title: Early results with LifeStent implantation in RESILIENT and non-RESILIENT inclusion criteria patients.
abstract: The purpose of our study was to determine outcomes of patients receiving the LifeStent (Bard Peripheral Vascular, Tempe, AZ) for femoropopliteal peripheral arterial disease in real-world academic practice outside the limitations of an industry supported trial. All patients from 2009 to 2012 at our institution who received a LifeStent during endovascular interventions and had follow-up were included. Outcomes evaluated included patency and freedom from limb loss. A total of 166 limbs in 151 patients had the LifeStent implanted in de novo vessels (54% male; 68 ± 12 years). Eighty-percent of limbs did not meet RESILIENT criteria due to Rutherford category >3 (51%), TransAtlantic Inter-Society Consensus II classifications C/ D (51%), zero runoff vessels (6%), or stent location (17%). Primary patency rates were 81% at 6 months and 58% at 12 months with predictors for primary patency loss at 1 year including Rutherford category >3 (HR: 1.8 (95% CI: 1.0-3.1), p = 0.04), tobacco use (HR: 1.8 (95% CI: 1.0-3.3), p = 0.04), and no clopidogrel at discharge (HR: 3.2 (95% CI: 1.6-6.7), p < 0.01). A preintervention Rutherford category >3 predicted 24-month limb loss (HR, 16.0 (95% CI: 2.0-122.0), p < 0.01). The LifeStent is a viable option regardless of the TransAtlantic Inter-Society Consensus II classification; however, critical limb ischemia, current tobacco use, and absence of clopidogrel on discharge predict decreased patency on follow-up.
authors.affiliation: Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, USA pstone0627@yahoo.com.
authors.forename: Patrick A
authors.initials: PA
authors.lastname: Stone
authors.affiliation: Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, USA.
authors.forename: John E
authors.initials: JE
authors.lastname: Campbell
authors.affiliation: Charleston Area Medical Center, Charleston, USA.
authors.forename: Rashi
authors.initials: R
authors.lastname: Fischer
authors.affiliation: Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, USA.
authors.forename: David
authors.initials: D
authors.lastname: Phang
authors.affiliation: Charleston Area Medical Center, Charleston, USA.
authors.forename: Stephanie N
authors.initials: SN
authors.lastname: Thompson
authors.affiliation: Charleston Area Medical Center, Charleston, USA.
authors.forename: Neil
authors.initials: N
authors.lastname: Dippel
authors.affiliation: Department of Surgery, Robert C. Byrd Health Sciences Center, West Virginia University, Charleston, USA.
authors.forename: Albeir
authors.initials: A
authors.lastname: Mousa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000379:methods; D057510:Endovascular Procedures; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000188:drug therapy / Q000601:surgery*; D011150:Popliteal Artery / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology*
keywords: Peripheral artery disease; angioplasty; stent; superficial femoral artery and popliteal artery