Three-Year Clinical Outcomes Following Implantation of LifeStent Self-Expanding Nitinol Stents in Patients With Femoropopliteal Artery Lesions

Abstract

The aim of this study was to evaluate midterm clinical outcomes after implantation of LifeStent self-expanding nitinol stents for the treatment of femoropopliteal lesions. This retrospective, multicenter, non-randomized study examined 260 femoropopliteal lesions in 250 consecutive patients with peripheral artery disease implanted with LifeStents from April 2016 to April 2017. The prevalence of chronic total occlusion (CTO), lesion length ≥25 cm, and distal reference vessel diameter (RVD) <5 mm was 58%, 35%, and 50%, respectively. The 3-year restenosis rate in the overall population was estimated to be 72.9% and a major adverse limb event was observed in 36.9%. Multivariate analysis revealed that chronic limb-threatening ischemia (CLTI) (odds ratio [OR]: 8.04; 95% confidence interval [CI]: 1.86–34.7), CTO (OR: 4.87; 95% CI: 1.43–16.6), lesion length ≥25 cm (OR: 5.95; 95% CI: 1.11–32.0), and distal RVD <5 mm (OR: 4.43; 95% CI: 1.34–14.6) were independent risk factors for 3-year restenosis. The present study demonstrated the midterm clinical outcomes and risk factors for restenosis after implantation of the LifeStent in femoropopliteal artery lesions. CLTI, CTO, lesion length ≥25 cm, and distal RVD <5 mm predicted decreased patency after a 3-year follow-up.

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

“…The scale of the problem of ISR in the endovascular treatment of PAD is well demonstrated by the results of a study conducted by Tan et al The study retrospectively analysed 260 femoropopliteal lesions treated in 250 patients with the implantation of LifeStent selfexpanding nitinol stents. The 3-year restenosis rate for the total population was estimated at 72.9%, and serious limb adverse events were reported in 36.9% [169]. In another study, the outcomes of the endovascular treatment of 481 femoropopliteal lesions with the implantation of InnovaTM self-expanding nitinol stents were analysed in 453 patients.…”

Endovascular Revascularization Outcomes in Peripheral Arterial Disease Patients With Type-Ii Diabetes Mellitus

“…A significant issue in endovascular revascularization is the comparison of percutaneous transluminal angioplasty with or without stent implantation, for the optimization of treatment in coronary artery disease, atherosclerotic carotid artery disease, and PAD (18). While it is conventionally believed that balloon angioplasty is the safer method for revascularization in PAD, recent studies have also suggested stent implantation as a viable option (19)(20)(21)(22). However, our findings align with the traditional view and demonstrate that stent implantation is an independent risk factor for target vessel restenosis (OR=5.08, P=0.030).…”

Expansion of Bypass as a Revascularization Option for Patients With Chronic Limb-Threatening Ischemia

“…3 In the BEST-CLI, the endovascular techniques applied to CLTI patients included the use of atherectomy (15%), drug-coated balloons (25%) and drugeluting stents (22%). 1 With wider application of advanced endovascular techniques, [4][5][6][7] the outcomes of patients offered endovascular treatment are expected to improve. Thus, the BEST-CLI results may become outdated.…”

“…As the authors reported, this early increase in reinterventions may have been related to a greater incidence of initial technical failures in the endovascular compared with the surgical group (15 vs 2%, respectively; P < .001). With continuous advances in the endovascular technology, the increased expertise and the wider application of novel devices/techniques, [4][5][6][7] the number of reinterventions in patients offered an endovascular-first approach are expected to decrease.…”