Maria Antonella Ruffino1, Marco Fronda2, Laura Bergamasco3, Massimiliano Natrella4, Gianluca Fanelli4, Raffaello Bellosta5, Matteo Pegorer5, Luca Attisani5, Massimo Ruggiero6, Pierantonio Malfa7, Domenico Patane'7, Pierleone Lucatelli8, Mario Corona8, Carmelo Ricci9, Laura Candeloro9, Michelangelo Ferri10, Sara Varello11, Lorenzo Gibello12, Gian Franco Veraldi13, Luca Mezzetto13, Paolo Fonio11. 1. Department of Diagnostic Imaging and Radiotherapy, Vascular Radiology, A.O.U. Città Della Salute e Della Scienza di Torino, Corso Bramante 88, Turin, Italy. 2. Radiology Unit, Department of Surgical Sciences, A.O.U. Città Della Salute e Della Scienza di Torino, Via Genova 3, Turin, Italy. mfronda@cittadellasalute.to.it. 3. Department of Surgical Sciences, University of Turin-A.O.U. Città della Salute e della Scienza di Torino, Via Genova 3, Turin, Italy. 4. Department of Diagnostic and Interventional Radiology, Interventional Radiology, U. Parini Hospital, Via Ginevra 3, Aosta, Italy. 5. Cardiovascular Department, Vascular and Endovascular Surgery, Poliambulanza Foundation Hospital, Via Bissolati 57, Brescia, Italy. 6. Endovascular Surgery-Vascular Surgery Unit, ASL BR1-Ospedale "A. Perrino", Strada per lo Spada 5, Brindisi, Italy. 7. UOC Diagnostic Imaging and Interventional Radiology, A.O. Per L'emergenza "Cannizzaro", Via Messina 829, Catania, Italy. 8. Department of Radiological Oncological and Anatomo-Pathological Sciences, Vascular and Interventional Radiology, Sapienza University of Rome, Viale del Policlinico 155, Roma, Italy. 9. Interventional Radiology Unit, Radiology Department, A.O.U. Senese, Viale Bracci 16, Siena, Italy. 10. S.C. Vascular and Endovascular Surgery, Ospedale Umberto I, Largo Filippo Turati 62, Turin, Italy. 11. Radiology Unit, Department of Surgical Sciences, A.O.U. Città Della Salute e Della Scienza di Torino, Via Genova 3, Turin, Italy. 12. Vascular Surgery Unit, Department of Surgical Sciences, University of Torino-A.O.U. Città Della Salute E Della Scienza Di Torino, Corso Bramante 88, Turin, Italy. 13. Department of Vascular Surgery, Integrated University Hospital of Verona, Piazzale Aristide Stefani 1, Verona, Italy.
Abstract
PURPOSE: To identify the risk factors associated with patency loss after bailout stenting with third-generation hybrid heparin-bonded nitinol stent of the femoropopliteal segment. METHODS: Prospective, multicenter, single-arm registry including 156 patients (50 females, mean age 72 ± 11 years) subjected, from February 2017 to December 2018, to provisional stenting with Gore Tigris vascular stent of the distal superficial femoral artery, with or without involvement of the popliteal artery, in 9 different centers. The 194 lesions, with Rutherford score ≥ 3, were stented in case of recoil, dissection or residual stenosis not responding to percutaneous trans-luminal angioplasty (PTA). The follow-up (FU) was performed with clinical evaluation and duplex ultrasound (DUS) at 1, 6 and 12 months. RESULTS: The primary patency rate was 99(95%CI 98-100)% at 1 month, 86(80-92)% at 6 months and 81(74-88)% at-12 months. After patency loss, 13/23 (56.5%) patients were re-treated, yielding a primary assisted patency of 91(86-96)% at 6 months and 88(82-94)% at 12 months and a secondary patency of 94(90-98)% at 6 months and 90(84-95)% at 12 months. Rutherford score ≥ 4 (p = 0.03) and previous severe treatments (p = 0.01) were identified as risk factors for early patency loss during FU. The involvement of the popliteal artery was not an independent risk factor for loss of patency. CONCLUSIONS: The bailout stenting of the femoropopliteal segment with third-generation nitinol stents is a safe and effective option in case of recoil, dissection or residual stenosis not responding to PTA. Critical limb ischemia and history of previous major treatment at the same level are significant prognostic factors for patency loss during FU.
PURPOSE: To identify the risk factors associated with patency loss after bailout stenting with third-generation hybrid heparin-bonded nitinol stent of the femoropopliteal segment. METHODS: Prospective, multicenter, single-arm registry including 156 patients (50 females, mean age 72 ± 11 years) subjected, from February 2017 to December 2018, to provisional stenting with Gore Tigris vascular stent of the distal superficial femoral artery, with or without involvement of the popliteal artery, in 9 different centers. The 194 lesions, with Rutherford score ≥ 3, were stented in case of recoil, dissection or residual stenosis not responding to percutaneous trans-luminal angioplasty (PTA). The follow-up (FU) was performed with clinical evaluation and duplex ultrasound (DUS) at 1, 6 and 12 months. RESULTS: The primary patency rate was 99(95%CI 98-100)% at 1 month, 86(80-92)% at 6 months and 81(74-88)% at-12 months. After patency loss, 13/23 (56.5%) patients were re-treated, yielding a primary assisted patency of 91(86-96)% at 6 months and 88(82-94)% at 12 months and a secondary patency of 94(90-98)% at 6 months and 90(84-95)% at 12 months. Rutherford score ≥ 4 (p = 0.03) and previous severe treatments (p = 0.01) were identified as risk factors for early patency loss during FU. The involvement of the popliteal artery was not an independent risk factor for loss of patency. CONCLUSIONS: The bailout stenting of the femoropopliteal segment with third-generation nitinol stents is a safe and effective option in case of recoil, dissection or residual stenosis not responding to PTA. Critical limb ischemia and history of previous major treatment at the same level are significant prognostic factors for patency loss during FU.
Authors: Herbert F Lugmayr; Hermann Holzer; Manfred Kastner; Harald Riedelsberger; Alexandra Auterith Journal: Radiology Date: 2002-01 Impact factor: 11.105
Authors: Martin Schillinger; Schila Sabeti; Christian Loewe; Petra Dick; Jasmin Amighi; Wolfgang Mlekusch; Oliver Schlager; Manfred Cejna; Johannes Lammer; Erich Minar Journal: N Engl J Med Date: 2006-05-04 Impact factor: 91.245
Authors: Alan T Hirsch; Ziv J Haskal; Norman R Hertzer; Curtis W Bakal; Mark A Creager; Jonathan L Halperin; Loren F Hiratzka; William R C Murphy; Jeffrey W Olin; Jules B Puschett; Kenneth A Rosenfield; David Sacks; James C Stanley; Lloyd M Taylor; Christopher J White; John White; Rodney A White; Elliott M Antman; Sidney C Smith; Cynthia D Adams; Jeffrey L Anderson; David P Faxon; Valentin Fuster; Raymond J Gibbons; Sharon A Hunt; Alice K Jacobs; Rick Nishimura; Joseph P Ornato; Richard L Page; Barbara Riegel Journal: Circulation Date: 2006-03-21 Impact factor: 29.690