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Sirolimus-eluting stents for the treatment of infrapopliteal arteries in chronic limb ischemia: long-term clinical and angiographic follow-up.
- Source :
-
Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists [J Endovasc Ther] 2012 Feb; Vol. 19 (1), pp. 12-9. - Publication Year :
- 2012
-
Abstract
- Purpose: To present the 5-year angiographic and clinical results of a retrospective registry assessing the performance of sirolimus-eluting stents (SES) in the treatment of infrapopliteal atherosclerotic disease.<br />Methods: From 2004 to 2009, 158 patients (95 men; mean age 71.9 years) with chronic lower limb ischemia (Rutherford categories 3-6) underwent primary SES placement in focal infrapopliteal lesions. The angiographic endpoint was patency, defined as freedom from in-stent stenosis (ISS) >50%. Clinical endpoints were death, amputation, and bypass surgery. Results were correlated with patient and lesion characteristics and cumulative outcomes were assessed with Kaplan-Meier analysis.<br />Results: Technical success was achieved in all cases. The primary patency rates were 97.0% after 6 months, 87.0% after 12 months, and 83.8% at 60 months. In-stent stenosis was predominantly observed in the first year after stent placement. Female gender was associated with a higher rate of ISS. During clinical follow-up of 144 (91%) patients over a mean 31.1±20.3 months, there were 27 (18.8%) deaths, 4 (2.8%) amputations, and no bypass surgery. Clinical status improved in 92% of the patients with critical limb ischemia (CLI) and 77% of the patients suffering from claudication (p=0.022).<br />Conclusion: Treatment of focal infrapopliteal lesions with SES showed encouraging long-term angiographic results in this registry. Clinical improvement was evident, but more pronounced in CLI patients than in patients suffering from claudication. Further studies are needed to evaluate the potential clinical benefit of SES as compared to balloon angioplasty or bare metal stents in the treatment of infrapopliteal lesions.
- Subjects :
- Aged
Aged, 80 and over
Amputation, Surgical
Angioplasty, Balloon adverse effects
Angioplasty, Balloon mortality
Atherosclerosis complications
Atherosclerosis diagnostic imaging
Atherosclerosis mortality
Atherosclerosis physiopathology
Chi-Square Distribution
Chronic Disease
Constriction, Pathologic
Female
Germany
Humans
Ischemia diagnostic imaging
Ischemia etiology
Ischemia mortality
Ischemia physiopathology
Kaplan-Meier Estimate
Male
Middle Aged
Proportional Hazards Models
Prosthesis Design
Radiography
Registries
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
Vascular Patency
Vascular Surgical Procedures
Angioplasty, Balloon instrumentation
Atherosclerosis therapy
Cardiovascular Agents administration & dosage
Drug-Eluting Stents
Ischemia therapy
Lower Extremity blood supply
Popliteal Artery diagnostic imaging
Popliteal Artery physiopathology
Sirolimus administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1545-1550
- Volume :
- 19
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Publication Type :
- Academic Journal
- Accession number :
- 22313195
- Full Text :
- https://doi.org/10.1583/11-3665.1