Annals of Vascular Surgery
Volume 20, Issue 2 , Pages 200-208, March 2006

Transluminal Stenting for Femoropopliteal Occlusive Disease: Analysis of Restenosis by Serial Arteriography

  • Trung D. Bui, MD

      Affiliations

    • Department of Vascular Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA
    • Department of Vascular Surgery, University of California Irvine, Medical Center, Orange, CA, USA
    • ,
  • Ian L. Gordon, MD, PhD

      Affiliations

    • Department of Vascular Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA
    • Department of Vascular Surgery, University of California Irvine, Medical Center, Orange, CA, USA
    • Corresponding Author InformationCorrespondence to: Ian L. Gordon, MD, PhD, Department of Vascular Surgery, University of California Irvine, Medical Center, 101 The City Drive, Building 53, Route 81, Orange, CA, 92868, USA
    • ,
  • Thang Nguyen, MD

      Affiliations

    • Department of Vascular Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA
    • Department of Vascular Surgery, University of California Irvine, Medical Center, Orange, CA, USA
    • ,
  • Roy M. Fujitani, MD

      Affiliations

    • Department of Vascular Surgery, University of California Irvine, Medical Center, Orange, CA, USA
    • ,
  • Samuel E. Wilson, MD

      Affiliations

    • Department of Vascular Surgery, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA
    • Department of Vascular Surgery, University of California Irvine, Medical Center, Orange, CA, USA
    • ,
  • Robert C. Conroy, MD

      Affiliations

    • Department of Radiology, Veterans Administration Long Beach Healthcare System, Long Beach, CA, USA

Our objective was to evaluate restenosis after stenting of femoropopliteal occlusions and the impact of percutaneous transluminal angioplasty (PTA) on recurrent stenosis. We used a retrospective analysis of contrast angiograms obtained during follow-up of stented limbs. Subjects included 27 claudicants (34 limbs) who had complete superficial femoral artery occlusion treated with PTA and Wallstents at the Veterans Adminstration Medical Center. During follow-up, 31 PTAs, three thrombolytic treatments, and one additional stenting were performed. Outcome was measured by contrast angiography. Primary patency at 1 and 3 years was 38% and 8% after stenting, and secondary patency (PTA required at least once in 21/34 limbs) was 89% and 55%, respectively. PTA performed during follow-up reduced within-stent restenosis on average from 48.3 ± 13.6% to 22.8 ± 18.0%. Recurrent stenosis after PTA measured 14.9 ± 10.9 months later was 46.8 ± 16.7%, showing little permanent impact of PTA on stenosis. Severe within-stent stenosis develops commonly after initial stenting of complete femoropopliteal occlusions. Supplemental PTA performed during follow-up provides immediate improvement in lumen diameter, but severe restenosis is still likely to recur.

 

PII: S0890-5096(06)60032-0

doi:10.1007/s10016-006-9011-5

Annals of Vascular Surgery
Volume 20, Issue 2 , Pages 200-208, March 2006

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