Treatment of Superficial Femoral Artery Restenosis

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

Research output: Contribution to journalArticle

3 Citations (Scopus)

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)
JournalJournal of Vascular and Interventional Radiology
DOIs
StateAccepted/In press - 2017

Fingerprint

Femoral Artery
Extremities
clopidogrel
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Stents
Confidence Intervals
Mortality
Metals
Cause of Death
Chronic Renal Insufficiency
Angioplasty
Therapeutics

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Treatment of Superficial Femoral Artery Restenosis. / Miller, Andrew J.; Takahashi, Edwin A.; Harmsen, William S.; Mara, Kristin C.; Misra, Sanjay.

In: Journal of Vascular and Interventional Radiology, 2017.

Research output: Contribution to journalArticle

Miller, Andrew J. ; Takahashi, Edwin A. ; Harmsen, William S. ; Mara, Kristin C. ; Misra, Sanjay. / Treatment of Superficial Femoral Artery Restenosis. In: Journal of Vascular and Interventional Radiology. 2017.
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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.",
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N2 - 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.

AB - 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.

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