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Endovascular treatment for the long femoropopliteal lesions has not substantial result. This study purpose to evaluate the predictor of primary patency and freedom from target lesion re-intervention in the complex lesions with a femoropopliteal artery.
Between August 2011 and June 2015, 68 patients (48 men; 73 ± 8 years) 83 lesions with symptomatic TASCC or D class were treated by endovascular intervention. We measured vessel diameter using intravascular ultrasonography (IVUS).
At 12 months post-intervention, clinical symptom, ABI, X-ray, and peak systolic velocity ratio (PSVR) of the duplex scan was estimated. Primary patency was defined as PSVR＜2.5.
Hemodialysis 15%. Rutherford class 1-3: 70%, 4: 5%, 5: 22%, 6: 4%. ABI 0.60 ± 0.14. Mean length was 242 ± 56 mm. Mean proximal and distal vessel diameter 6.8 ± 1.0 mm, 5.8 ± 0.9 mm. Chronic total occlusion was 64 vessels (77%). TASC C was 34 lesions (41%), and D was 49 lesions (59%). BMS and DES were implanted in 63 and 20 lesions.
Primary and secondary patency were recorded in 71%, 82% lesions. Freedom from target lesion re-intervention (TLR) was 81% at 12 months post procedure. In the distal vessel diameter <6 mm, primary patency was 53%. It was >6 mm, primary patency was 71%. There was a significant difference between 2 groups. Stent fractures were 7.2%.
Primary patency with distal vessel diameter<6 mm was significantly lower than it >6 mm. Distal vessel diameter is predicted or of stent restenosis in complex femoropopliteal arterial disease. IVUS is a useful tool to predict primary patency, and select the stent size, kind.