Long‐term outcomes of SMART stent implantation in patients with femoro‐popliteal disease

Matsumi, Junya; Tobita, Kazuki; Shishido, Koki; Mizuno, Shingo; Yamanaka, Futoshi; Murakami, Masato; Tanaka, Yutaka; Takahashi, Saeko; Akasaka, Takeshi; Saïto, Shigeru

doi:10.1002/ccd.26718

Cited by 3 publications

(1 citation statement)

References 23 publications

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“…In terms of postoperative patency, the primary patency was significantly longer in the patients of the group with occlusion lesions <2 cm compared with the group with occlusion lesions ≥ 2 cm ( Figure 9C ). There are no relevant data in the endovascular treatment of CVO/CVS before, while a negative correlation between lesion length and postoperative patency has been documented in the field of arterial interventions ( 19 , 20 ). Many previous studies have suggested that calcification or organization is one of the main causes of recanalization failure ( 13 , 21 – 23 ).…”

Section: Discussionmentioning

confidence: 99%

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

Wen

Chen

Lin

et al. 2022

Front. Cardiovasc. Med.

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ObjectiveThis study aims to investigate the association between clinical factors of patients with central (superior vena cava, brachiocephalic, or subclavian) venous occlusion or central venous stenosis (CVO/CVS) and the difficulty of interventional recanalization as well as the duration of postoperative patency.MethodsA total of 103 hemodialysis patients with CVO/CVS treated with endovascular treatment were enrolled. The two-step cluster analysis was selected to differentiate the cases into distinct phenotypes automatically. Differences in characteristics, the difficulty of interventional recanalization, and the duration of postoperative primary patency time between the two clusters were statistically compared.ResultsThe 103 cases were divided into distinct two clusters by the two-step cluster analysis with 48 (46.6%) in cluster 1 and 55 (53.4%) in cluster 2. Compared to cluster 2, patients in cluster 1 have a higher proportion of blunt stump, side branches, occlusion lesions >2 cm, calcification, or organization. Moreover, the above four factors were, in turn, the most critical four predictors distinguishing 103 patients into two clusters. The remaining six factors were, in turn, occlusion located in the superior vena cava (SVC), duration of central venous catheterization (CVC), lesion location, vessel diameter, number of CVC, and previously failed lesion. Of the four most important factors, with the exception of occlusion lesions exceeding 2 cm, there were significant differences in the length of procedure time between the groups grouped by the remaining three factors. And there was a significant difference in the primary patency rate between the group with blunt stump and the group without blunt stump and also between the group with occlusion lesions ≥ 2 cm and the group with occlusion lesions <2 cm. The operation time of cluster 1 was longer than that of cluster 2. In terms of postoperative patency time, the primary patency time was significantly longer in the patients of cluster 2 compared with cluster 1 (P = 0.025).ConclusionPatients were divided into distinct two clusters. CVO/CVS of patients in cluster 1 was more challenging to be recanalized than that in cluster 2, and the primary patency time was significantly longer in the patients of cluster 2 compared with cluster 1. Blunt stump, side branches, occlusion lesions exceeding 2 cm, and calcification or organization are the four most critical predictors distinguishing 103 patients into two clusters.

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Section: Discussionmentioning

confidence: 99%

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

Wen

Chen

Lin

et al. 2022

Front. Cardiovasc. Med.

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The Importance of Patency of Tibial Run Off Arteries on Clinical Outcomes After Stenting for Chronic Total Occlusions in the Superficial Femoro-popliteal Artery

Watanabe

Hozawa

Kawamoto

et al. 2018

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS After angioplasty of an occluded superficial femoral or popliteal artery, interventionalists face the dilemma of what to do with occlusive disease of the tibial arteries. This study shows that the patency of the tibial arteries is an important predictor of mid-term patency of the femoropopliteal artery and that a successful tibial percutaneous transluminal angioplasty improves clinical outcome. These findings suggest that percutaneous transluminal angioplasty for chronic total occlusions in the superficial femoropopliteal artery should be accompanied by an effort to improve tibial runoff.Objective/background: The aim was to evaluate the impact of patent tibial arteries on stenting for chronic total occlusions (CTO) in superficial femoropopliteal artery (SFA) lesions. Additionally, the efficacy of additive tibial percutaneous transluminal angioplasty (PTA) was evaluated. Methods: A total of 238 limbs in 199 patients with de novo SFA CTO lesions treated with bare nitinol stents between 2009 and 2015 were retrospectively identified. These limbs were divided into two groups (group A [number of patent tibial arteries at baseline angiogram ! 2, 127 limbs in 104 patients] vs. group B [number of patent tibial arteries at baseline angiogram 1, 111 limbs in 95 patients]). Furthermore, the efficacy of additive tibial PTA on stenting for SFA CTO lesions was evaluated by comparing subgroups (group B with tibial PTA vs. without tibial PTA). The primary end point was freedom from major adverse limb events (MALE) two years after PTA, defined as a composite of ischaemic driven target lesion revascularisation (TLR) and major amputation. Results: Group A had a significantly higher MALE free survival rate two years after PTA compared with group B (80.9% vs. 43.5%; p < .001), which was mainly driven by higher TLR free survival rates (80.9% vs. 45.9%; p < .001). In subgroup analysis, patients in group B with tibial PTA had significantly higher MALE free survival rate at two years compared with those without tibial PTA (65.5% vs. 26.2%; p ¼ .001). Conclusion: The presence of patent tibial arteries was an important predictor of MALE after PTA for SFA CTO lesions. Furthermore, additional tibial PTA on SFA CTO stenting might be beneficial for clinical outcomes.

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The Midterm Outcomes of Endovascular Therapy for Femoropopliteal Lesions via Drug-Coated Balloon, Directional Atherectomy and Bare Metal Stent Angioplasty

Lin,

Quan,

Dong

et al. 2024

Rev. Cardiovasc. Med.

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Background: This study investigated the midterm primary patency of drug-coated balloons (DCBs), directional atherectomy plus balloon angioplasty (DA), and bare metal stent (BMS) angioplasty for the treatment of femoropopliteal lesions. Methods: This two-center retrospective cohort study included 105 patients (110 limbs) undergoing DCB, DA, and BMS angioplasty—32 patients (34 limbs), 31 patients (32 limbs), and 42 patients (44 limbs), respectively. The demographic, baseline, and procedure data were collected, and the complications and midterm outcomes (patency, amputation-free survival, and clinically driven target lesion revascularization rates) were analyzed. Results: All three procedures achieved a 100% success rate. Significant improvements were noted in ankle brachial index, walking distance, and Rutherford classification at 30 days post-procedure (p < 0.001), with no differences or severe complications among the groups. The all-cause mortality rate during the follow-up period, was 5.5%, and amputation-free survival rates at 24 months were 97.0%, 90.6% and 90.9% in the DCB, DA, and BMS angioplasty groups, respectively. The primary patency rate for the DCB group (79.4%) exceeded those of the DA (56.2%) and BMS (52.2%) groups (p < 0.05), with no significant difference between the DA and BMS groups at 24 months. The secondary patency and clinically driven target lesion revascularization rates were similar among the three groups. A runoff number ≤1, Trans-Atlantic Intersociety Consensus (TASC) D, and severe calcification were found to be independent risk factors for primary patency. Conclusions: The DCB procedure demonstrated superior primary patency, compared to both BMS and DA procedures, in the treatment of femoropopliteal lesions.

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Long‐term outcomes of SMART stent implantation in patients with femoro‐popliteal disease

Abstract: Although SMART stent implantation produced favorable long-term results, TASC IIC/D FP lesions had poor outcomes. © 2016 Wiley Periodicals, Inc.

Cited by 3 publications

References 23 publications

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

Clinical Implications of Phenotypes of Hemodialysis Patients With Central Venous Occlusion or Central Venous Stenosis Defined by Cluster Analysis

The Importance of Patency of Tibial Run Off Arteries on Clinical Outcomes After Stenting for Chronic Total Occlusions in the Superficial Femoro-popliteal Artery

The Midterm Outcomes of Endovascular Therapy for Femoropopliteal Lesions via Drug-Coated Balloon, Directional Atherectomy and Bare Metal Stent Angioplasty

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