Timing of Restenosis and Reocclusion Following Endovascular Therapy for Femoropopliteal Lesions
Kenji Suzuki1, Daisuke Ueshima2, Kazuki Tobita3
1Department of Cardiology, Tokyo Saiseikai Central Hospital, Tokyo, JPN.
Insights
Different femoropopliteal devices show varying primary patency rates and distinct timing for restenosis and reocclusion. Understanding these differences is key for effective endovascular therapy.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Biomedical Engineering
Background:
- Drug-eluting devices and covered stents are standard for femoropopliteal lesions.
- Limited data exists on the specific restenosis and reocclusion patterns for these devices.
Purpose of the Study:
- To compare primary patency, restenosis, and reocclusion timing among four femoropopliteal endovascular devices.
- To provide detailed insights into the performance differences of bare nitinol stents, covered stents, drug-eluting stents, and drug-coated balloons.
Main Methods:
- A retrospective, multicenter study included 2,786 femoropopliteal cases from seven institutes.
- Patients were treated with bare nitinol stent (BNS), covered stent (CS), drug-eluting stent (DES), or drug-coated balloon (DCB).
Main Results:
- Two-year primary patency rates were 62% (BNS), 75% (CS), 74% (DES), and 65% (DCB).
- Lesion lengths and device backgrounds differed significantly (p<0.001).
- Peak restenosis occurred 6-9 months (BNS, DCB) and 12-15 months (CS, DES); reocclusion varied from 0-3 months (DCB) to 6-9 months (BNS, DES).
Conclusions:
- Primary patency rates vary significantly across the studied femoropopliteal devices.
- The timing of restenosis and reocclusion is device-specific, influencing long-term outcomes.
Purpose:
Drug-eluting device and covered stent have become the mainstream of endovascular therapy for femoropopliteal lesions. Although there have been many reports on the primary patency of each device, there are few detailed data on restenosis and reocclusion.
Materials And Methods:
This was a physician-initiated, multicenter, retrospective study. From seven institutes, 3,635 femoropopliteal cases were enrolled in this study. Among them, we studied 2,786 cases treated with drug-eluting stent (DES), drug-coated balloon (DCB), covered stent (CS), and bare nitinol stent (BNS).
Results:
The lesion background for each device was different, with mean lesion lengths of 140 (80-220) mm for BNS, 250 (180-300) mm for CS, 200 (100-260) mm for DES, and 123 (60-216) mm for DCB (p<0.001). Primary patency at two years was 62% for BNS, 75% for CS, 74% for DES, and 65% for DCB. The timing of restenosis and reocclusion was also different for each device. Peak restenosis timing was six to nine months for BNS and DCB and 12-15 months for CS and DES. The timing of reocclusion was six to nine months for BNS and DES, three to six months for CS, and zero to three months for DCB.
Conclusions:
Not only was the primary patency for each device different, but the timing of restenosis and reocclusion for each device was also different.
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