Peripheral artery disease(PAD) involving the femoropopliteal segment is very significant. It is treatable using endovascular therapy(EVT). But the risk of stenosis recurrence or restenosis leads to restricted blood flow. This study presents an innovative angiographic system of scoring for risk stratification. It helps the clinicians’ decision regarding the use of paclitaxel-eluting devices.
The prospective study involved 1799 limbs from 1578 registered PAD patients. They were undergoing EVT for femoropopliteal using intravascular ultra-sound support. The baseline patient and limb traits for restenosis at 12 months were identified. Multivariable analysis was used along with a generalized linear mixed model and logit-link function. The study took inter-subject and inter-center variations as random effects.
Regression analysis estimated 65.1% primary patency after 12 months. The multivariate analysis presented three independent risk factors like distal reference vessel diameter/1 mm, lesion length/10 cm, and chronic total occlusion. The baseline risk factors were not associated. Plain angioplasty had a 12-month higher restenosis risk than nitinol stent, but stent-grafts and drug-eluting stents had a lower risk.
The study displayed a new angiographic score, after femoropopliteal EVT, for 12-month restenosis. The risk was independently and significantly associated with this score in a real-world clinical setup. But TransAtlantic Society Consensus II, TASC, was not part of the 3-factor score development.
Ref: https://journals.sagepub.com/doi/full/10.1177/1526602820948472
