: D
authors: Kawasaki
authors: Department of Cardiology, Shin-Koga Hospital, Kurume, Japan.
authors: Yoshiaki
authors: Y
authors: Shintani
authors: Department of Cardiology, Fukuoka Red Cross Hospital, Fukuoka, Japan.
authors: Nobuhiro
authors: N
authors: Suematsu
authors: Department of Vascular Surgeon, Matsuyama Red Cross Hospital, Matsuyama, Japan.
authors: Terutoshi
authors: T
authors: Yamaoka
authors: Department of Advanced Cardiovascular Therapeutics, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Shinsuke
authors: S
authors: Nanto
authors: Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
authors: Masaaki
authors: M
authors: Uematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects* / Q000295:instrumentation; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000145:classification / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000503:physiopathology; D016016:Proportional Hazards Models; D012008:Recurrence; D012039:Regional Blood Flow; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: Trans-Atlantic Inter-Society Consensus (TASC); endovascular therapy; femoropopliteal lesions; nitinol stent; restenosis