Midterm outcomes of subintimal angioplasty supported by primary proximal stenting for chronic total occlusion of the superficial femoral artery

Sung Jin Hong, Young Guk Ko, Jung Sun Kim, Myeong Ki Hong, Yangsoo Jang, Donghoon Choi

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To investigate the midterm outcomes of subintimal angioplasty in occluded superficial femoral arteries (SFA) and evaluate the clinical and procedural factors affecting these results. Methods: Between April 2004 and April 2012, 150 patients (122 men; mean age 69±10 years) with chronic total occlusions in the SFA underwent subintimal angioplasty with primary stenting in 172 limbs. The average lesion length was 22.6±8.5 cm. Stents were routinely implanted at the proximal entry into the subintimal channel. The primary endpoint was binary restenosis. Results: Technical success was achieved in 161 (94%) limbs; there were no procedure-related deaths or complications requiring surgery, but distal embolization and arterial perforation occurred in 2 and 4 limbs, respectively. The cumulative freedom from binary restenosis rates at 1 and 3 years were 77% and 59%, respectively, in the entire study group. The 96 patients without critical limb ischemia (CLI) had significantly higher patency rates at 1 and 3 years (84% and 66%, respectively) than the 54 patients with CLI (66% and 43%, respectively; p=0.011). Based on multivariate analysis, a larger number of stents, lower post-procedure ankle-brachial index, and lower body mass index were each independent predictors of binary restenosis. Conclusion: Subintimal angioplasty with routine stenting at the proximal stump is safe and effective for the treatment of chronic total SFA occlusions.

Original languageEnglish
Pages (from-to)782-791
Number of pages10
JournalJournal of Endovascular Therapy
Volume20
Issue number6
DOIs
Publication statusPublished - 2013 Dec 1

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Femoral Artery
Angioplasty
Extremities
Stents
Ischemia
Ankle Brachial Index
Body Mass Index
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Midterm outcomes of subintimal angioplasty supported by primary proximal stenting for chronic total occlusion of the superficial femoral artery",
abstract = "Purpose: To investigate the midterm outcomes of subintimal angioplasty in occluded superficial femoral arteries (SFA) and evaluate the clinical and procedural factors affecting these results. Methods: Between April 2004 and April 2012, 150 patients (122 men; mean age 69±10 years) with chronic total occlusions in the SFA underwent subintimal angioplasty with primary stenting in 172 limbs. The average lesion length was 22.6±8.5 cm. Stents were routinely implanted at the proximal entry into the subintimal channel. The primary endpoint was binary restenosis. Results: Technical success was achieved in 161 (94{\%}) limbs; there were no procedure-related deaths or complications requiring surgery, but distal embolization and arterial perforation occurred in 2 and 4 limbs, respectively. The cumulative freedom from binary restenosis rates at 1 and 3 years were 77{\%} and 59{\%}, respectively, in the entire study group. The 96 patients without critical limb ischemia (CLI) had significantly higher patency rates at 1 and 3 years (84{\%} and 66{\%}, respectively) than the 54 patients with CLI (66{\%} and 43{\%}, respectively; p=0.011). Based on multivariate analysis, a larger number of stents, lower post-procedure ankle-brachial index, and lower body mass index were each independent predictors of binary restenosis. Conclusion: Subintimal angioplasty with routine stenting at the proximal stump is safe and effective for the treatment of chronic total SFA occlusions.",
author = "Hong, {Sung Jin} and Ko, {Young Guk} and Kim, {Jung Sun} and Hong, {Myeong Ki} and Yangsoo Jang and Donghoon Choi",
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T1 - Midterm outcomes of subintimal angioplasty supported by primary proximal stenting for chronic total occlusion of the superficial femoral artery

AU - Hong, Sung Jin

AU - Ko, Young Guk

AU - Kim, Jung Sun

AU - Hong, Myeong Ki

AU - Jang, Yangsoo

AU - Choi, Donghoon

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N2 - Purpose: To investigate the midterm outcomes of subintimal angioplasty in occluded superficial femoral arteries (SFA) and evaluate the clinical and procedural factors affecting these results. Methods: Between April 2004 and April 2012, 150 patients (122 men; mean age 69±10 years) with chronic total occlusions in the SFA underwent subintimal angioplasty with primary stenting in 172 limbs. The average lesion length was 22.6±8.5 cm. Stents were routinely implanted at the proximal entry into the subintimal channel. The primary endpoint was binary restenosis. Results: Technical success was achieved in 161 (94%) limbs; there were no procedure-related deaths or complications requiring surgery, but distal embolization and arterial perforation occurred in 2 and 4 limbs, respectively. The cumulative freedom from binary restenosis rates at 1 and 3 years were 77% and 59%, respectively, in the entire study group. The 96 patients without critical limb ischemia (CLI) had significantly higher patency rates at 1 and 3 years (84% and 66%, respectively) than the 54 patients with CLI (66% and 43%, respectively; p=0.011). Based on multivariate analysis, a larger number of stents, lower post-procedure ankle-brachial index, and lower body mass index were each independent predictors of binary restenosis. Conclusion: Subintimal angioplasty with routine stenting at the proximal stump is safe and effective for the treatment of chronic total SFA occlusions.

AB - Purpose: To investigate the midterm outcomes of subintimal angioplasty in occluded superficial femoral arteries (SFA) and evaluate the clinical and procedural factors affecting these results. Methods: Between April 2004 and April 2012, 150 patients (122 men; mean age 69±10 years) with chronic total occlusions in the SFA underwent subintimal angioplasty with primary stenting in 172 limbs. The average lesion length was 22.6±8.5 cm. Stents were routinely implanted at the proximal entry into the subintimal channel. The primary endpoint was binary restenosis. Results: Technical success was achieved in 161 (94%) limbs; there were no procedure-related deaths or complications requiring surgery, but distal embolization and arterial perforation occurred in 2 and 4 limbs, respectively. The cumulative freedom from binary restenosis rates at 1 and 3 years were 77% and 59%, respectively, in the entire study group. The 96 patients without critical limb ischemia (CLI) had significantly higher patency rates at 1 and 3 years (84% and 66%, respectively) than the 54 patients with CLI (66% and 43%, respectively; p=0.011). Based on multivariate analysis, a larger number of stents, lower post-procedure ankle-brachial index, and lower body mass index were each independent predictors of binary restenosis. Conclusion: Subintimal angioplasty with routine stenting at the proximal stump is safe and effective for the treatment of chronic total SFA occlusions.

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