A Novel Angiographic Risk Score for Femoropopliteal Interventions

被引:18
作者
Iida, Osamu [1 ]
Takahara, Mitsuyoshi [2 ,3 ]
Soga, Yoshimitsu [4 ]
Fujihara, Masahiko [5 ]
Kawasaki, Daizo [6 ]
Hirano, Keisuke [7 ]
Choi, Donghoon [8 ]
Mano, Toshiaki [1 ]
机构
[1] Kansai Rosai Hosp, Cardiovasc Ctr, 3-1-69 Inabaso, Amagasaki, Hyogo 6608511, Japan
[2] Osaka Univ, Dept Metab Med, Grad Sch Med, Suita, Osaka, Japan
[3] Osaka Univ, Dept Diabet Care Med, Grad Sch Med, Suita, Osaka, Japan
[4] Kokura Mem Hosp, Dept Cardiol, Kitakyushu, Fukuoka, Japan
[5] Kishiwada Tokushukai Hosp, Dept Cardiol, Kishiwada, Japan
[6] Morinomiya Hosp, Dept Cardiol, Osaka, Japan
[7] Saiseikai Yokohama City Eastern Hosp, Dept Cardiol, Yokohama, Kanagawa, Japan
[8] Yonsei Univ, Dept Cardiol, Severance Hosp, Seoul, South Korea
关键词
angiographic scoring system; endovascular therapy; femoropopliteal segment; occlusion; peripheral artery disease; patency; restenosis; risk stratification; stenosis; STENT IMPLANTATION; ANGIOPLASTY; DIAMETER; LESIONS; ARTERY;
D O I
10.1177/1526602820948472
中图分类号
R61 [外科手术学];
学科分类号
摘要
Purpose To present a novel angiographic scoring system that stratifies the risk of restenosis after endovascular therapy (EVT) to inform the decision to use paclitaxel-eluting devices in the femoropopliteal segment. Materials and Methods A prospective, multicenter registry including 1799 limbs of 1578 patients (mean age 74 +/- 9 years; 1090 men) with symptomatic peripheral artery disease undergoing intravascular ultrasound-supported femoropopliteal EVT was used as the basis for developing the angiographic score. Multivariable analysis identified baseline patient and limb characteristics associated with restenosis at 12 months. These risk factors for 12-month restenosis were explored using a generalized linear mixed model with a logit-link function in which the inter-institutional and inter-subject variability were treated as random effects. The multiple imputation method was adopted to address missing data. Results of the regression analysis are presented as the odds ratio (OR) with 95% confidence interval (CI). Results Twelve-month primary patency was estimated to be 65.1% (95% CI 62.7% to 67.5%). After multivariable analysis, distal reference vessel diameter per 1 mm (OR 0.71, 95% CI 0.62 to 0.81, p<0.001), lesion length per 10 cm (OR 1.39, 95% CI 1.19 to 1.62, p<0.001), and chronic total occlusion (OR 1.56, 95% CI 1.15 to 2.10, p=0.004) were independently associated with the 12-month restenosis risk, whereas baseline patient risk factors were not. Compared to bare nitinol stent implantation, plain angioplasty (OR 2.31, 95% CI 1.67 to 3.18, p<0.001) was independently associated with a higher risk of 12-month restenosis, while drug-eluting stents (OR 0.65, 95% CI 0.43 to 0.99, p=0.045) and stent-grafts (OR 0.24, 95% CI 0.12 to 0.50, p<0.001) were independently associated with a lower risk of 12-month restenosis. The angiographic score, which was developed by using the 3 angiographic factors but not the TransAtlantic Society Consensus II (TASC) class, was significantly and independently associated with 12-month restenosis. Conclusion The current study demonstrated a novel angiographic score for 12-month restenosis after femoropopliteal EVT in a real-world clinical practice. The developed score was significantly and independently associated with the 12-month restenosis risk, but the TASC class was not.
引用
收藏
页码:967 / 973
页数:7
相关论文
共 21 条
[1]   2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS) [J].
Aboyans, Victor ;
Ricco, Jean-Baptiste ;
Bartelink, Marie-Louise E. L. ;
Bjorck, Martin ;
Brodmann, Marianne ;
Cohnert, Tina ;
Collet, Jean-Philippe ;
Czerny, Martin ;
De Carlo, Marco ;
Debus, Sebastian ;
Espinola-Klein, Christine ;
Kahan, Thomas ;
Kownator, Serge ;
Mazzolai, Lucia ;
Naylor, A. Ross ;
Roffi, Marco ;
Roether, Joachim ;
Sprynger, Muriel ;
Tendera, Michal ;
Tepe, Gunnar ;
Venermo, Maarit ;
Vlachopoulos, Charalambos ;
Desormais, Ileana .
EUROPEAN HEART JOURNAL, 2018, 39 (09) :763-+
[2]  
[Anonymous], 2019, TREATM PER ART DIS P
[3]   Outback Catheter for Femoropopliteal Occlusions: Immediate and Long-term Results [J].
Bausback, Yvonne ;
Botsios, Spiridon ;
Flux, Jacqueline ;
Werner, Martin ;
Schuster, Johannes ;
Aithal, Jairam ;
Varcoe, Ramon ;
Braeunlich, Sven ;
Ulrich, Matthias ;
Scheinert, Dierk ;
Schmidt, Andrej .
JOURNAL OF ENDOVASCULAR THERAPY, 2011, 18 (01) :13-21
[4]   Durable Clinical Effectiveness With Paclitaxel-Eluting Stents in the Femoropopliteal Artery 5-Year Results of the Zilver PTX Randomized Trial [J].
Dake, Michael D. ;
Ansel, Gary M. ;
Jaff, Michael R. ;
Ohki, Takao ;
Saxon, Richard R. ;
Smouse, H. Bob ;
Machan, Lindsay S. ;
Snyder, Scott A. ;
O'Leary, Erin E. ;
Ragheb, Anthony O. ;
Zeller, Thomas .
CIRCULATION, 2016, 133 (15) :1472-1483
[5]   Calcium Burden Assessment and Impact on Drug-Eluting Balloons in Peripheral Arterial Disease [J].
Fanelli, F. ;
Cannavale, A. ;
Gazzetti, M. ;
Lucatelli, P. ;
Wlderk, A. ;
Cirelli, C. ;
d'Adamo, A. ;
Salvatori, F. M. .
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY, 2014, 37 (04) :898-907
[6]  
FDA, 2019, UPD TREATM PER ART D
[7]   A polymer-coated, paclitaxel-eluting stent (Eluvia) versus a polymer-free, paclitaxel-coated stent (Zilver PTX) for endovascular femoropopliteal intervention (IMPERIAL): a randomised, non-inferiority trial [J].
Gray, William A. ;
Keirse, Koen ;
Soga, Yoshimitsu ;
Benko, Andrew ;
Babaev, Anvar ;
Yokoi, Yoshiaki ;
Schroeder, Henrik ;
Prem, Jeffery T. ;
Holden, Andrew ;
Popma, Jeffrey ;
Jaff, Michael R. ;
Diaz-Cartelle, Juan ;
Mueller-Huelsbeck, Stefan .
LANCET, 2018, 392 (10157) :1541-1551
[8]   Effect of Intravascular Ultrasound-Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation The IVUS-XPL Randomized Clinical Trial [J].
Hong, Sung-Jin ;
Kim, Byeong-Keuk ;
Shin, Dong-Ho ;
Nam, Chung-Mo ;
Kim, Jung-Sun ;
Ko, Young-Guk ;
Choi, Donghoon ;
Kang, Tae-Soo ;
Kang, Woong-Chol ;
Her, Ae-Young ;
Kim, Yonghoon ;
Hur, Seung-Ho ;
Hong, Bum-Kee ;
Kwon, Hyuckmoon ;
Jang, Yangsoo ;
Hong, Myeong-Ki .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2015, 314 (20) :2155-2163
[9]   The Characteristics of In-Stent Restenosis After Drug-Eluting Stent Implantation in Femoropopliteal Lesions and 1-Year Prognosis After Repeat Endovascular Therapy for These Lesions [J].
Iida, Osamu ;
Takahara, Mitsuyoshi ;
Soga, Yoshimitsu ;
Hirano, Keisuke ;
Yamauchi, Yasutaka ;
Zen, Kan ;
Kawasaki, Daizo ;
Nanto, Shinsuke ;
Yokoi, Hiroyoshi ;
Uematsu, Masaaki .
JACC-CARDIOVASCULAR INTERVENTIONS, 2016, 9 (08) :828-834
[10]   Mortality Risk in Acute Ischemic Stroke Patients With Large Vessel Occlusion Treated With Mechanical Thrombectomy [J].
Katsanos, Aristeidis H. ;
Malhotra, Konark ;
Goyal, Nitin ;
Palaiodimou, Lina ;
Schellinger, Peter D. ;
Caso, Valeria ;
Cordonnier, Charlotte ;
Turc, Guillaume ;
Magoufis, Georgios ;
Arthur, Adam ;
Alexandrov, Andrei V. ;
Tsivgoulis, Georgios .
JOURNAL OF THE AMERICAN HEART ASSOCIATION, 2019, 8 (21)