Impact of Post-Procedural Intravascular Ultrasound Findings on Long-Term Results Following Self-Expanding Nitinol Stenting in Superficial Femoral Artery Lesions

Background: Previous intravascular ultrasound (IVUS) studies have reported that a tiny reference cross-sectional area (CSA), stent under-expansion, stent asymmetry, stent edge dissection, and tissue protrusion are associated with target lesion revascularization (TLR) after coronary intervention. In...

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Bibliographic Details
Published in:Circulation Journal 2013, Vol.77(6), pp.1543-1550
Main Authors: Miki, Kojiro, Fujii, Kenichi, Fukunaga, Masashi, Kawasaki, Daizo, Shibuya, Masahiko, Imanaka, Takahiro, Tamaru, Hiroto, Masutani, Motomaru, Ohyanagi, Mitsumasa, Masuyama, Tohru
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alloys
Endovascular therapy
Female
Femoral Artery - diagnostic imaging
Femoral Artery - surgery
Follow-Up Studies
Humans
Intravascular ultrasound
Male
Middle Aged
Prosthesis Failure - adverse effects
Restenosis
Risk Factors
Self-expanding nitinol stent
Stents - adverse effects
Superficial femoral artery
Ultrasonography, Interventional
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Summary:Background: Previous intravascular ultrasound (IVUS) studies have reported that a tiny reference cross-sectional area (CSA), stent under-expansion, stent asymmetry, stent edge dissection, and tissue protrusion are associated with target lesion revascularization (TLR) after coronary intervention. In the lower limb, however, it has not been reported that these findings correlate with TLR after endovascular therapy (EVT). Methods and Results: A total of 236 consecutive superficial femoral artery (SFA) lesions in patients who underwent IVUS after self-expanding nitinol stent implantation, were analyzed. Stent expansion ratio was calculated as minimum stent CSA/reference lumen CSA, radial stent symmetry index as minimum/maximum stent diameter, and axial stent symmetry index as minimum/maximum stent CSA. TLR was defined as clinically driven revascularization with ≥75% restenosis of the target lesion. The mean follow-up period was 34±15 months. TLR were performed in 42 lesions (17.8%). There were no significant differences in stent expansion ratio, stent symmetry indices, and tissue protrusion between the TLR and no-TLR groups. Multivariate analysis indicated that total stent length (odds ratio [OR], 1.004; P
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-12-1182