Angiographic classification of patterns of restenosis following femoropopliteal artery intervention: A proposed scoring system

Garcia, Lawrence A.; Rocha‐Singh, Krishna; Ramanathan, Krishnan; Zeller, Thomas; Tepe, Gunnar; Fleming, Mark D.; Granada, Juan F.; Turco, Mark; Tieche, Christopher; Jaff, Michael R.

doi:10.1002/ccd.27198

Cited by 3 publications

(2 citation statements)

References 48 publications

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“…Fisher's exact test was used to restenosis rate in the TOBA II cohort is lower than the rate of restenosis than the 20-37% range reported for stents and is within the 3-20% range reported for non-stent technologies. [13][14][15][16]18 There are a few limitations to this study. Although the sample size of the TOBA II cohort is small, it is still the largest cohort to date in which patients received standard treatment.…”

Section: Discussionmentioning

confidence: 99%

Restenosis After Tack Implantation is Associated with Less Complex Patterns of Restenosis Compared to Stent Implantation

Kolluri¹,

Gray

Armstrong

et al. 2020

Vascular and Endovascular Review

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In-stent restenosis is complex, difficult to treat and has led to a ‘leave less metal behind’ approach to femoropopliteal intervention. Postangioplasty dissection often requires scaffolding to maintain patency. The Tack Endovascular System provides minimal-metal dissection repair that preserves future treatment options. Tack implants are designed to minimise the inflammation and neointimal hyperplasia that lead to in-stent restenosis. An independent angiographic core laboratory evaluated the restenosis patterns in clinically driven target lesion revascularisation (CD-TLR) during the 12 months following the index procedure in the Tack Optimized Balloon Angioplasty (TOBA) II study and compared these results to those published for nitinol stent implantation. Of the 213 patients in TOBA II, 31 (14.6%) required a CD-TLR. Of these, 28 had angiograms that were evaluated by the core laboratory, and 45.2%, 16.1%, and 29% were graded as Tosaka class I, II and III, respectively. There were no significant differences (p>0.05) in lesion length, degree of calcification or dissection class between the three groups. Tack restenotic lesion classification and analysis show a prevalence of both class I and shorter lesions relative to in-stent restenosis, which may be beneficial to long-term patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Restenosis After Tack Implantation is Associated with Less Complex Patterns of Restenosis Compared to Stent Implantation

Kolluri¹,

Gray

Armstrong

et al. 2020

Vascular and Endovascular Review

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show abstract

“…also exhibit edge restenosis but may also be "edge bilateral"; type 3, "moderate" pattern; type 4, "diffuse" pattern; and type 5, "occlusion." This classification, proposed by Dr. Garcia 20) , was used because it allowed us to classify restenosis occurring after balloon angioplasty or stenting in the same manner.…”

Section: Introductionmentioning

confidence: 99%

Effect of Target Lesion Revascularization on Restenosis Lesions of the Superficial Femoral Artery without Recurred Symptoms after Endovascular Therapy

Utsunomiya

Takahara

Fujihara

et al. 2021

JAT

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This study aims to elucidate the effects of early application of target lesion revascularization (TLR) to restenosis lesions of the superficial femoral artery (SFA) without recurrence of symptoms. Despite recent improvements in endovascular therapy (EVT) for the SFA, restenosis remains to be a problem. However, restenosis is not always associated with the recurrence of limb symptoms. Although early application of TLR is not generally approved for restenosis lesions of the SFA without recurred symptoms, it is expected to contribute to longterm patency and other favorable outcomes. Nonetheless, its effectiveness remains to be determined. Methods:We retrospectively analyzed 616 patients who developed restenosis after undergoing femoro-popliteal EVT for claudication (Rutherford category 1 to 3) due to de novo femoro-popliteal lesions between January 2010 and December 2016 at 11 centers in Japan. Recurred symptoms were defined as symptoms of the same or higher Rutherford categories than those immediately before the initial EVT.Results: Of the patients, 291 (47 %) lacked recurred symptoms; 69 (24 %) underwent TLR for restenosis. After propensity matching, the risk of occlusion was determined to be not significantly different between the TLR and observation groups; the 3-year occlusion-free rate was 68 % and 62 %, respectively (P 0.84). The risk of recurring symptoms, critical limb ischemia, and all-cause death was also found to be comparable between groups. The incidence of target vessel revascularization was significantly higher in the TLR than in the observation group (1.55 [95 % confidence interval: 1.25-1.93] vs. 0.59 [0.41-0.85] per 3 person-years). Conclusions:In patients with SFA restenosis without recurred symptoms, early application of TLR showed no advantages.

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Failure mode and bimodal restenosis of drug-coated balloon in femoropopliteal intervention

Huang

Chou

Chen

et al. 2018

International Journal of Cardiology

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Angiographic classification of patterns of restenosis following femoropopliteal artery intervention: A proposed scoring system

Cited by 3 publications

References 48 publications

Restenosis After Tack Implantation is Associated with Less Complex Patterns of Restenosis Compared to Stent Implantation

Restenosis After Tack Implantation is Associated with Less Complex Patterns of Restenosis Compared to Stent Implantation

Effect of Target Lesion Revascularization on Restenosis Lesions of the Superficial Femoral Artery without Recurred Symptoms after Endovascular Therapy

Failure mode and bimodal restenosis of drug-coated balloon in femoropopliteal intervention

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