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Long‐term outcomes of SMART stent implantation in patients with femoro‐popliteal disease
Author(s) -
Matsumi Junya,
Tobita Kazuki,
Shishido Koki,
Mizuno Shingo,
Yamanaka Futoshi,
Murakami Masato,
Tanaka Yutaka,
Takahashi Saeko,
Akasaka Takeshi,
Saito Shigeru
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26718
Subject(s) - medicine , term (time) , cardiology , surgery , quantum mechanics , physics
Objectives This study aimed to determine the long‐term outcomes of SMART stent implantation for femoro‐popliteal (FP) lesions. Background The long‐term results of SMART stent implantation for FP lesions remained unknown. Methods We studied 319 limbs in 269 patients (mean age: 73.2 ± 7.7 years) who underwent SMART stent implantation for FP lesions (mean treated‐lesion length: 118.5 ± 81.0 mm) from 2004 to 2014, retrospectively. These patients were followed‐up for a mean of 52.8 ± 33.8 months (median: 51.0 months). Kaplan–Meier and log‐rank analyses were used to determine time to event. Hazard ratios (HRs) with 95% confidence interval (CI) were calculated through univariate and multivariate Cox proportional hazard analyses to estimate predictors of primary patency loss. Results Overall, 37.3% of lesions were TransAtlantic Inter‐Society Consensus (TASC) IIC/D lesions, and 41.1% exhibited chronic total occlusion. Post‐procedural primary patency rates were 87.7%, 79.4%, 68.1%, 53.7%, and 50.3%, at 1, 3, 5, 7, and 10 years, respectively; the corresponding secondary patency rates were 96.5%, 91.7%, 85.0%, 73.8%, and 67.7%, respectively. TASC IIA/B lesions had considerably better primary patency rates than C/D lesions at all time points. Multivariate analysis indicated that lesion length (with >200 mm vs. <100 mm) significantly promoted primary patency loss (HR, 2.555; 95% CI, 1.429–4.568; P = 0.002), as well as hemodialysis (HR, 1.881; 95% CI, 1.208–2.928; P = 0.005). Conclusions Although SMART stent implantation produced favorable long‐term results, TASC IIC/D FP lesions had poor outcomes. © 2016 Wiley Periodicals, Inc.