Drug-coated stent implantation vs. bypass surgery for in-stent occlusion after femoropopliteal stenting

This study was a dual-center, observational study from January 2004 to December 2015. A total of 172 ISO lesions were observed, and after excluding 120 ISO lesions, 52 ISO lesions (50 patients; mean age, 71.0  ± 9.2 years; male, 59.6%) after FP bare-nitinol stenting were enrolled. The included patients with clinical symptoms underwent either DCS implantation (n = 28) or BSX (n = 22). The primary endpoint was recurrent in-stent restenosis (ReISR); secondary endpoints were recurrent target lesion revascularization (ReTLR), recurrent occlusion (reocclusion) and major adverse limb events (MALE), and perioperative complications (POCs), respectively. ReISR or reocclusion w as defined as ISR or occlusion after TLR. Stent restenosis was defined as a peak systolic velocity ratio (PSVR) >  2.4 on a duplex scan or ≥ 50% stenosis on angiography. Graft restenosis was defined as a PSV >  300 cm/s and velocity ratio 3.5 or uniformly low PSV <  45 cm/s throughout the entire graft based on graft surveillance. The mean follow-up period was 36.6 ± 25.5 months. At 2 years, the rates of freedom from ReISR, ReTLR, and MALE were not significantly different between the DCS implantation and BSX groups (68.9% vs. 73.7%,p = 0.81; 84.7% vs. 73.7%,p = 0.45; 84.7% vs. 78.6%,p = 0.60, respectively). However, the freedom from reocclusion rate was significantly lower in the DCS implantation group (81.6% vs. 100%,p = 0.04). The occurrence of PO...
Source: Heart and Vessels - Category: Cardiology Source Type: research