Transcatheter Interventions for the Treatment of Peripheral Atherosclerotic Lesions: Part I

Endovascular Intervention for Peripheral Artery Disease

“…78 Meta-analyses on the use of angioplasty with or without stenting have shown lower vessel patency for the treatment of SFA occlusions compared with stenoses in patients with CLI, but limb salvage rates were not reported. 79,80 Small studies have shown that SFA stenting for CLI is feasible and in a report by Todoran et al, [81][82][83] was associated with patency rates at 30 months that equaled that in their IC population. More recently, the use of new DCB has been described in CLI patients with obstructive SFA disease.…”

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

“…In a meta-analysis of 1,003 patients undergoing intervention to the FP artery, the patency rates at 1, 3, and 5 years were 59, 52, and 45%, respectively. 30 It is likely that restenosis in the FP segment is high because of higher baseline inflammatory state, more atherosclerotic burden, longer lesions, and significant differences in flow in the distal vascular bed. [31][32][33] In one study, higher restenosis rate was Fig.…”

“…Despite a high rate of acute procedural success, target lesion revascularization (TLR) and target vessel revascularization remain elevated. 3,4 We have previously proposed a triad of optimal peripheral vascular revascularization strategy (►Fig. 1) 5 with an emphasis on three key principles: (1) Mechanical, improve vessel compliance to allow dilatation of a stenotic segment at low balloon inflation pressure and reduce dissection and recoil.…”

Nitinol Stent Implantation Versus Percutaneous Transluminal Angioplasty in Superficial Femoral Artery Lesions up to 10 cm in Length

“…Total occlusions are known to be associated with markedly higher restenosis rates than stenoses, 8 and their lower prevalence in the PTA group (25% versus 37% in stent-group patients) may have resulted in a lower PTA group restenosis rate than would have been found if total occlusions had been equally prevalent in both treatment arms. Finally, gender appeared to affect 12-month restenosis exclusively in the PTA arm, such that women assigned to PTA had a markedly lower restenosis rate (24.0%) than men (43.4%).…”

“…We therefore based our assumptions of restenosis rates in either treatment arm on a then-recent review of PTA results, 8 on the 9-month results of the small-size (49 patients total) SIROCCO II trial of sirolimuseluting versus bare-metal nitinol stenting of SFA lesions, 9 and on a retrospective single-center analysis of nitinol stenting in the SFA 10 and hypothesized binary restenosis rates in the PTA and stent arm of 45% and 25%, respectively (an absolute difference of 20%). However, we observed rates of 39% and 32%, respectively (an absolute difference of 7%).…”