Author + information
- Kojiro Miki,
- Kenichi Fujii,
- Daizo Kawasaki,
- Masashi Fukunaga,
- Hiroto Tamaru,
- Takahiro Imanaka,
- Masahiko Shibuya,
- Motomaru Masutani,
- Mitsumasa Ohyanagi and
- Tohru Masuyama
Previous intravascular ultrasound (IVUS) study reported that target lesion revascularization (TLR) in lesions with non flow–limiting residual stent edge dissection was comparable to that in lesions without residual stent edge dissection after stent implantaton in the coronary artery lesions. However, no data are available whether this finding applied in the superficial femoral artery (SFA) lesions after self–expanding nitinol stent implantation.
We analyzed 236 de novo SFA lesions in consecutive 184 patients who underwent IVUS examinations after endovascular therapy with self–expanding nitinol stent. Stent edge dissection was defined as a disruption of the vessel luminal surface at stent edge with visible flap. Stent edge dissection was also classified into intimal dissection or medial dissection. TLR was defined as clinically driven revascularization with angiographic ≥75% restenosis of the target lesion.
The mean follow–up period was 34±15 months. During this period, TLRs were performed in 42 lesions (17.8%). Stent edge dissections were identified in 56 lesions (23.7%). Although the prevalence of intimal edge dissection was similar between two groups, medial edge dissection was frequently observed in TLR group compared to no–TLR group (23.8% versus 7.2%, p=0.003). Multivariate analysis revealed that medial edge dissection was an independent predictor of TLR (OR=2.99, p<0.05).
Medial edge dissections after self–expanding nitinol stent implantation in the SFA lesions should be treated to prevent TLR. However, lesions without flow–limiting intimal dissection should be left conservatively as spontaneous healing is possible.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.–4:30 p.m.
Session Title: Endovascular Intervention
Abstract Category: 41. TCT@ACC–i2: Carotid, Neurovascular, and Endovascular Intervention
Presentation Number: 2109–219
- 2013 American College of Cardiology Foundation