title: Efficacy of treatment of edge stenosis of endografts inserted for superficial femoral artery stenotic disease.
abstract: OBJECTIVE
  The role of endografts in the treatment of extensive superficial femoral artery (SFA) occlusive disease is enlarging. Results are limited by the occurrence of edge stenosis. The aim of the study was to retrospectively evaluate the efficacy of treatment of edge stenosis of endografts inserted for SFA occlusive disease.
  
  
  METHODS
  All patients, treated between November 2001 and December 2011, with a self-expandable polytetrafluoroethylene-endograft were gathered in a prospective database in three hospitals. The incidence of primary edge stenosis and the incidence of re-edge stenosis after treatment were retrospectively noted and a comparison was made between the results of percutaneous transluminal angioplasty (PTA) and extension of the endograft.
  
  
  RESULTS
  A total of 88 patients presented with 115 edge stenoses, of which the majority presented within 1 year after insertion of the endograft (mean time to edge stenosis 10.7 ± 8.2 months). Seventy-three stenoses (63%) manifested at the proximal and 42 at the distal edge (37%). The 1-year incidence of restenosis and/or occlusion was 45% after PTA and 43% after endograft extension, with 1-year patency rates of 81% and 92%, respectively. The incidence of restenosis/occlusion after treatment with PTA was 12% higher at two years compared to extension of the endograft (55% vs. 43%, respectively).
  
  
  CONCLUSIONS
  Edge stenosis may well be treated with either PTA or extension of the endograft. The incidence of restenosis and/or occlusion after both PTA and extension is high, but patency rates are acceptable. Aggressive surveillance is needed during the first year after insertion.
authors.affiliation: Department of Surgery, Rijnstate Hospital Arnhem, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Bahar
authors.initials: B
authors.lastname: Golchehr
authors.affiliation: Department of Surgery, Rijnstate Hospital Arnhem, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Holewijn
authors.affiliation: Department of Surgery, Isala Clinics Zwolle, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Rombout R
authors.initials: RR
authors.lastname: Kruse
authors.affiliation: Department of Surgery, Antonius Hospital Sneek, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Laurens A
authors.initials: LA
authors.lastname: van Walraven
authors.affiliation: Division of Vascular Surgery, Department of Surgery, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Clark J
authors.initials: CJ
authors.lastname: Zeebregts
authors.affiliation: Department of Surgery, Rijnstate Hospital Arnhem, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
authors.forename: Michel M P J
authors.initials: MM
authors.lastname: Reijnen
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000601:surgery*; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011138:Polytetrafluoroethylene; D011474:Prosthesis Design; D012008:Recurrence; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D014654:Vascular Patency
chemical_list: D011138:Polytetrafluoroethylene
keywords: Viabahn; covered stent; edge stenosis; endograft; endoluminal bypass; occlusive disease; superficial femoral artery