title: Femoropopliteal Artery Stent Thrombosis: Report From the Excellence in Peripheral Artery Disease Registry.
abstract: BACKGROUND
  There are limited data on femoropopliteal artery stent thrombosis (ST), which is a serious adverse outcome of peripheral artery interventions.
  
  
  RESULTS
  Index procedures resulting in femoropopliteal ST were compared with stent procedures without subsequent ST in the Excellence in Peripheral Artery Disease registry. The study data had a total of 724 cases of stent procedures and 604 unique patients. Femoropopliteal ST occurred in 26 of 604 patients (4.3%) over a median follow-up of 6 months post procedure. ST was more likely to occur in men (96.3% versus 82.2%; P=0.026) and to have an initial intervention for chronic total occlusions (88.5% versus 64.0%; P=0.01). There was no significant difference in ST between drug-coated and bare-metal stents (4.4% versus 3.4%; P=0.55), but the rate of ST was significantly higher with self-expanding covered stent grafts compared with bare-metal stents (10.6% versus 3.4%; P=0.02). ST was significantly associated with an increased risk of 12-month major adverse limb events (hazard ratio, 4.99; 95% confidence interval, 2.31-10.77; P<0.001) compared with no ST. On multivariate analysis, treatment of chronic total occlusion lesions (odds ratio, 3.46; 95% confidence interval, 0.98-12.20; P=0.05) and in-stent restenosis lesions (odds ratio, 5.30; 95% confidence interval, 1.83-15.32; P=0.002) were independently associated with an increased risk of ST.
  
  
  CONCLUSIONS
  In a multicenter peripheral interventional registry, femoropopliteal ST occurred in 4.3% of patients who underwent stent procedures, and it was associated with treatment of chronic total occlusions and in-stent restenosis lesions, and had higher 12-month major adverse limb events.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01904851.
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.). subhash.banerjee@va.gov.
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Karan
authors.initials: K
authors.lastname: Sarode
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Atif
authors.initials: A
authors.lastname: Mohammad
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Osvaldo
authors.initials: O
authors.lastname: Gigliotti
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Mirza S
authors.initials: MS
authors.lastname: Baig
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Shirling
authors.initials: S
authors.lastname: Tsai
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Nicolas W
authors.initials: NW
authors.lastname: Shammas
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Anand
authors.initials: A
authors.lastname: Prasad
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Mazen
authors.initials: M
authors.lastname: Abu-Fadel
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Andrew
authors.initials: A
authors.lastname: Klein
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Ehrin J
authors.initials: EJ
authors.lastname: Armstrong
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Haekyung
authors.initials: H
authors.lastname: Jeon-Slaughter
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
authors.affiliation: From the Veteran Affairs North Texas Healthcare System, Dallas (S.B., K.S., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (S.B., A.M., M.S.B., S.T., H.J.-S., E.S.B.); Seton Medical Center, Austin, TX (O.G.); Midwest Cardiovascular Research Foundation, Davenport, IA (N.W.S.); Department of Medicine, Division of Cardiology, University of Texas Health Science Center, San Antonio (A.P.); Department of Internal Medicine, University of Oklahoma Medical Center (M.A.-F.); John Cochran Veteran Affairs Medical Center, St. Louis, MO (A.K.); Eastern Colorado Veteran Affairs Healthcare System, Denver (E.J.A.); and Brigham and Women's Hospital Heart and Vascular Center, Harvard Medical School, Boston, MA (D.L.B.).
authors.forename: Deepak L
authors.initials: DL
authors.lastname: Bhatt
mesh_terms: D006083:Graft Occlusion, Vascular / Q000453:epidemiology*; D006801:Humans; D007866:Leg / Q000098:blood supply*; D012042:Registries; D014481:United States / Q000453:epidemiology
keywords: confidence intervals; odds ratio; peripheral artery disease; stent; thrombosis
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