Angiographic Dissection Patterns and Patency Outcomes After Balloon Angioplasty for Superficial Femoral Artery Disease
| Autor: | Makoto Utsunomiya, Masahiko Fujihara, Osamu Iida, Mitsuyoshi Takahara, Kiyonori Nanto, Yoshiaki Yokoi, Shinya Sasaki |
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| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Dissection (medical) Femoral artery 030204 cardiovascular system & hematology Balloon Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Japan Restenosis Predictive Value of Tests Risk Factors Angioplasty medicine.artery medicine Humans Vascular Patency Radiology Nuclear Medicine and imaging 030212 general & internal medicine Aged Retrospective Studies Aged 80 and over medicine.diagnostic_test business.industry Angiography Retrospective cohort study Middle Aged Vascular System Injuries medicine.disease Femoral Artery Treatment Outcome Female Stents Surgery Radiology Cardiology and Cardiovascular Medicine business Angioplasty Balloon |
| Zdroj: | Journal of Endovascular Therapy. 24:367-375 |
| ISSN: | 1545-1550 1526-6028 |
| Popis: | Purpose: To investigate the angiographic dissection patterns after balloon angioplasty for superficial femoral artery (SFA) lesions, the clinical outcome associated with each dissection pattern, and the predictive factors for severe dissection. Methods: A retrospective, multicenter analysis examined 621 patients (mean age 72.8±9.5 years; 414 men) with 748 symptomatic de novo SFA lesions treated with endovascular therapy. Vessel dissection after the initial balloon angioplasty procedure was graded into 7 types according to a modified version of the coronary artery classification types A to F. Severe vessel dissection patterns were defined as type C or higher. Nitinol stent implantation was performed in 555 (74.2%) lesions for residual stenosis >30% or flow-limiting dissection; 193 lesions (25.8%) were treated with balloon angioplasty only. To determine the clinical outcomes associated with each dissection pattern and identify predictive factors for severe dissection, 2-year follow-up data for the 193 lesions treated with balloon angioplasty only were analyzed for primary patency and clinically driven target lesion revascularization (TLR). Results: No dissection was found in 16% (120/748) of lesions, and types A and B dissections were seen in 19% (142/748) and 23% (172/748), respectively. Dissection grades above type C were observed in 42% of cases, most frequently type D (180/748, 24%) and less often type C (37/748, 5%), type E (67/748, 9%), and type F (30/748, 4%). The bailout stent implantation rate increased according to dissection severity. At up to 2 years, the severe dissection group (types C–F) showed a significantly lower patency rate (p15 cm (p=0.001), and chronic total occlusion (p |
| Databáze: | OpenAIRE |
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