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Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting
The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stentin...
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| Published in: | Heart and vessels 2021-05, Vol.36 (5), p.646-653 |
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| creator | Tomoi, Yusuke Soga, Yoshimitsu Okazaki, Jin Iida, Osamu Shiraki, Tatsuya Hiramori, Seiichi Ando, Kenji |
| description | The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stenting. This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0 ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (
n
= 28) or BSX (
n
= 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion was defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) > 2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV > 300 cm/s and velocity ratio 3.5 or uniformly low PSV |
| doi_str_mv | 10.1007/s00380-020-01740-8 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2475088892</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2475088892</sourcerecordid><originalsourceid>FETCH-LOGICAL-c399t-68c55b6825279ec73736702a28c3d7885146f362fd6e589630323da97933dc7e3</originalsourceid><addsrcrecordid>eNp9kUtLxDAUhYMoOj7-gAspuHFTTXInr6X4BsGNrkMmTYcObVOTVJh_b8aOCi5chAvJd8_NPQehU4IvCcbiKmIMEpeY5kPEHJdyB80IJ6ykTMAummFF8iVQcYAOY1xhTJgiah8dAICifM5maHkbxmVpvUmuKmJyfSqabmhNn0xqfF98xMtisR5MjEUcw9KFdVH7UDR9OcHe2naMG9LUyYWidp0PfvBD2yRn2kmy6ZfHaK82bXQn23qE3u7vXm8ey-eXh6eb6-fSglKp5NIytuCSMiqUswIEcIGpodJCJaRkZM5r4LSuuGNSccBAoTJKKIDKCgdH6GLSHYJ_H11MumuidW3eyPkxajoXDEspFc3o-R905cfQ599pygimSlCyoehE2eBjDK7WQ2g6E9aaYL2JQU8x6ByD_opBy9x0tpUeF52rflq-fc8ATEDMT3229Xf2P7KfcTmSeQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2510297212</pqid></control><display><type>article</type><title>Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting</title><source>Springer Nature</source><creator>Tomoi, Yusuke ; Soga, Yoshimitsu ; Okazaki, Jin ; Iida, Osamu ; Shiraki, Tatsuya ; Hiramori, Seiichi ; Ando, Kenji</creator><creatorcontrib>Tomoi, Yusuke ; Soga, Yoshimitsu ; Okazaki, Jin ; Iida, Osamu ; Shiraki, Tatsuya ; Hiramori, Seiichi ; Ando, Kenji</creatorcontrib><description>The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stenting. This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0 ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (
n
= 28) or BSX (
n
= 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion was defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) > 2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV > 300 cm/s and velocity ratio 3.5 or uniformly low PSV < 45 cm/s throughout the entire graft based on graft surveillance. The mean follow-up period was 36.6 ± 25.5 months. At 2 years, the rates of freedom from ReISR, ReTLR, and MALE were not significantly different between the DCS implantation and BSX groups (68.9% vs. 73.7%,
p
= 0.81; 84.7% vs. 73.7%,
p
= 0.45; 84.7% vs. 78.6%,
p
= 0.60, respectively). However, the freedom from reocclusion rate was significantly lower in the DCS implantation group (81.6% vs. 100%,
p
= 0.04). The occurrence of POCs was not significantly different between the DCS implantation and BSX groups (7.1% vs 4.2%,
p
= 1.0). Although BSX was the gold-standard therapy for ISO lesions after FP bare-nitinol stenting, DCS implantation might be a good option because the rates of freedom from ReISR, ReTLR, and MALE were similar.</description><identifier>ISSN: 0910-8327</identifier><identifier>EISSN: 1615-2573</identifier><identifier>DOI: 10.1007/s00380-020-01740-8</identifier><identifier>PMID: 33392645</identifier><language>eng</language><publisher>Tokyo: Springer Japan</publisher><subject>Angiography ; Biomedical Engineering and Bioengineering ; Cardiac Surgery ; Cardiology ; Complications ; Grafting ; Heart surgery ; Implantation ; Implants ; Intermetallic compounds ; Lesions ; Males ; Medicine ; Medicine & Public Health ; Nickel titanides ; Occlusion ; Original Article ; Patients ; Restenosis ; Stenosis ; Stents ; Surgery ; Surgical implants ; Vascular Surgery ; Velocity</subject><ispartof>Heart and vessels, 2021-05, Vol.36 (5), p.646-653</ispartof><rights>Springer Japan KK, part of Springer Nature 2021</rights><rights>Springer Japan KK, part of Springer Nature 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c399t-68c55b6825279ec73736702a28c3d7885146f362fd6e589630323da97933dc7e3</citedby><cites>FETCH-LOGICAL-c399t-68c55b6825279ec73736702a28c3d7885146f362fd6e589630323da97933dc7e3</cites><orcidid>0000-0002-8939-0222</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33392645$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Tomoi, Yusuke</creatorcontrib><creatorcontrib>Soga, Yoshimitsu</creatorcontrib><creatorcontrib>Okazaki, Jin</creatorcontrib><creatorcontrib>Iida, Osamu</creatorcontrib><creatorcontrib>Shiraki, Tatsuya</creatorcontrib><creatorcontrib>Hiramori, Seiichi</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><title>Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting</title><title>Heart and vessels</title><addtitle>Heart Vessels</addtitle><addtitle>Heart Vessels</addtitle><description>The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stenting. This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0 ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (
n
= 28) or BSX (
n
= 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion was defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) > 2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV > 300 cm/s and velocity ratio 3.5 or uniformly low PSV < 45 cm/s throughout the entire graft based on graft surveillance. The mean follow-up period was 36.6 ± 25.5 months. At 2 years, the rates of freedom from ReISR, ReTLR, and MALE were not significantly different between the DCS implantation and BSX groups (68.9% vs. 73.7%,
p
= 0.81; 84.7% vs. 73.7%,
p
= 0.45; 84.7% vs. 78.6%,
p
= 0.60, respectively). However, the freedom from reocclusion rate was significantly lower in the DCS implantation group (81.6% vs. 100%,
p
= 0.04). The occurrence of POCs was not significantly different between the DCS implantation and BSX groups (7.1% vs 4.2%,
p
= 1.0). Although BSX was the gold-standard therapy for ISO lesions after FP bare-nitinol stenting, DCS implantation might be a good option because the rates of freedom from ReISR, ReTLR, and MALE were similar.</description><subject>Angiography</subject><subject>Biomedical Engineering and Bioengineering</subject><subject>Cardiac Surgery</subject><subject>Cardiology</subject><subject>Complications</subject><subject>Grafting</subject><subject>Heart surgery</subject><subject>Implantation</subject><subject>Implants</subject><subject>Intermetallic compounds</subject><subject>Lesions</subject><subject>Males</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Nickel titanides</subject><subject>Occlusion</subject><subject>Original Article</subject><subject>Patients</subject><subject>Restenosis</subject><subject>Stenosis</subject><subject>Stents</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Vascular Surgery</subject><subject>Velocity</subject><issn>0910-8327</issn><issn>1615-2573</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kUtLxDAUhYMoOj7-gAspuHFTTXInr6X4BsGNrkMmTYcObVOTVJh_b8aOCi5chAvJd8_NPQehU4IvCcbiKmIMEpeY5kPEHJdyB80IJ6ykTMAummFF8iVQcYAOY1xhTJgiah8dAICifM5maHkbxmVpvUmuKmJyfSqabmhNn0xqfF98xMtisR5MjEUcw9KFdVH7UDR9OcHe2naMG9LUyYWidp0PfvBD2yRn2kmy6ZfHaK82bXQn23qE3u7vXm8ey-eXh6eb6-fSglKp5NIytuCSMiqUswIEcIGpodJCJaRkZM5r4LSuuGNSccBAoTJKKIDKCgdH6GLSHYJ_H11MumuidW3eyPkxajoXDEspFc3o-R905cfQ599pygimSlCyoehE2eBjDK7WQ2g6E9aaYL2JQU8x6ByD_opBy9x0tpUeF52rflq-fc8ATEDMT3229Xf2P7KfcTmSeQ</recordid><startdate>20210501</startdate><enddate>20210501</enddate><creator>Tomoi, Yusuke</creator><creator>Soga, Yoshimitsu</creator><creator>Okazaki, Jin</creator><creator>Iida, Osamu</creator><creator>Shiraki, Tatsuya</creator><creator>Hiramori, Seiichi</creator><creator>Ando, Kenji</creator><general>Springer Japan</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8939-0222</orcidid></search><sort><creationdate>20210501</creationdate><title>Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting</title><author>Tomoi, Yusuke ; Soga, Yoshimitsu ; Okazaki, Jin ; Iida, Osamu ; Shiraki, Tatsuya ; Hiramori, Seiichi ; Ando, Kenji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c399t-68c55b6825279ec73736702a28c3d7885146f362fd6e589630323da97933dc7e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Angiography</topic><topic>Biomedical Engineering and Bioengineering</topic><topic>Cardiac Surgery</topic><topic>Cardiology</topic><topic>Complications</topic><topic>Grafting</topic><topic>Heart surgery</topic><topic>Implantation</topic><topic>Implants</topic><topic>Intermetallic compounds</topic><topic>Lesions</topic><topic>Males</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Nickel titanides</topic><topic>Occlusion</topic><topic>Original Article</topic><topic>Patients</topic><topic>Restenosis</topic><topic>Stenosis</topic><topic>Stents</topic><topic>Surgery</topic><topic>Surgical implants</topic><topic>Vascular Surgery</topic><topic>Velocity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Tomoi, Yusuke</creatorcontrib><creatorcontrib>Soga, Yoshimitsu</creatorcontrib><creatorcontrib>Okazaki, Jin</creatorcontrib><creatorcontrib>Iida, Osamu</creatorcontrib><creatorcontrib>Shiraki, Tatsuya</creatorcontrib><creatorcontrib>Hiramori, Seiichi</creatorcontrib><creatorcontrib>Ando, Kenji</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Heart and vessels</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Tomoi, Yusuke</au><au>Soga, Yoshimitsu</au><au>Okazaki, Jin</au><au>Iida, Osamu</au><au>Shiraki, Tatsuya</au><au>Hiramori, Seiichi</au><au>Ando, Kenji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting</atitle><jtitle>Heart and vessels</jtitle><stitle>Heart Vessels</stitle><addtitle>Heart Vessels</addtitle><date>2021-05-01</date><risdate>2021</risdate><volume>36</volume><issue>5</issue><spage>646</spage><epage>653</epage><pages>646-653</pages><issn>0910-8327</issn><eissn>1615-2573</eissn><abstract>The optimal revascularization for in-stent occlusion (ISO) lesions after femoropopliteal (FP) bare-nitinol stenting has not been established. We, therefore, investigated the comparison between drug-coated stent (DCS) implantation and bypass surgery (BSX) for ISO lesions after FP bare-nitinol stenting. This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0 ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (
n
= 28) or BSX (
n
= 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion was defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) > 2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV > 300 cm/s and velocity ratio 3.5 or uniformly low PSV < 45 cm/s throughout the entire graft based on graft surveillance. The mean follow-up period was 36.6 ± 25.5 months. At 2 years, the rates of freedom from ReISR, ReTLR, and MALE were not significantly different between the DCS implantation and BSX groups (68.9% vs. 73.7%,
p
= 0.81; 84.7% vs. 73.7%,
p
= 0.45; 84.7% vs. 78.6%,
p
= 0.60, respectively). However, the freedom from reocclusion rate was significantly lower in the DCS implantation group (81.6% vs. 100%,
p
= 0.04). The occurrence of POCs was not significantly different between the DCS implantation and BSX groups (7.1% vs 4.2%,
p
= 1.0). Although BSX was the gold-standard therapy for ISO lesions after FP bare-nitinol stenting, DCS implantation might be a good option because the rates of freedom from ReISR, ReTLR, and MALE were similar.</abstract><cop>Tokyo</cop><pub>Springer Japan</pub><pmid>33392645</pmid><doi>10.1007/s00380-020-01740-8</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-8939-0222</orcidid></addata></record> |
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| source | Springer Nature |
| subjects | Angiography Biomedical Engineering and Bioengineering Cardiac Surgery Cardiology Complications Grafting Heart surgery Implantation Implants Intermetallic compounds Lesions Males Medicine Medicine & Public Health Nickel titanides Occlusion Original Article Patients Restenosis Stenosis Stents Surgery Surgical implants Vascular Surgery Velocity |
| title | Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting |
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