Impact of Plaque Calcification and Stent Oversizing on Clinical Outcomes of Atherosclerotic Femoropopliteal Arterial Occlusive Disease Following Stent Angioplasty

Autor: Jia-cheng Weng, Hai-peng He, Xin-ling Zhang, Yang Zhao, Henghui Yin, Shuang-hong Cai
Rok vydání: 2019
Předmět:
Male
Target lesion
medicine.medical_specialty
Time Factors
Computed Tomography Angiography
medicine.medical_treatment
Pilot Projects
030204 cardiovascular system & hematology
030230 surgery
Prosthesis Design
Risk Assessment
Amputation
Surgical
Peripheral Arterial Disease
03 medical and health sciences
0302 clinical medicine
Recurrence
Risk Factors
medicine
Humans
Popliteal Artery
Vascular Calcification
Vascular Patency
Aged
Retrospective Studies
Computed tomography angiography
Aged
80 and over
medicine.diagnostic_test
Proportional hazards model
business.industry
Angioplasty
Stent
Middle Aged
Limb Salvage
medicine.disease
Femoral Artery
Stent placement
Treatment Outcome
medicine.anatomical_structure
Amputation
Female
Stents
Surgery
Radiology
Cardiology and Cardiovascular Medicine
business
Preliminary Data
Artery
Calcification
Zdroj: European Journal of Vascular and Endovascular Surgery. 58:215-222
ISSN: 1078-5884
Popis: Objective Plaque calcification and stent oversizing are two key factors contributing to in stent restenosis (ISR) following femoropopliteal stent angioplasty. This study aimed to explore a pre-operative quantitative assessment method of plaque calcification and rational parameters of stent oversizing in the femoropopliteal artery. Methods A total of 115 patients with atherosclerotic femoropopliteal arterial occlusive disease treated from January 2013 to January 2016 were included retrospectively. Computed tomography angiography (CTA) imaging was performed to analyse calcified plaque parameters (calcified plaque volume [CV], standard CV [SCV], burden of calcified plaque) and stent oversizing parameters at different vessel segments (distal oversizing, maximum oversizing, plaque oversizing). Optimal cut offs for the six parameters were determined by the maximum Youden's index. The relationship between calcified plaque, stent oversizing, and clinical outcomes were assessed by correlation analysis and multivariable Cox regression models. Results The one year primary patency rate was 77.4%; the rates of ISR, major amputation, target lesion revascularisation, and mortality were 40.9%, 8.7%, 17.4%, and 12.2%, respectively. For all six parameters, patients with values greater than the cut offs had a significantly higher incidence of ISR than those with values below the cut offs. ISR was positively correlated with all six calcification and oversizing parameters. Amputation and mortality were positively correlated with calcification parameters. Multivariable Cox regression analysis demonstrated that all six parameters were independent risk factors for ISR. All calcification parameters were identified as independent risk factors for amputation, while only CV and SCV were independent risk factors for mortality. Conclusion Calcified plaque in the femoropopliteal artery can be quantitatively analysed on pre-operative CTA images. High calcified plaque burden and excessive stent oversizing were associated with unfavourable outcomes following stent angioplasty.
Databáze: OpenAIRE
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