Long-segment femoropopliteal stenoses: is angioplasty a boon or a bust?

Abstract

Analysis of 193 femoropopliteal angioplasties demonstrated patency rates in the stenotic group of 75.5% at 6 months and 54.4% at 54 months. The patency rates for the occlusive group were 93.7% at 6 months and 72.9% at 54 months; these rates were significantly better than those in patients with stenoses. A group of 14 patients with long-segment (greater than 7 cm) stenosis had the highest risk of early failure, with a 6-month patency of 23.1%. After removal of the long-segment stenosis group from the results, there were no significant differences between the long-term patencies for stenotic and occlusive lesions. If angioplasty of long stenoses is attempted, a high initial success rate but early failure should be anticipated.

Nitinol Stent Implantation Versus Balloon Angioplasty for Lesions in the Superficial Femoral Artery and Proximal Popliteal Artery

“…2 For more complex disease and longer lesions, the results with PTA are poor. [3][4][5][6][7][8] A recent analysis of the published experience of PTA for SFA lesions up to 15 cm in length (mean, 8.7 cm) revealed a 12-month primary patency rate of only 33%. 4 For lesions Ͼ10 cm in length, primary patency rates have been reported to be as low as 20% at 1 year.…”

“…4 For lesions Ͼ10 cm in length, primary patency rates have been reported to be as low as 20% at 1 year. [5][6][7][8] …”

Making dollars and sense of antisense

“…Restenosis has remained, until now, a major limitation to the clinical usefulness of percutaneous transluminal angioplasty (PTA), and poor long-term results, especially after the treatment of longer lesions in the femoropopliteal region, have been reported [12][13][14]. The two primary phenomena that contribute to restenosis after successful angioplasty are chronic vessel constriction (remodelling) and neointimal hyperplasia (excessive formation of tissue) by means of cell proliferation [15].…”

Endovaskuläre Brachytherapie (EVBT) mit Rhenium-188 zur Restenoseprophylaxe nach Angioplastie infrainguinaler Läsionen: Erste Erfahrungen

“…In einem unselektionierten Patientengut zeigte sich nach 2 Jahren lediglich noch eine kumulative Offenheitsrate von 46 %[2]. Lange und komplexe femoropopliteale Stenosen erreichen im Verlauf nach PTA eine Offenheitsrate von nur 23% nach einem halben Jahr[3] bzw. von 20 % nach 3 Jahren [4].…”