This article is more than 5 years old. Information may no longer be current.
Adventitial, medial injury after atherectomy associated with 1-year patency
Click Here to Manage Email Alerts
Among patients with femoropopliteal stenosis, adventitial or medial injury after atherectomy yielded a significantly higher risk for 1-year restenosis compared with patients who did not experience the injury.
Arthur Tarricone, MPH, of Mount Sinai Medical Center in New York, and fellow researchers conducted the study in 116 consecutive patients (mean age, 69 years; 48% men) with symptomatic femoropopliteal stenosis. All patients had claudication and TransAtlantic Inter-Society Consensus (TASC) A/B lesions in the superficial femoral or popliteal arteries, and were treated with directional atherectomy at a single center between 2007 and 2010.
Researchers performed physical examination and duplex ultrasound scans at 3, 6 and 12 months for clinical follow-up. They defined the primary endpoint as duplex-documented 1-year rate of restenosis (peak systolic velocity ratio < 2.4).
Overall, 53% of patients had adventitial injury.
Tarricone and colleagues reported no differences between patients with or without adventitial injury in baseline demographic and clinical features (P > .05), lesion length (P = .40) or vessel runoff (P = .37).
The incidence of 1-year restenosis was 57%. Compared with patients without adventitial or medial injury, those who experienced the injury were at higher risk for 1-year restenosis (97% vs. 11%; P < .0001).
“Our study suggests that adventitial or medial injury results in aggressive restenosis,” Tarricone and colleagues concluded. “Devising a structured and careful interventional approach by avoiding adventitial or medial injury may serve to reduce restenosis after directional atherectomy. While our study clearly demonstrates the relationship between adventitial or medial injury to restenosis, further studies are needed to evaluate the effect of both imaging modalities and/or concomitant drug-coated balloons in preventing restenosis after directional atherectomy.” – by Brian Ellis
Disclosure: The researchers report no relevant financial disclosures.
Click Here to Manage Email Alerts