title: Efficacy of intravascular ultrasound in femoropopliteal stenting for peripheral artery disease with TASC II class A to C lesions.
abstract: OBJECTIVE
  To investigate whether use of intravascular ultrasound (IVUS) improves primary patency following nitinol stenting for TASC II (TransAtlantic Inter-Society Consensus) A-C femoropopliteal lesions.
  
  
  METHODS
  Using a retrospective multicenter database of 1198 limbs from 965 patients (695 men; mean age 72±9 years) with TASC II A-C lesions (28% critical limb ischemia) treated by provisional stenting from April 2004 to December 2011, primary patency rate was compared between 234 propensity score-matched pairs with vs. without IVUS use.
  
  
  RESULTS
  IVUS was used in 22% (n=268) of the overall population. It was more likely to be used in cases with generally more complicated femoropopliteal lesions (e.g., more severe TASC II class, longer lesion length, and narrower reference diameter). Analysis of the 234 propensity score-matched pairs (mean follow-up 1.9±1.5 years; 142 events) revealed higher 5-year primary patency with than without IVUS use (65%±6% vs. 35%±6%, p<0.001). IVUS resulted in significantly better assisted primary patency (p<0.001), secondary patency (p=0.004), freedom from any reintervention (p<0.001), freedom from any adverse limb event (p<0.001), and event-free survival (p<0.001).
  
  
  CONCLUSIONS
  IVUS use in femoropopliteal stenting for TASC II A-C lesions appears to be associated with higher primary patency rate.
authors.affiliation: 1 Department of Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Iida
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Takahara
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Soga
authors.forename: Kenji
authors.initials: K
authors.lastname: Suzuki
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hirano
authors.forename: Daizo
authors.initials: D
authors.lastname: Kawasaki
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Shintani
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Suematsu
authors.forename: Terutoshi
authors.initials: T
authors.lastname: Yamaoka
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000497:Alloys; D003251:Constriction, Pathologic; D016208:Databases, Factual; D018572:Disease-Free Survival; 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; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D057216:Propensity Score; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency
chemical_list: D000497:Alloys; C013616:nitinol
keywords: balloon angioplasty; femoropopliteal segment; intravascular ultrasound; occlusion; patency; peripheral artery disease; popliteal artery; restenosis; stenosis; stent; superficial femoral artery