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The Zilver PTX stent is the first drug-eluting stent approved for the superficial femoral artery (SFA). Previous studies have shown that Zilver PTX decreases target lesion revascularization. However, we experienced the cases that resulted in the obstruction due to the thrombus in the stent early after the stent implantation. We evaluated the restenotic characteristic of Zilver PTX.
This is a single center retrospective study enrolling 72 femoropopliteal lesions. All the patients are implanted Zilver PTX optimally from January 2014 to September 2016. We defined primary patency as the cases that the restenosis rate was less than 50% in the angiographic quantitative vascular analysis (QVA) or that peak systolic velocity ratio (PSVR) is ≤2.5.
At two years the primary patency and secondary patency were 93.5% and 100%, respectively. There were 4 cases that resulted in the obstruction due to the thrombus in the stent within about one month after the stent implantation. They had over 75% stenosis at the ostium of superficial femoral artery (P<0.001, Fisher's exact test). We added stent implantation to SFA ostium and balloon dilatation in the stent, and then we could get secondary patency.
If patients have ostial SFA lesions of atherosclerosis, it is safe and reasonable that we implant Zilver PTX from the ostium of SFA to cover all lesions.