Advances in Clinical and Experimental Medicine

Title abbreviation: Adv Clin Exp Med
JCR Impact Factor (IF) – 2.1
5-Year Impact Factor – 2.2
Scopus CiteScore – 3.4 (CiteScore Tracker 3.4)
Index Copernicus  – 161.11; MEiN – 140 pts

ISSN 1899–5276 (print)
ISSN 2451-2680 (online)
Periodicity – monthly

Download original text (EN)

Advances in Clinical and Experimental Medicine

2017, vol. 26, nr 2, March-April, p. 311–318

doi: 10.17219/acem/58997

Publication type: original article

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Clinical risk factors for loss of stent primary patency in patients with chronic legs ischemia

Klaudia Koza1,B,C,D,E,F, Paweł Grzelązka1,B,C,E,F, Adrianna Trofimiuk1,B,C,E,F, Karol Suppan2,B,C,F, Marcin Wasielewski2,B,C,F, Joanna Wiśniewska2,B,C,F, Jacek Budzyński3,A,B,C,D,E,F

1 Student Scientific Group, Chair and Clinic of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland

2 Clinic of Vascular and Internal Diseases, Jan Biziel University Hospital No. 2, Bydgoszcz, Poland

3 Chair of Vascular and Internal Diseases, Faculty of Health Sciences, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Toruń, Poland

Abstract

Background. The outcome of endovascular therapy can be influenced by a number of factors, either demographic, biochemical, angiographic or procedural. Knowledge about these factors may help in the individualization of therapeutic methods, surveillance intensity, and should, ultimately, improve intervention efficacy.
Objectives. The aim of this study was to estimate the effect of clinical and biochemical factors on the late outcome of lower limb artery stenting.
Material and Methods. The medical documentation of 91 patients with at least a 1 year follow-up after the stenting of a lower limb artery was retrospectively evaluated. Uniand multivariate analyses were performed.
Results. Primary patency within an approximately 1.5-year follow-up amounted to 68.2%. The probability of freedom from target lesion revascularization was significantly greater in patients with dyslipidemia. According to the Cox proportional-hazards analysis, the risk of target extremity revascularization was significantly affected by the following (hazard ratio [HR], 95% confidence interval): Age (0.93, 0.88–0.99); dyslipidemia at inclusion (0.046, 0.01–0.23); LDL blood concentration (1.02; 1.01–1.04); hematocrit (1.2, 1.02–1.42); mean platelet volume (0.66, 0.44–0.99); INR (1.58, 1.13–2.21); and aPTT (1.18, 1.07–1.3).
Conclusion. Endovascular treatment with stenting in patients with atherosclerotic peripheral arterial disease is effective, but the risk of primary patency loss was affected by the presence of dyslipidemia, age, and blood coagulation parameters. The effect of dyslipidemia on stent failure occurrence should be evaluated in further studies.

Key words

risk factors, dyslipidemia, peripheral artery disease, in-stent restenosis, blood coagulation

References (31)

  1. Laird JR, Yeo KK. The treatment of femoropopliteal in-stent restenosis: Back to the future. J Am Coll Cardiol. 2012;59:24–25.
  2. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society consensus for the management of peripheral arterial disease (TASC II). J Vasc Surg. 2007;45(Suppl S):S5–S67.
  3. Dippel EJ, Makam P, Kovach R, et al. Randomized controlled study of excimer laser atherectomy for treatment of femoropopliteal in-stent restenosis: Initial results from the EXCITE ISR (EXCImer Laser Randomized Controlled Study for Treatment of FemoropopliTEal In-Stent Restenosis) Trial. JACC Cardiovasc Interv. 2015;8:92–101.
  4. Bosiers M, Scheinert D, Peeters P, et al. Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease. J Vasc Surg. 2012;55:390–398.
  5. Singh GD, Armstrong EJ, Laird JR. Femoropopliteal in-stent restenosis: Current treatment strategies. J Cardiovasc Surg (Torino). 2014;55:325–33.
  6. Speck U, Scheller B, Hamm B. Drug-coated balloons for restenosis prophylaxis. Rofo. 2014;186:348–358.
  7. Schmidt A, Zeller T, Sievert H, et al. Photoablation using the turbo-booster and excimer laser for in-stent restenosis treatment: Twelve-month results from the PATENT study. J Endovasc Ther. 2014;21:52–60.
  8. Liistro F, Grotti S, Porto I, et al. Drug-eluting balloon in peripheral intervention for the superficial femoral artery: The DEBATE-SFA randomized trial (drug eluting balloon in peripheral intervention for the superficial femoral artery). JACC Cardiovasc Interv. 2013; 6:1295–1302.
  9. Tsetis D, Belli AM, Morgan R, et al. Preliminary experience with cutting balloon angioplasty for iliac artery in-stent restenosis. J Endovasc Ther. 2008;15:193–202.
  10. Karthik S, Tuite DJ, Nicholson AA, et al. Cryoplasty for arterial restenosis. Eur J Vasc Endovasc Surg. 2007;33:40–43.
  11. Tosaka A, Soga Y, Iida O, et al. Classification and clinical impact of restenosis after femoropopliteal stenting. J Am Coll Cardiol. 2012;59: 16–23.
  12. Swanson N, Hogrefe K, Javed Q, Malik N, Gershlick AH. Vascular endothelial growth factor (VEGF)-eluting stents: In vivo effects on thrombosis, endothelialization and intimal hyperplasia. J Invasive Cardiol. 2003;15:688–692.
  13. Grzelązka P, Koza K, Trofimiuk A, et al. The association between periprocedural factors and the late outcome of percutaneous stenting of lower extremity arteries. A retrospective cohort study. Postep Kardiol Inter. 2015;11(2);1–6.
  14. Kavaliauskienė Z, Benetis R, Inčiūra D, Aleksynas N, Kaupas RS, Antuševas A. Factors affecting primary patency of stenting for TransAtlantic Inter-Society (TASC II) type B, C, and D iliac occlusive disease. Medicina (Kaunas). 2014;50:287–294.
  15. Diehm N, Baumgartner I, Jaff M, et al. A call for uniform reporting standards in studies assessing endovascular treatment for chronic ischae-mia of lower limb arteries. Eur Heart J. 2007;28:798–805.
  16. Perk J, De Backer G, Gohlke H, et al.; European Association for Cardiovascular Prevention & Rehabilitation (EACPR); ESC Committee for Prac-tice Guidelines (CPG). European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012;33:1635–1701.
  17. Montalescot G, Sechtem U, Achenbach S, et al. ESC guidelines on the management of stable coronary artery disease: The Task Force on the management of stable coronary artery disease of the European Society of Cardiology. Eur Heart J. 2013;34:2949–3003.
  18. Gabrielli R, Rosati MS, Vitale S, et al. Randomized controlled trial of remote endarterectomy versus endovascular intervention for TransAt-lantic Inter-Society Consensus II D femoropopliteal lesions. J Vasc Surg. 2012;56:1598–1605.
  19. Baril DT, Marone LK, Kim J, Go MR, Chaer RA, Rhee RY. Outcomes of endovascular interventions for TASC II B and C femoropopliteal lesions. J Vasc Surg. 2008;48:627–633.
  20. Antoniou GA, Fisher RK, Georgiadis GS, Antoniou SA, Torella F. Statin therapy in lower limb peripheral arterial disease: Systematic review and meta-analysis. Vascul Pharmacol. 2014;63:79–87.
  21. Galiñanes EL, Reynolds S, Dombrovskiy VY, Vogel TR. The impact of preoperative statin therapy on open and endovascular abdominal aortic aneurysm repair outcomes. Vascular. 2014, pii: 1708538114552837.
  22. Suckow BD, Kraiss LW, Schanzer A, et al. Statin therapy after infrainguinal bypass surgery for critical limb ischemia is associated with im-proved 5-year survival. J Vasc Surg. 2015;61:126–133.e1.
  23. Markel A. Statins and peripheral arterial disease. Int Angiol. 2015;34: 416–427.
  24. Poredoš P, Jezovnik MK, Kalodiki Eet al. Medical management of patients with peripheral arterial disease. Int Angiol. 2015;34:75–93.
  25. Dosluoglu HH, Davari-Farid S, Pourafkari L, Harris LM, Nader ND. Statin use is associated with improved overall survival without affecting patency and limb salvage rates following open or endovascular revascularization. Vasc Med. 2014;19:86–93.
  26. Leader A, Pereg D, Lishner M. Are platelet volume indices of clinical use? A multidisciplinary review. Ann Med. 2012;44:805–816.
  27. Pal R, Bagarhatta R, Gulati S, Rathore M, Sharma N. Mean platelet volume in patients with acute coronary syndromes: A supportive diagnostic predictor. J Clin Diagn Res. 2014;8:MC01–4.
  28. Taglieri N, Saia F, Rapezzi C, et al. Prognostic significance of mean platelet volume on admission in an unselected cohort of patients with non ST-segment elevation acute coronary syndrome. Thromb Haemost. 2011;106:132–140.
  29. Seyyed-Mohammadzad MH, Eskandari R, Rezaei Y, et al. Prognostic value of mean platelet volume in patients undergoing elective percuta-neous coronary intervention. Anadolu Kardiyol Derg. 2015;15:25–30.
  30. Cosmi B, Conti E, Coccheri S. Anticoagulants (heparin, low molecular weight heparin and oral anticoagulants) for intermittent claudication. Cochrane Database Syst Rev. 2014;5:CD001999.
  31. Robertson L, Ghouri MA, Kovacs F. Antiplatelet and anticoagulant drugs for prevention of restenosis/reocclusion following peripheral endovascular treatment. Cochrane Database Syst Rev. 2012;8:CD002071.