Key result
LifeStent implantation achieves ~58% primary patency, with loss linked to smoking and no discharge clopidogrel.
Why the study?
Does LifeStent implantation improve patency and freedom from limb loss in real-world patients with femoropopliteal peripheral arterial disease?
Cohort (n=151)
No
Does LifeStent implantation improve patency and freedom from limb loss in real-world patients with femoropopliteal peripheral arterial disease?
LifeStent implantation is a viable option for real-world patients with femoropopliteal peripheral arterial disease, though critical limb ischemia, tobacco use, and lack of clopidogrel at discharge predict decreased patency.
Answers are grounded in this paper and cite their sources.
Patency predictors after LifeStent may inform selection in femoropopliteal disease; hypothesis-generating and requires randomized confirmation.
The purpose of our study was to determine outcomes of patients receiving the LifeStent (Bard Peripheral Vascular, Tempe, AZ) for femoropopliteal peripheral arterial disease in real-world academic practice outside the limitations of an industry supported trial. All patients from 2009 to 2012 at our institution who received a LifeStent during endovascular interventions and had follow-up were included. Outcomes evaluated included patency and freedom from limb loss. A total of 166 limbs in 151 patients had the LifeStent implanted in de novo vessels (54% male; 68 ± 12 years). Eighty-percent of limbs did not meet RESILIENT criteria due to Rutherford category >3 (51%), TransAtlantic Inter-Society Consensus II classifications C/ D (51%), zero runoff vessels (6%), or stent location (17%). Primary patency rates were 81% at 6 months and 58% at 12 months with predictors for primary patency loss at 1 year including Rutherford category >3 (HR: 1.8 (95% CI: 1.0-3.1), p = 0.04), tobacco use (HR: 1.8 (95% CI: 1.0-3.3), p = 0.04), and no clopidogrel at discharge (HR: 3.2 (95% CI: 1.6-6.7), p < 0.01). A preintervention Rutherford category >3 predicted 24-month limb loss (HR, 16.0 (95% CI: 2.0-122.0), p < 0.01). The LifeStent is a viable option regardless of the TransAtlantic Inter-Society Consensus II classification; however, critical limb ischemia, current tobacco use, and absence of clopidogrel on discharge predict decreased patency on follow-up.
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Stone et al. (2014) conducted a cohort in Femoropopliteal peripheral arterial disease (n=151). LifeStent implantation was evaluated on Primary patency at 12 months. LifeStent implantation yielded 12-month primary patency of 58%, with patency loss predicted by Rutherford category >3, tobacco use, and no clopidogrel at discharge.
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