Hemodynamic outcome of endovascular therapy for transatlantic intersociety consensus type B femoropopliteal arterial occlusive lesions

Abstract

Endovascular therapy for TASC type B femoropopliteal lesions is safe and technically feasible. However, the length of time that a treated arterial segment remains free of stenosis is limited, and is not improved with adjunctive stenting. Recurrent stenosis, not occlusion, was the most common study end point, and few patients subsequently required surgical bypass. Predictors of outcome after endovascular therapy for TASC type B lesions were not identified in this study.

Fracture of self-expanding nitinol stents stressed in vitro under simulated intravascular conditions

“…achieved after treatment of relatively short segmental lesions, 21-23 but long-term patency after endovascular recanalization of more complex stenoses and occlusions in the superficial femoral artery is generally about 50%. [3][4][5][6][7][8][9][10] The possible explanations for the discouraging results of infrainguinal endovascular intervention are many. The infrainguinal circulation is characterized by long conduits with a heavy plaque burden, high impedance outflow with low mean flow rates, prolonged fractions of the cardiac cycle with stagnant flow, and a tendency toward exaggerated bending and twisting with skeletal movement.…”

“…Although technical success rates have recently approached 95%, 1,2 intermediate-term restenosis and failure complicate up to 50% of interventions in complex lesions and occlusions. [3][4][5][6][7][8][9][10] Several procedural adjuncts designed to improve patency have been suggested, including atherectomy, cryoplasty, and intraluminal stenting. 8,[11][12][13] Stenting has become increasingly applied, given the recent demonstration of its superiority over simple percutaneous angioplasty in a randomized trial.…”

Imatinib Mesilate Inhibits Neointimal Hyperplasia via Growth Inhibition of Vascular Smooth Muscle Cells in a Rat Model of Balloon Injury

“…Administration of imatinib mesilate after PCI may be preferred to DES especially when patients have complications with hematological problems or allergies. Coronary stenosis in small arteries less than 2.5 mm, winding arteries (Schunkert et al 1999), or arterial stenosis in limbs (Costanza et al 2004) would be treated with PCI followed by imatinib mesilate administration. In fact, the placement of a stent is not suitable for an elbow-shaped bending artery in the inguinal or popliteal region, and interventional therapy has not been established for class II lesions in the femoral-popliteal or infrapopliteal regions because of the high rate of restenosis (Hirsch et al 2006).…”

Primary Nitinol Stenting for Femoropopliteal Disease

“…1,18 However, for infrainguinal disease, the effectiveness of these stents in preventing intimal hyperplasia and long-term restenosis has been limited. [19][20][21][22][23][24][25] TASC I calculated weighted-average patency rates for the first-generation stainless steel stents of 67% at 1 year (11 papers) and 58% at 3 years (4 papers). 1 Dorrucci 4 calculated weighted-average primary patency rates ( Fig.…”