title: Factors Affecting the Results of Superficial Femoral Artery Stenting.
abstract: BACKGROUND
  The aim of this study was to assess the durability of superficial femoral artery (SFA) stents and factors that affect stent patency.
  
  
  METHODS
  A retrospective assessment of 214 SFA stent procedures between 2003 and 2012 was conducted from a prospectively compiled database. Patency rates and patient outcomes were compiled from case notes and computerized records. Stent patency was confirmed by either duplex scan or clinical examination (palpable distal pulse). Survival and patency were compared across a range of factors using Kaplan-Meier plots and log-rank tests. Factors found to be significant were further assessed by Cox regression models.
  
  
  RESULTS
  Data were analyzed for 214 limbs in 205 patients. Inclusion criteria included those patients who received an SFA stent for treatment of claudication or critical limb ischemia (CLI) with follow-up data. This gave a study group of 151 limbs divided into 76 claudicant and 75 patients with CLI (male-female ratio = 103:48, mean age 71 years, standard deviation 11.7). Seventy-one percent of procedures were elective and 29% were emergency procedures; 53% of procedures were carried out on a day case basis. Median follow-up was 11 months (range 1 day-89 months). Patency was significantly worse for patients with CLI (P = .009), with a 1- and 3-year patency of 63% and 34% compared to 79% and 60% in patients with claudication. Significant factors associated with patency included oral therapy controlled diabetes (P = .003), lesions located in either the mid-SFA (P = .029) or the mid-popliteal (P = .013), and periprocedural complications (P = .005). There was no significant difference in patency rates between insulin-dependent and nondiabetic patients (hazard ratio: 1.0, 95% confidence interval: 0.4-5.6, P = .983). The overall amputation rate for the total study group was 5%. Patients with 1- and 3-year survival were 98% and 96% in the claudication group and 74% and 51%, respectively, in the CLI group.
  
  
  CONCLUSIONS
  SFA stents have superior outcomes in claudicants. Patency is related to severity of disease, diabetes, and location of disease.
authors.affiliation: Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom markuskayus@hotmail.com mark.kay2@uhb.nhs.uk.
authors.forename: Mark
authors.initials: M
authors.lastname: Kay
authors.affiliation: Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: Radu
authors.initials: R
authors.lastname: Rogoveanu
authors.affiliation: Institute of Translational Medicine, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: James
authors.initials: J
authors.lastname: Hodson
authors.affiliation: Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Tallowin
authors.affiliation: Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Hopkins
authors.affiliation: Department of Interventional Radiology, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Duddy
authors.affiliation: Department of Vascular Surgery, University Hospitals Birmingham NHS Foundation Trust, Mindelsohn Way, Birmingham, United Kingdom.
authors.forename: Rajiv
authors.initials: R
authors.lastname: Vohra
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000671:Amputation, Surgical; D016638:Critical Illness; D016208:Databases, Factual; D017558:Elective Surgical Procedures; D004630:Emergencies; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D011859:Radiography; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: popliteal artery; stent; superficial femoral artery