CC BY-NC-ND 4.0 · The Arab Journal of Interventional Radiology 2018; 02(03): S4
DOI: 10.1055/s-0041-1730655

Long-Term Primary Patency Rate After Nitinol Self-Expandable Stents Implantation in Long Totally Occluded Femoropopliteal (TASC II C and D) Lesions (Retrospective Study)

Mahmoud Farouk Elmahdy
Cairo University, Cairo, Egypt
› Author Affiliations

Background: Endovascular therapy for long femoropopliteal lesions using percutaneous transluminal balloon angioplasty or first-generation of peripheral stents was associated with unacceptable 1-year restenosis rates. However, with recent advances in equipment and techniques, a better primary patency rate is expected. Hence, this study was conducted to detect the long-term primary patency rate of nitinol self-expandable stents implanted in long totally occluded femoropopliteal lesions (TASC II type C and D) and determine the predictors of reocclusion or restenosis in the stented segments. Methods: The demographics, clinical, anatomical, and procedural data of 213 patients with 240 de novo totally occluded femoropopliteal (TASC II type C and D) lesions treated with nitinol self-expandable stents were retrospectively analyzed. Of these limbs; 159 (66.2%) presented with intermittent claudication, whereas 81 (33.8%) presented by critical limb ischemia. The mean time of follow-up was 36 ± 22.6 months (range: 6.3–106.2 months). Outcomes evaluated were primary patency rate and predictors of reocclusion or restenosis in the stented segments. Results: The mean age of the patients was 70.9 ± 9.3 years, with male gender 66.2%. Mean preprocedural ankle-brachial index was 0.45 ± 0.53. One hundred and seventy-five (73%) lesions were TASC II type C, whereas 65 (27%) were type D lesions. The mean length of the lesions was 17.9 ± 11.3 mm. Procedure-related complications occurred in 10 (4.1%) limbs. There was no periprocedural mortality. Reocclusion and restenosis were detected during follow-up in 45 and 30 limbs, respectively, and all were retreated by endovascular approach. None of the patients required major amputation. Primary patency rates were 81.4% ± 1.1%, 77.7% ± 1.9%, and 74.4% ± 2.8% at 12, 24, and 36 months, respectively. Male gender, severe calcification, and TASC II D lesion were independent predictors for reocclusion, while predictors of restenosis were DM, smoking, and TASC IID lesions. Conclusion: Treatment of long totally occluded femoropopliteal (TASC II C and D) lesions with nitinol self-expandable stents is safe and is associated with highly acceptable long-term primary patency rates.

Publication History

Article published online:
11 May 2021

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