Yoshimitsu Soga1, Mitsuyoshi Takahara2, Osamu Iida3, Kenji Suzuki4, Keisuke Hirano5, Daizo Kawasaki6, Yoshiaki Shintani7, Terutoshi Yamaoka8, Kenji Ando9. 1. Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan sogacchy@yahoo.co.jp. 2. Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Suita, Japan Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Suita, Japan. 3. Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan. 4. Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, Japan. 5. Department of Cardiology, Yokohama City Eastern Hospital, Yokohama, Japan. 6. Cardiovascular Division, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan. 7. Department of Cardiology, Shin-Koga Hospital, Kurume, Japan. 8. Department of Vascular Surgery, Matsuyama Red Cross Hospital, Matsuyama, Japan. 9. Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.
Abstract
PURPOSE: To evaluate the relationship between 1-year primary patency and lesion length in patients with femoropopliteal disease treated with bare nitinol stents. METHODS: The study was a retrospective analysis of a prospectively maintained multicenter database. Between January 2004 and December 2011, 1047 consecutive patients (mean age 72 years; 765 men) underwent femoropopliteal stenting with nitinol stents in 1373 limbs. The mean vessel diameter was 5.3±0.7 mm and the mean lesion length was 142±75 mm. One-year follow-up data were collected and analyzed to ascertain which lesion length would be expected to demonstrate a 1-year primary patency above the established 66% objective performance goal (OPG). RESULTS: The lower limit of the 95% confidence interval (CI) for the unadjusted 1-year primary patency was >66% when the lesion length was ≤243 mm. After adjustment of the covariates to match those of the OPG-derived population, the 1-year primary patency decreased linearly with longer lesion length. The 1-year primary patency was 83.2% (95% CI 79.8% to 86.1%) for a 100-mm lesion length, 76.4% (95% CI 71.7% to 80.5%) for a 200-mm lesion length, and 70.7% (95% CI 62.4% to 77.7%) for a 300-mm lesion length. The maximum lesion length providing a 1-year primary patency significantly greater than 66% was calculated to be 263 mm. CONCLUSION: The 1-year primary patency of femoropopliteal lesions treated with bare nitinol stents decreased linearly with longer lesion length. The maximum lesion length providing a higher patency rate than the OPG of 66% was ~25 cm.
PURPOSE: To evaluate the relationship between 1-year primary patency and lesion length in patients with femoropopliteal disease treated with bare nitinol stents. METHODS: The study was a retrospective analysis of a prospectively maintained multicenter database. Between January 2004 and December 2011, 1047 consecutive patients (mean age 72 years; 765 men) underwent femoropopliteal stenting with nitinol stents in 1373 limbs. The mean vessel diameter was 5.3±0.7 mm and the mean lesion length was 142±75 mm. One-year follow-up data were collected and analyzed to ascertain which lesion length would be expected to demonstrate a 1-year primary patency above the established 66% objective performance goal (OPG). RESULTS: The lower limit of the 95% confidence interval (CI) for the unadjusted 1-year primary patency was >66% when the lesion length was ≤243 mm. After adjustment of the covariates to match those of the OPG-derived population, the 1-year primary patency decreased linearly with longer lesion length. The 1-year primary patency was 83.2% (95% CI 79.8% to 86.1%) for a 100-mm lesion length, 76.4% (95% CI 71.7% to 80.5%) for a 200-mm lesion length, and 70.7% (95% CI 62.4% to 77.7%) for a 300-mm lesion length. The maximum lesion length providing a 1-year primary patency significantly greater than 66% was calculated to be 263 mm. CONCLUSION: The 1-year primary patency of femoropopliteal lesions treated with bare nitinol stents decreased linearly with longer lesion length. The maximum lesion length providing a higher patency rate than the OPG of 66% was ~25 cm.