Impact of Stent-to-Vessel Diameter Ratio on Restenosis in the Superficial Femoral Artery After Endovascular Therapy

Background:Although stent-to-vessel (S/V) diameter ratio has been described as a restenotic factor after superficial femoral artery (SFA) stenting, the reference vessel diameter is commonly measured distally at a healthy site. It remains unclear whether S/V ratio assessed at the lesion site would be...

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Bibliographic Details
Published in:Circulation Journal 2018/04/25, Vol.82(5), pp.1412-1417
Main Authors: Kurata, Naoya, Iida, Osamu, Shiraki, Tatsuya, Fujita, Masashi, Masuda, Masaharu, Okamoto, Shin, Ishihara, Takayuki, Nanto, Kiyonori, Kanda, Takashi, Sunaga, Akihiro, Tsujimura, Takuya, Takahara, Mitsuyoshi, Mano, Toshiaki
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alloys
Female
Femoral Artery - diagnostic imaging
Femoral Artery - physiopathology
Femoral Artery - surgery
Femoropopliteal artery
Graft Occlusion, Vascular - diagnostic imaging
Graft Occlusion, Vascular - physiopathology
Humans
Male
Peripheral artery disease
Retrospective Studies
Self-expandable nitinol stent
Stent/vessel ratio
Stents
Ultrasonography, Interventional
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Summary:Background:Although stent-to-vessel (S/V) diameter ratio has been described as a restenotic factor after superficial femoral artery (SFA) stenting, the reference vessel diameter is commonly measured distally at a healthy site. It remains unclear whether S/V ratio assessed at the lesion site would be more predictive than that assessed distally at a healthy site.Methods and Results:A total of 117 patients (mean age, 73±7 years; 74% male) who underwent successful nitinol stent implantation in SFA lesions (mean lesion length, 172±104 mm) on intravascular ultrasound (IVUS) were retrospectively analyzed. S/V ratio at the proximal and distal healthy site, and at the smallest lesion site, was evaluated on IVUS. One-year restenosis predictors were evaluated on multivariate analysis. Mean S/V diameter ratio on IVUS at proximal and distal healthy sites, and at the lesion site, was 0.98±0.11, 1.02±0.11 and 1.15±0.16, respectively. One-year primary patency was 77%. On multivariate analysis, lesion length (OR, 1.06 per 10-mm increment; P=0.046) and S/V ratio measured at the lesion site (OR, 1.34 per 0.1 increment; P=0.032), but not that at the distal healthy site (OR, 1.05 per 0.1 increment; P=0.705), were significantly associated with 1-year restenosis.Conclusions:S/V ratio assessed on IVUS at the lesion site, but not at the distal healthy site, was independently associated with 1-year restenosis after SFA stenting.
ISSN:1346-9843
1347-4820
DOI:10.1253/circj.CJ-17-0726