title: Comparable 2-Year Restenosis Rates Following Subintimal and Intraluminal Drug-Eluting Stent Implantation for Femoropopliteal Chronic Total Occlusion.
abstract: To report midterm outcomes after subintimal vs intraluminal drug-eluting stent (DES) implantation for femoropopliteal (FP) chronic total occlusion (CTO).
  
  
  
  This subanalysis of the prospective, multicenter ZEPHYR study (ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy) included 176 patients (mean age 74±8 years; 130 men) with 192 de novo FP CTOs that were evaluated by intravascular ultrasound after successful guidewire crossing. The primary outcome was the 2-year restenosis rate after subintimal (n=73) or intraluminal (n=119) DES implantation. Propensity score matching extracted 61 matched pairs (mean age 75 years; 49 men) for patency analysis to minimize baseline intergroup differences. Restenosis rates are reported with the 95% confidence interval (CI).
  
  
  
  The 1-year restenosis rates in the groups with subintimal and intraluminal DES implantation were 45% (95% CI 32% to 59%) and 35% (95% CI 22% to 49%), respectively (p=0.352), whereas the corresponding rates at 2 years were not significantly different (p=0.648) at 56% (95% CI 41% to 71%) and 51% (95% CI 34% to 68%). Baseline characteristics had no significant interaction effect on the association of subintimal angioplasty with restenosis risk.
  
  
  
  In FP CTO, 2-year restenosis rates were comparable after subintimal or intraluminal DES implantation.
authors: Kansai Rosai Hospital Cardiovascular Center, Hyogo, Japan.
authors: Takayuki
authors: T
authors: Ishihara
authors: Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.|Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Mitsuyoshi
authors: M
authors: Takahara
authors: Kansai Rosai Hospital Cardiovascular Center, Hyogo, Japan iida.osa@gmail.com.
authors: Osamu
authors: O
authors: Iida
authors: Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan.
authors: Yoshimitsu
authors: Y
authors: Soga
authors: Division of Cardiology, Saiseikai Yokohama-City Eastern Hospital, Kanagawa, Japan.
authors: Keisuke
authors: K
authors: Hirano
authors: Cardiovascular Center, Kikuna Memorial Hospital, Kanagawa, Japan.
authors: Yasutaka
authors: Y
authors: Yamauchi
authors: Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Shiga, Japan.
authors: Kan
authors: K
authors: Zen
authors: Cardiovascular Division, Department of Internal Medicine, Morinomiya Hospital, Osaka, Japan.
authors: Daizo
authors: D
authors: Kawasaki
authors: Nishinomiya Municipal Central Hospital, Hyogo, Japan.
authors: Shinsuke
authors: S
authors: Nanto
authors: Cardiovascular Center, Fukuoka Sanno Hospital, Fukuoka, Japan.
authors: Hiroyoshi
authors: H
authors: Yokoi
authors: Kansai Rosai Hospital Cardiovascular Center, Hyogo, Japan.
authors: Masaaki
authors: M
authors: Uematsu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D054855:Drug-Eluting Stents; D005263:Femoral Artery; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000628:therapy*; D011150:Popliteal Artery; D011446:Prospective Studies; D011474:Prosthesis Design; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: angioplasty; chronic total occlusion; drug-eluting stent; endovascular therapy; femoropopliteal segment; popliteal artery; recanalization; restenosis; subintimal angioplasty; superficial femoral artery