Treatment of Superficial Femoral Artery Restenosis

Andrew J. Miller, Edwin A. Takahashi, William S. Harmsen, Kristin C. Mara, Sanjay Misra

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Purpose To determine the predictors of restenosis, major adverse limb events (MALEs), postoperative death (POD), and all-cause mortality after repeat endovascular treatment of superficial femoral artery (SFA) restenosis. Materials and Methods This was a retrospective review of 440 patients with 518 SFA lesions who were treated between January 2002 and October 2011. Ninety-six limbs were treated for restenosis with bare metal stents (BMSs) or percutaneous transluminal angioplasty (PTA), of which 28 limbs developed another restenosis requiring a third procedure. The interaction measured in this study was between the second and third intervention. Predictors of SFA patency, MALEs, POD, and all-cause mortality after SFA restenosis treatment were identified. Results Patients who were treated with BMSs (n = 51) had similar rates of restenosis compared with patients who were treated with PTA (n = 45) (hazard ratio [HR] 1.40; 95% confidence interval [CI] 0.68–2.90; P =.37). Patients in the BMS group who took statins had a significantly lower risk of restenosis than patients who did not take statins (HR 0.13; 95% CI 0.04–0.41; P <.001). Stage 4–5 chronic kidney disease (CKD) (n = 12) was associated with a significantly higher risk of MALE + POD (HR 6.17; 95% CI 1.45–26.18; P =.014) and all-cause mortality (HR 2.83; 95% CI 1.27–6.33; P =.01). Clopidogrel was protective against all-cause mortality (HR 0.41; 95% CI 0.20–0.80; P =.01). Conclusions Patients in the BMS group who took statins at the time of intervention had a significantly lower risk of developing restenosis. Stage 4–5 CKD was a risk factor for MALE + POD and all-cause mortality, while clopidogrel decreased all-cause mortality risk.

Original languageEnglish (US)
Pages (from-to)1681-1686
Number of pages6
JournalJournal of Vascular and Interventional Radiology
Volume28
Issue number12
DOIs
StatePublished - Dec 2017

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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