This article is more than 5 years old. Information may no longer be current.
Stent thrombosis somewhat common after SFA revascularization
Among patients who had endovascular revascularization of the superficial femoral artery, stent thrombosis occurred in more than 7% of patients, with a 5-year probability of more than 13%, researchers reported.
The researchers retrospectively analyzed 717 patients (mean age, 71 years; 65% men; 34% with critical limb ischemia) who had 1,264 stents placed in 984 SFA lesions.
Most stents implanted in the cohort were bare-metal stents, with 93% of patients receiving either the Smart Control (Cordis/Cardinal Health) or Everflex (Medtronic) nitinol self-expanding stents. Less than 1% received a drug-eluting stent (Zilver PTX, Cook Medical).
Stent thrombosis was observed in 7.5% of patients, with 14% of cases occurring within 30 days, 51% occurring between 31 days and 1 year and 35% occurring later than 1 year, Christian Bradaric, MD, from Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, and colleagues wrote.
The estimated 5-year probability of stent thrombosis was 13.4% (95% CI, 10-16.7), according to the researchers.
Bradaric and colleagues determined the following were independent predictors of stent thrombosis: longer stent length (HR = 1.09; 95% CI, 1.06-1.11), longer lesion length (HR = 1.1; 95% CI, 1.08-1.13), female gender (HR = 1.79; 95% CI, 1.12-2.86), chronic total occlusion (HR = 4.21; 95% CI, 2.51-7.05), implantation of two stents (HR = 6.06; 95% CI, 3.35-11), implantation of three or more stents (HR = 16.83; 95% CI, 9.43-30) and TASC-II C or D lesions (HR = 17.7; 95% CI, 5.56-56.1).
“Future studies are warranted to evaluate whether a closer follow-up, an intensification or
prolongation of [dual antiplatelet therapy] or anticoagulant therapy, or modifications of endovascular strategies might mitigate the incidence of stent thrombosis and translate into better patency rates after stenting of femoropopliteal [peripheral artery disease],” the researchers wrote. – by Erik Swain
Disclosure: The authors report no relevant financial disclosures.