SFA Stents Show Acceptable Long Term Patency


December 7, 2012

December 7, 2012 — More than half of patients treated for claudication or critical limb ischemia (CLI) with stenting of the superficial femoral artery (SFA) had primary patency at five years.

“Stenting of the SFA is associated with an acceptable success rate even after five years and in patients with long SFA lesions,” noted Giovanni Torsello, M.D., at the 39th annual VEITHsymposium.

Primary patency rates for 517 patients were, respectively, 86 percent, 75 percent and 61 percent at one, three and five years. Primary patency was defined as the absence of hemodynamically-significant stenosis on duplex ultrasound imaging (systolic velocity ratio <2.4) at the target lesion and without target lesion revascularization (TLR). There were no significant difference between TASC A/B and TASC C/D lesions groups or between bare-metal stents and drug-eluting, said Torsello, who is the chief of the department of vascular surgery at St. Franziskus-Hospital in Münster, Germany.

The results come from a retrospective review of 517 patients who reached a follow-up of at least 2 years. Overall 827 stents were implanted in 543 limbs.

More than three quarters of patients (77.9 percent) were treated for claudication, and the remaining patients were treated for CLI. TASC II C or D lesions were seen in 35.5 percent of patients, based on angiography. Complete occlusion in was seen in 42.7 percent and 13.8 percent had popliteal involvement. The average lesion length was 154.2 ±94.0 mm. After a mean follow-up of 93.4 ±1.6 months, 18.8 percent of patients died.  Mean ankle-brachial index increased from 0.67 ±0.17 to 0.98±1.7 at follow up (p<0.001). TLR was performed in 27.8 percent of the limbs treated. In addition, secondary patency rates were 95 percent, 90 percent and 76 percent after one, three and five years. Eight patients (1.5 percent) underwent major amputation.

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