Abstract
Background
Endovascular therapy is an established treatment for peripheral arterial disease. In aortoiliac disease, above the inguinal ligament, percutaneous transluminal angioplasty (PTA) + stent results in good long-term patency rates[1]. In comparison, long-term patency rates of PTA + stent in femoropopliteal disease, below the inguinal ligament are inferior, despite advancements in stent technology[2]. Multi-level disease is more common, lesions are often longer in length and rates of re-stenosis remain high. There is a paucity of data of long-term outcomes in infrainguinal stents and therefore debate to what the optimal treatment strategy should be[3].
Method
5-year retrospective analysis of 59 patients between 2014 and 2019 in a UK regional vascular centre. Patients with Rutherford Score 3 - 6 were treated by Vascular Surgeons and Interventional Radiologists with PTA + stent. Outcomes included patency at 6, 12, 24, 36 months, need for revascularisation/reintervention, major amputation, and death.
Results
12% of stents occluded at 30 days and 39% of stents occluded at 12 months. 34% patients required further intervention (PTA, femoropopliteal bypass, amputation) and 7 out of 59 (12%) target limbs were amputated.
Conclusions
Whilst PTA + stent demonstrates an effective intervention for a selection of patients, it is evident that further work is required in order to identify the best treatment strategy and most clinically useful outcome measure.
Sex Differences in the Long-term Outcomes of Peripheral Arterial Disease
