Low-molecular-weight heparin for prevention of restenosis after femoropopliteal percutaneous transluminal angioplasty: A randomized controlled trial

Koppensteiner, Renate; Spring, Silviana; Amann-Vesti, Beatrice; Meier, Thomas; Pfammatter, Thomas; Rousson, Valentin; Borggrefe, Martin; Loo, Bernd van der

doi:10.1016/j.jvs.2006.07.044

Cited by 43 publications

(32 citation statements)

References 20 publications

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“…Several trials have obtained similar results comparable with our study [20,35]. It still remains unclear why argatroban treatment does not provide a similar benefit in the prevention of restenosis.…”

Section: Discussionsupporting

confidence: 88%

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Zhou

Liu

et al. 2014

Eur Neurol

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Background/Aims: Restenosis following extracranial artery stenting is a limitation that affects long-term outcomes. Effective and satisfying pharmacological strategies in preventing restenosis have not been established. This study aimed to evaluate whether argatroban, a direct thrombin inhibitor, could reduce the risk of in-stent restenosis after extracranial artery stenting. Methods: One hundred and fourteen patients hospitalized between August 2010 and August 2011 were enrolled. Patients were randomly assigned to argatroban (n = 58) and blank control groups (n = 56). The patients in the argatroban arm were treated with 10 mg of intravenous argatroban twice daily 2 days before and 3 days after the stenting procedures. Patients were followed for 12 months after the procedure. During follow-up, restenosis and target revascularization were analyzed. Recurrent cerebrovascular and cardiovascular events and deaths were also compared between the groups. Results: One patient in the stenting group withdrew immediately after the procedure due to unsuccessful stenting. Restenosis occurred in 4 patients (7.4%) in the argatroban group and in 11 patients (21.6%) in the control group during the 6- to 9-month angiographic follow-up period (p = 0.032). Nine months after the procedures, argatroban-treated patients had a trend towards a lower incidence of target revascularization compared with the controls (5.4 vs. 13.7%, p = 0.188). No major bleeding events or other adverse events occurred in the argatroban group. Conclusion: This pilot clinical trial is the first that uses argatroban to prevent restenosis in ischemic cerebrovascular disease, and suggests that intravenous administration of argatroban is effective and safe in preventing restenosis after extracranial artery stenting. Larger randomized controlled clinical trials are warranted.

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Section: Discussionsupporting

confidence: 88%

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Zhou

Liu

et al. 2014

Eur Neurol

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“…Despite this interesting result, dalteparin 2500 UI, administered for 3 months after femoropopliteal angioplasty plus aspirin 100 mg/day versus aspirin alone, failed to reduce incidence of restenosis/reocclusion at 12 months. However, dalteparin appeared to be beneficial at the 12-month follow-up in the subgroup of patients with critical limb ischemia (Koppensteiner et al, 2006).…”

Section: Low Molecular Weight Heparinsmentioning

confidence: 87%

Antithrombotic Therapy After Peripheral Angioplasty

Zalunardo¹,

Tonello²,

Busato³

et al. 2012

Angioplasty, Various Techniques and Challenges in Treatment of Congenital and Acquired Vascular Stenoses

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“…The median TVR time was 24 months with a well-known high rate of 40 % TVR in the fi rst 12 months [9]. One in fi ve patients is estimated to need an intervention on the opposite leg after 4 years.…”

Section: Discussionmentioning

confidence: 99%

Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

Johner

Clemens

Husmann

et al. 2016

Vasa

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Summary: Background:We evaluated the long-term outcome after endovascular revascularisation for acute limb ischaemia (ALI). Patients and methods: From a prospectively maintained database, 318 endovascular interventions for ALI were identifi ed between 2004 and 2010. Event history and survival were analysed using the Kaplan-Meier method and Cox regression. Endpoints were target vessel revascularisation (TVR), non-target extremity revascularisation (NTER), amputation, major vascular events, coronary artery revascularisation and amputation-free survival. Results: Follow-up data of 303 patients (mean age 68.5 ± 12.7 years, 40 % female) were available. The mean follow-up time was 38.7 ± 26.2 months. TVR was performed in 40.1 ± 2.9 % at 1 year and 66.5 ± 3.8 % at 5 years. NTER at 1 and 5 years were 7.1 ± 1.5 % and 29.2 ± 4 %, respectively. The proportion of patients who needed major or minor amputation was 4.3 ± 1.2 % after 1 year and 9 ± 2.1 % after 5 years. Amputation-free survival at 1 year was 90.3 ± 1.8 % and 74.8 ± 3.2 % at 5 years. Coronary artery disease (HR 2.22, 95 % CI 1.33 to 3.7, p = 0.002) and atrial fi brillation (HR 2.56, % CI 1.3 to 5.04, p = 0.007) were independently associated with a worse amputation-free survival. The cumulative proportion surviving one year following acute limb ischemia was 95.4 ± 1.2 % and 79.7 ± 3.1 % after 5 years. Conclusions: Long-term amputation-free survival after successful revascularisation for ALI is high; negative predictors are coronary artery disease and atrial fi brillation.

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Low-molecular-weight heparin for prevention of restenosis after femoropopliteal percutaneous transluminal angioplasty: A randomized controlled trial

Abstract: Treatment with 2500 IU dalteparin subcutaneously given for 3 months after femoropopliteal PTA failed to reduce restenosis/reocclusion at 12 months. However, dalteparin may be beneficial in the subgroup of patients with CLI at 12 months follow-up.

Cited by 43 publications

References 20 publications

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Argatroban for Preventing Occlusion and Restenosis after Extracranial Artery Stenting

Antithrombotic Therapy After Peripheral Angioplasty

Long-term follow-up after endovascular revascularisation for acute limb ischaemia - a retrospective single-centre cohort

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