Abstract No. 401 - Outcomes of endovascular intervention on atherosclerotic disease involving the popliteal artery

Abstract

To evaluate outcomes including limb salvage, amputation-free survival, and patency after endovascular intervention in patients with atherosclerotic popliteal artery disease. We retrospectively reviewed all cases with endovascular intervention on the popliteal artery in patients with atherosclerotic arterial disease between 7/2005 and 8/2015. A total of 207 limbs were treated in 206 patients (median age 70.0 years, range 46-94, 121 males and 85 females) with Rutherford classification of 3-5. The popliteal artery lesions were treated with primary angioplasty and secondary stent implantation for suboptimal angioplasty results. Kaplan-Meier analyses were performed to estimate the cumulative distribution functions for limb salvage, amputation-free survival, primary patency and primary assisted patency. Univariate and multivariate analysis with COX model were performed to obtain hazard ratio (HR) estimates. Limb salvage rates were 87.6%, 84.1%, and 79.4% at 12, 24, and 48 months, respectively; Amputation-free survival rates were 71.6%, 66.9%, and 49.2% at 12, 24, and 48 months, respectively; Primary patency was 55.1%, 46.3%, and 38.4% at 12, 24, and 48 months, respectively, with median primary patency of 17.2 months; primary assisted patency was 70.1%, 60.5%, and 48.2% at 12, 24, and 48 months, respectively, with median primary assisted patency of 48.8 months. Diabetes was an independent risk factor for limb amputation (HR = 2.62; 95% CI: [0.99, 6.97], P = 0.053); chronic kidney disease was an independent risk factor for amputation or death (HR = 1.84; [1.17, 2.89], P = 0.008); and smaller artery size was an independent risk factor associated with decreased patency (HR = 0.74; [0.57, 0.97], P = 0.029). Run-off weighting, presence of chronic occlusion, and stent use were not predictors of poor outcome for vessel patency. Endovascular intervention on atherosclerotic lesions in the popliteal artery provided modest patency outcomes. Diabetes and chronic kidney disease were predictors of poor outcomes for limb salvage and amputation-free survival, respectively, while smaller artery size was a predictor for poor vessel patency.