Tomoharu Dohi1, Osamu Iida1, Yoshimitsu Soga2, Mitsuyoshi Takahara3, Masaaki Uematsu1
1Kansai Rosai Hospital, Amagasaki, Japan; 2Kokura Memorial Hospital, Kitakyusyu, Japan; 3Osaka University, Suita, Japan.
OBJECTIVES: The purpose of this study is to investigate the prevalence and predictors of in-stent occlusion.
METHODS: This study is a retrospective analysis of a multicenter database. Between January 2004 and December 2011, 2447 lesions from 1,954 patients with FP lesions (mean age, 73.0±9.3 years; 71% male) were treated with nitinol stents. Multivariate analysis for clinical and procedural predictors of in-stent occlusion was performed with Cox proportional hazard ratio.
RESULTS: Sixty-one percent of the patients had diabetes, and 71% were claudicant. Mean lesion length was 142±88 mm, and 52% were chronic total occlusions (CTOs). Mean follow-up period was 2.3±1.7 years. In-stent occlusion rate was 5.2%, 11.2% and 16.4% at 1, 3 and 5 years, respectively. Multivariate analysis revealed female gender (hazard ratio [HR], 1.64; P = .0009), critical limb ischemia (HR, 1.48; P = .017), cilostazol administration (HR, 0.53; p<0.0001), TASC II class C/D lesions (HR, 2.05; p=0.0015), CTOs (HR, 1.46; p=0.0425), lesion length >200mm (HR, 1.60; p=0.0127), reference vessel diameter <6mm (HR, 1.37; p=0.0427) to be independent predictors of in-stent occlusion after FP stenting.
CONCLUSIONS: The rate of in-stent occlusion was lower than expected, and FP stenting appears to be a viable treatment option. Better patient selection and use of adjunctive medical therapy may further improve the outcome of FP stenting.
AUTHOR DISCLOSURES: T. Dohi: Nothing to disclose; O. Iida: Nothing to disclose; Y. Soga: Nothing to disclose; M. Takahara: Nothing to disclose; M. Uematsu: Nothing to disclose.