Outcome of endovascular therapy of iliac, superficial femoral and popliteal arteries in 136 patients / 中华心血管病杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the effect and clinical outcome of balloon angioplasty or selected stent implantation in patients with severe lower limb artery disease.</p><p><b>METHODS</b>A total of 136 consecutive patients who had severe claudication or chronic limb ischemia due to atherosclerotic stenosis or occlusion of the iliac (n = 81), superficial femoral (n = 43) and popliteal (n = 12) arteries underwent balloon angioplasty initially and selected stent implantation was followed in cases of dissection or more than 30% residual stenosis after balloon angioplasty (n = 99). Restenosis and clinical outcomes were assessed at 6 months and 12 months.</p><p><b>RESULTS</b>Baseline mean (+/- SD) lesion length ranged from 1.5 cm - 18.0 cm [(6.2 +/- 2.9) cm] and stenosis ranged from 70% - 100% (88.6% +/- 7.5%). The mean length of treated segments was 2.0 cm - 19.0 cm [(7.3 +/- 3.2) cm], and residual stenosis after procedure was 0% - 30% (8.7% +/- 5.1%). There were two procedure-related thrombosis complications and patients recovered post related treatments. At 6 months, the rates of restenosis were 7.3% in iliac lesions, 19.4% in femoropopliteal lesions and 12.3% in all lesions, 10.2% in the stent group and 17.8% in the balloon angioplasty group, respectively (P > 0.05) and revascularization was performed in 10 patients; at 12 months, the rates of restenosis were 12.5% in iliac lesions, 29.9% in femoropopliteal lesions and 19.6% in all lesions, 16.1% in the stent group and 28.9% in the balloon angioplasty group (P > 0.05), respectively. Six-minute walk distance was significantly longer and ankle brachial index (ABI) was significantly higher at 6 months and 12 months in the stent group compared to balloon angioplasty group (all P < 0.001). All patients are alive and 3 acute myocardial infarction and 2 minor stroke were observed during 12 months follow-up.</p><p><b>CONCLUSIONS</b>Endovascular therapy in the iliac, superficial femoral and popliteal artery was safe and effective. The rate of restenosis in the stent group was comparable to that in balloon angioplasty group during 12 months follow up. Stent implantation is superior to balloon angioplasty in terms of six-minute maximal walk capacity and ABI during 12 months follow up.</p>