title: Long-Term Outcomes of Self-Expandable Nitinol Stent Implantation With Intraluminal Angioplasty to Treat Chronic Total Occlusion in the Superficial Femoral Artery (TransAtlantic Inter-Society Consensus Type D Lesions).
abstract: OBJECTIVE
  To evaluate the long-term outcomes of self-expandable nitinol stent implantation with intraluminal angioplasty for chronic total occlusion (CTO) in the superficial femoral artery (SFA) of patients with TransAtlantic Inter-Society Consensus (TASC) D lesions.
  
  
  METHODS
  From 2004 to 2011, self-expandable nitinol stent implantation in SFA was performed successfully in 72 consecutive limbs of 68 patients with TASC D lesions. These patients were assessed for an average of 38.8 ± 25.6 months. The procedure was performed using a 0.014" or 0.018" guidewire and intraluminal angioplasty.
  
  
  RESULTS
  Patients with hemodialysis constituted 20.6% of cases. The mean occlusion length was 244.6 ± 34.1 mm. A bidirectional approach was performed in 69.4% of cases. Primary patency rates were 77.9%, 71.9%, 67.2%, and 51.5% at 1 year, 2 years, 3 years, and 5 years, respectively. Secondary patency rates were 88.6%, 78.7%, 71.1%, and 56.0% at 1 year, 2 years, 3 years, and 5 years, respectively. Cox regression multivariate analysis for hemodialysis pertaining to loss of primary and secondary patency resulted in hazard ratio = 2.555 (95% confidence interval, 1.108-5.891; P=.03) for loss of primary patency and hazard ratio = 3.615 (95% confidence interval, 1.380-9.471; P=.01) for loss of secondary patency.
  
  
  CONCLUSIONS
  Long-term patency of self-expandable nitinol intraluminal stent implantation with intraluminal angioplasty to treat CTO (TASC D) in SFA is promising. Hemodialysis was the only independent predictor for loss of primary and secondary patency.
authors: Department of Cardiology, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa 247-0072, Japan. mjunya2318@gmail.com.
authors: Junya
authors: J
authors: Matsumi
authors: Tomoki
authors: T
authors: Ochiai
authors: Kazuki
authors: K
authors: Tobita
authors: Koki
authors: K
authors: Shishido
authors: Kazuya
authors: K
authors: Sugitatsu
authors: Shingo
authors: S
authors: Mizuno
authors: Futoshi
authors: F
authors: Yamanaka
authors: Masato
authors: M
authors: Murakami
authors: Yutaka
authors: Y
authors: Tanaka
authors: Saeko
authors: S
authors: Takahashi
authors: Takeshi
authors: T
authors: Akasaka
authors: Shigeru
authors: S
authors: Saito
mesh_terms: D000368:Aged; D000497:Alloys; D000792:Angiography; D000800:Angioplasty, Balloon / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery*; D002908:Chronic Disease; D032921:Consensus; D057510:Endovascular Procedures / Q000379:methods*; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D011474:Prosthesis Design; D012189:Retrospective Studies; D000069322:Self Expandable Metallic Stents; D013997:Time Factors
chemical_list: D000497:Alloys; C013616:nitinol