Author + information
- Subhash Banerjee,
- Karan Sarode,
- Atif Mohammad,
- Osvaldo Gigliotti,
- Michael Luna,
- Tayo Addo,
- Mirza Baig,
- Shirling Tsai,
- Nicolas Shammas,
- Anand Prasad,
- Mazen Abu-Fadel,
- Andrew Klein and
- Emmanouil Brilakis
In-stent restenosis (ISR) is commonly encountered during endovascular revascularization of infrainguinal arteries. However, limited data exists guiding operator decision-making.
We analyzed data for 1,056 procedures performed between April 2005 and August 2014 from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry.
A total of 200 (18.9%) procedures treated ISR. Non-diabetic (47.2% vs. 57.5%; p=0.009) patients and women (n=48; 24.0% vs. 17.9%; p=0.048) were more frequently treated for ISR. Compared to those without ISR, average lesion lengths were similar (131.0±87.9 vs. 123.4±83.0 mm; p=0.312), with greater involvement of superficial femoral artery (SFA) (93.0% vs. 78.2%; p<0.001), and fewer chronic total occlusions (47.0% vs. 54.7%; p=0.05). Most ISR were treated without additional stents (58.3% vs. 45.1%; p<0.001), and higher atherectomy use (46.5% vs. 32.1%; p<0.001) compared to non-ISR lesions. Drug eluting stent (DES) use was higher in ISR (9.2% vs. 4.2%; p=0.018). Procedural success rates of ISR were similar to non-ISR lesions (94.4% vs. 93.7%; p=0.686), as were peri-procedural complication rates (6.6% vs. 4.1%; p=0.151) and need for repeat target limb revascularization (TLR; 18.5% vs. 13.7%; p=0.089). Stent thrombosis was higher in ISR lesions (Figure 1).
ISR is more frequently encountered in the SFA and is treated predominantly with atherectomy. However, DES are more frequently used in ISR lesions.
Poster Hall B1
Sunday, March 15, 2015, 9:45 a.m.-10:30 a.m.
Session Title: Peripheral and Vascular Biology
Abstract Category: 31. TCT@ACC-i2: Carotid and Endovascular Intervention
Presentation Number: 2102-311
- 2015 American College of Cardiology Foundation