A Long-term Results with the Palmaz Stent in the Superficial Femoral Artery

Bergeron, Patrice; Pinot, Jean J.; Poyen, Vincent; Benichou, Huber; Khanoyan, Patrick; Rudondy, P; Wang, Yu; Chiarandini, Stefano; Hussein, Radwan El; Rieu, Régis; Larroude, Laurence; Pelissier, R.

doi:10.1583/1074-6218(1995)002<0161:altrwt>2.0.co;2

Cited by 66 publications

(20 citation statements)

References 19 publications

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“…EVT options for FPOD include PTA alone, especially for short focal lesions <4 cm, 193 angioplasty with selfexpanding stents, 194 angioplasty with balloon-expandable stents, 195 angioplasty with covered stent grafts, 196,197 atherectomy, [198][199][200] antimyoproliferative drug-coated balloons, [201][202][203] and drug-eluting stents (DESs). 204 Combination EVT involving atherectomy and DESs has been reported in European trials.…”

Section: Summary Of Evidence: Interventions For Aortoiliac Occlusive mentioning

confidence: 99%

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Conte

Pomposelli

Clair

et al. 2015

Journal of Vascular Surgery

705

508

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Peripheral arterial disease (PAD) continues to grow in global prevalence and consumes an increasing amount of resources in the United States health care system. Overall rates of intervention for PAD have been rising steadily in recent years. Changing demographics, evolution of technologies, and an expanding database of outcomes studies are primary forces influencing clinical decision making in PAD. The management of PAD is multidisciplinary, involving primary care physicians and vascular specialists with varying expertise in diagnostic and treatment modalities. PAD represents a broad spectrum of disease from asymptomatic through severe limb ischemia. The Society for Vascular Surgery Lower Extremity Practice Guidelines committee reviewed the evidence supporting clinical care in the treatment of asymptomatic PAD and intermittent claudication (IC). The committee made specific practice recommendations using the GRADE (Grades of Recommendation Assessment, Development and Evaluation) system. There are limited Level I data available for many of the critical questions in the field, demonstrating the urgent need for comparative effectiveness research in PAD. Emphasis is placed on risk factor modification, medical therapies, and broader use of exercise programs to improve cardiovascular health and functional performance. Screening for PAD appears of unproven benefit at present. Revascularization for IC is an appropriate therapy for selected patients with disabling symptoms, after a careful risk-benefit analysis. Treatment should be individualized based on comorbid conditions, degree of functional impairment, and anatomic factors. Invasive treatments for IC should provide predictable functional improvements with reasonable durability. A minimum threshold of a >50% likelihood of sustained efficacy for at least 2 years is suggested as a benchmark. Anatomic patency (freedom from restenosis) is considered a prerequisite for sustained efficacy of revascularization in IC. Endovascular approaches are favored for most candidates with aortoiliac disease and for selected patients with femoropopliteal disease in whom anatomic durability is expected to meet this minimum threshold. Conversely, caution is warranted in the use of interventions for IC in anatomic settings where durability is limited (extensive calcification, small-caliber arteries, diffuse infrainguinal disease, poor runoff). Surgical bypass may be a preferred strategy in good-risk patients with these disease patterns or in those with prior endovascular failures. Common femoral artery disease should be treated surgically, and saphenous vein is the preferred conduit for infrainguinal bypass grafting. Patients who undergo invasive treatments for IC should be monitored regularly in a surveillance program to record subjective improvements, assess risk factors, optimize compliance with cardioprotective medications, and monitor hemodynamic and patency status.

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Section: Summary Of Evidence: Interventions For Aortoiliac Occlusive mentioning

confidence: 99%

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Conte

Pomposelli

Clair

et al. 2015

Journal of Vascular Surgery

705

508

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“…Routine stenting of the superior femoral artery is a subject of intense debate considering its variable long‐term patency rates [25, 26]. In the present study, less aggressive laser debulking and predilatation resulted in more suboptimal results after balloon dilatation and the greater need for more frequent stent implantation (80%), possibly leading to low rates of abrupt closure (1%) and distal embolization (0%).…”

Section: Discussionmentioning

confidence: 60%

Wireless laser‐assisted angioplasty of the superficial femoral artery in patients with critical limb ischemia who have failed conventional percutaneous revascularization

Boccalandro

Muench

Sdringola

et al. 2004

Cathet Cardio Intervent

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Percutaneous revascularization has become an effective treatment for patients suffering from chronic critical limb ischemia (CLI) due to chronic atherosclerotic obstructions, including total occlusions. Unlike other vascular beds, total chronic occlusions of the femoropopliteal arteries are frequently found in patients with severe claudication or CLI. As a consequence, patients with long chronic total occlusions of the femoropopliteal arteries are generally not considered optimal candidates for percutaneous revascularization and are frequently referred for surgical revascularization. In the present study, we sought to evaluate the feasibility, safety, and outcome of a modified wireless laser ablation technique to recanalize total occlusions in patients with CLI who had failed conventional percutaneous techniques for limb salvage. Procedural success, complications, actuarial freedom of limb loss, and surgical revascularization were evaluated in 25 patients after a mean follow-up of 13 +/- 8 months. Procedural success was achieved in 21 patients (84%). Actuarial freedom from surgical revascularization or limb loss was 72%. There was one vascular perforation. No deaths or distal embolization occurred. Three patients (12%) required limb amputation during follow-up, whereas four patients (16%) had surgical revascularization in the presence of feasible vascular targets. Limb salvage was achieved in 88% of patients when laser recanalization was combined with surgical revascularization. These results suggest that the use of laser ablation is safe and facilitates angioplasty and stenting in patients with CLI that failed conventional endovascular revascularization. This technique might prevent limb loss in patients with CLI due to femoropopliteal total occlusions, particularly in patients with unsuitable anatomy for surgical revascularization.

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“…In the TASC document, an analysis of 11 publications indicated a weighted average primary patency rate of 67% after 1 year and of 58% after 3 years following femoropopliteal stenting 4 . Thus, bare metal stenting has not improved patency rates compared with balloon angioplasty alone 26–29 . While the weighted average 5‐year patency rates after balloon angioplasty are indicated as 48% 4 and 40%, 30 respectively, the 4‐year patency rates following bare metal stenting reaches 37% (Table 2).…”

Section: Endovascular Interventions In Femoropopliteal Arteriesmentioning

confidence: 98%

“…4 Thus, bare metal stenting has not improved patency rates compared with balloon angioplasty alone. [26][27][28][29] While the weighted average 5year patency rates after balloon angioplasty are indicated as 48% 4 and 40%, 30 respectively, the 4-year patency rates following bare metal stenting reaches 37% ( Table 2). 30 In a meta-analysis from 19 publications, Muradin et al 31 extracted a 3-year primary patency rate after balloon dilation of 30%, 48%, and 61%, respectively, depending on lesion type and clinical classification (occlusions with critical ischemia, occlusions and claudication, stenoses with claudication).…”

Section: Endovascular Interventions In Femoropopliteal Arteriesmentioning

confidence: 99%

Endovascular Interventions in Iliac and Infrainguinal Occlusive Artery Disease

Ruef

Hofmann

Haase

2004

J Interven Cardiology

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Percutaneous endovascular procedures are increasingly applied to treat symptomatic peripheral occlusive artery disease. While the primary technical success and recanalization rates in iliac and infrainguinal interventions are high, differences in the long-term patency rates exist with respect to the anatomic localization, separating the iliac, femoropopliteal, and infrapopliteal arterial regions. In iliac arteries, even complex lesions can be recanalized with good long-term patency rates, especially when using self-expanding nitinol stents. In the infrainguinal arteries the method of choice is still under debate (e.g., balloon angioplasty vs stent implantation). A high restenosis rate represents one of the major limitations in femoropopliteal and infrapopliteal interventions. Therefore, additional methods and treatment strategies for peripheral interventions with the potential for future applications are under investigation and will be discussed such as drug-eluting stents, brachytherapy, subintimal angioplasty, laser angioplasty, atherectomy/thrombectomy, cutting balloon, polytetrafluoroethylene (PTFE)-covered stent grafts, biodegradable stents, and cryoplasty. The increasing amount of data on successful peripheral interventions supports the necessity to adapt and reevaluate the current consensus guidelines that were put together in 2000.

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A Long-term Results with the Palmaz Stent in the Superficial Femoral Artery

Abstract: Palmaz stents performed will in the SFA, demonstrating a low acute thrombosis rate and good long-term patency. The incidence of restenosis is likely to be greater in occlusions than in stenoses.

Cited by 66 publications

References 19 publications

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Society for Vascular Surgery practice guidelines for atherosclerotic occlusive disease of the lower extremities: Management of asymptomatic disease and claudication

Wireless laser‐assisted angioplasty of the superficial femoral artery in patients with critical limb ischemia who have failed conventional percutaneous revascularization

Endovascular Interventions in Iliac and Infrainguinal Occlusive Artery Disease

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