title: Long-term outcomes of SMART stent implantation in patients with femoro-popliteal disease.
abstract: OBJECTIVE
  This study aimed to determine the long-term outcomes of SMART stent implantation for femoro-popliteal (FP) lesions.
  
  
  BACKGROUND
  The long-term results of SMART stent implantation for FP lesions remained unknown.
  
  
  METHODS
  We studied 319 limbs in 269 patients (mean age: 73.2 ± 7.7 years) who underwent SMART stent implantation for FP lesions (mean treated-lesion length: 118.5 ± 81.0 mm) from 2004 to 2014, retrospectively. These patients were followed-up for a mean of 52.8 ± 33.8 months (median: 51.0 months). Kaplan-Meier and log-rank analyses were used to determine time to event. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated through univariate and multivariate Cox proportional hazard analyses to estimate predictors of primary patency loss.
  
  
  RESULTS
  Overall, 37.3% of lesions were TransAtlantic Inter-Society Consensus (TASC) IIC/D lesions, and 41.1% exhibited chronic total occlusion. Post-procedural primary patency rates were 87.7%, 79.4%, 68.1%, 53.7%, and 50.3%, at 1, 3, 5, 7, and 10 years, respectively; the corresponding secondary patency rates were 96.5%, 91.7%, 85.0%, 73.8%, and 67.7%, respectively. TASC IIA/B lesions had considerably better primary patency rates than C/D lesions at all time points. Multivariate analysis indicated that lesion length (with >200 mm vs. <100 mm) significantly promoted primary patency loss (HR, 2.555; 95% CI, 1.429-4.568; P = 0.002), as well as hemodialysis (HR, 1.881; 95% CI, 1.208-2.928; P = 0.005).
  
  
  CONCLUSIONS
  Although SMART stent implantation produced favorable long-term results, TASC IIC/D FP lesions had poor outcomes. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Junya
authors.initials: J
authors.lastname: Matsumi
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Tobita
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Shishido
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Futoshi
authors.initials: F
authors.lastname: Yamanaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Murakami
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Saeko
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Akasaka
authors.affiliation: Department of Cardiology and Catheterization, Laboratory and Cardiovascular R&D Center, Shonan Kamakura General Hospital, Kamakura, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011150:Popliteal Artery; D011474:Prosthesis Design; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: femoro-politeal; long-term outcomes; nitinol stent