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Treatment of Superficial Femoral Artery Restenosis

Andrew J Miller1, Edwin A Takahashi2, William S Harmsen3

  • 1Department of Radiology, Mayo Clinic, Rochester, Minnesota; Division of Vascular and Interventional Radiology, Mayo Clinic, Rochester, Minnesota.

Journal of Vascular and Interventional Radiology : JVIR
|September 23, 2017
PubMed

Insights

Statins significantly reduced restenosis risk in patients treated with bare metal stents (BMSs) for superficial femoral artery (SFA) restenosis. Advanced chronic kidney disease (CKD) increased adverse events and mortality, while clopidogrel improved survival.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Devices

Background:

  • Superficial femoral artery (SFA) restenosis is a common complication after endovascular treatment.
  • Repeat interventions are often necessary but carry significant risks.
  • Predicting outcomes after repeat treatment is crucial for patient management.

Purpose of the Study:

  • To identify predictors of restenosis after repeat endovascular treatment of SFA lesions.
  • To determine factors associated with major adverse limb events (MALEs), postoperative death (POD), and all-cause mortality.
  • To evaluate the impact of treatment modalities and medications on outcomes.

Main Methods:

  • Retrospective review of 440 patients with 518 SFA lesions treated between 2002 and 2011.
  • Analysis of 96 limbs treated for restenosis with bare metal stents (BMSs) or percutaneous transluminal angioplasty (PTA).
  • Identification of predictors for SFA patency, MALEs, POD, and mortality.

Main Results:

  • BMS and PTA showed similar restenosis rates.
  • Statin use in the BMS group was associated with significantly lower restenosis risk (HR 0.13).
  • Stage 4-5 chronic kidney disease (CKD) increased MALE + POD (HR 6.17) and mortality (HR 2.83). Clopidogrel reduced mortality (HR 0.41).

Conclusions:

  • Statin therapy at the time of BMS intervention is associated with reduced restenosis.
  • Stage 4-5 CKD is a significant risk factor for adverse limb events and mortality.
  • Clopidogrel use demonstrates a protective effect against all-cause mortality.
Abstract

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