title: Intravascular ultrasound measurements after drug-eluting stent placement in femoropopliteal lesions: determining predictors of restenosis.
abstract: OBJECTIVE
  To investigate the relationship between postprocedure intravascular ultrasound (IVUS) findings and restenosis after placement of drug-eluting stents (DES) for femoropopliteal lesions.
  
  
  METHODS
  Between July 2012 and May 2013, DES were placed in 64 patients with 88 de novo femoropopliteal lesions. In 40 patients (mean age 74.2±9.4 years; 27 men), DES were placed in 50 lesions under IVUS guidance, and restenosis was monitored for 1 year. All patients were symptomatic (Rutherford 2-6), and 17 patients (43%) suffered from critical limb ischemia. IVUS findings after stenting were compared for patients with vs without restenosis, which was defined as a peak systolic velocity ratio >2.4 on duplex ultrasonography or >50% diameter stenosis on angiography.
  
  
  RESULTS
  Ten patients (14 lesions) developed restenosis, while 30 patients (36 lesions) did not. There were no significant differences in the frequency of diabetes or dialysis between the 2 groups. Female patients were predominant in the restenosis group (p<0.003). There were no significant differences of the percentage of TransAtlantic Inter-Society Consensus C/D lesions or stent edge dissection. Multivariate analysis indicated that cilostazol use [odds ratio (OR) 0.13; p=0.046], distal lumen cross-sectional area (CSA) (OR 0.86; p=0.035), and axial symmetry index (OR 0.60; p=0.045) were independent predictors of restenosis. Using receiver operator characteristic analysis, the best cutoff values of the distal lumen CSA and axial symmetry index for predicting restenosis were 17.1 cm(2) and 0.6, respectively.
  
  
  CONCLUSIONS
  IVUS guidance of DES placement in femoropopliteal lesions can offer useful predictors of restenosis at 1 year. The utility of distal lumen CSA and the axial symmetry index in the prediction of restenosis after femoropopliteal DES placement should be confirmed in a larger cohort.
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan hello_morisun@yahoo.co.jp.
authors: Shinsuke
authors: S
authors: Mori
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Keisuke
authors: K
authors: Hirano
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Masatsugu
authors: M
authors: Nakano
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Toshiya
authors: T
authors: Muramatsu
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Reiko
authors: R
authors: Tsukahara
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Yoshiaki
authors: Y
authors: Ito
authors: Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama City, Japan.
authors: Hiroshi
authors: H
authors: Ishimori
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D019540:Area Under Curve; D001783:Blood Flow Velocity; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003251:Constriction, Pathologic; D016638:Critical Illness; D054855:Drug-Eluting Stents; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007511:Ischemia / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D007564:Japan; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D017239:Paclitaxel / Q000008:administration & dosage*; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000000981:diagnostic imaging* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D012372:ROC Curve; D011859:Radiography; D012008:Recurrence; D012039:Regional Blood Flow; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018616:Ultrasonography, Doppler, Duplex; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D017239:Paclitaxel
keywords: drug-eluting stent; endovascular therapy; intravascular ultrasound; restenosis; stenosis; superficial femoral artery