Long‐term clinical outcomes after self‐expandable bare nitinol stent implantation for femoropopliteal occlusive disease in hemodialysis patients

Abstract

AbstractObjectivesTo compare the long‐term clinical outcomes after self‐expandable bare nitinol stent (BNS) implantation between hemodialysis (HD) and non‐HD patients with femoropopliteal (FP) disease.BackgroundAlthough a BNS has been commonly used in patients with FP disease, the long‐term efficacy of BNSs in HD patients remains unknown.MethodsIn total, 427 HD patients treated with a BNS for FP disease were enrolled, along with 157 non‐HD patients as a control group. Over the following 5 years, the incidence of target lesion revascularization (TLR), major amputation and mortality was investigated. We also performed propensity‐score matching analysis.ResultsThe 5‐year TLR rate (45.2 vs. 32.5%, p = .013) and mortality rate (39.3 vs. 14.0%, p = .0002) were significantly higher in the HD group than in the non‐HD group. The major amputation rate was comparable between the groups (7.2% in the HD group vs. 2.8% in the non‐HD group, p = .16). In the propensity‐score‐matched cohort, the TLR rate, and mortality rate were remained higher in the HD group than in the non‐HD group (48.9 vs. 34.1%, hazard ratio [HR] 2.11, 95% confidence interval [CI] 1.30–3.49, p = .0024, and 47.9 vs. 12.0%, HR 3.38, 95% CI 1.86–6.56, p < .0001, respectively). The adjusted amputation rate was consistently similar between the groups (1.7% in the HD group vs. 2.7% in the non‐HD group, HR 0.90, 95% CI 0.26–2.99, p = .86).ConclusionsThe TLR rate and mortality at 5 years post BNS implantation for FP disease were significantly higher in HD patients than in non‐HD patients, though the limb salvage rate was similar.