Abstract
AbstractBackground and aimThere is only a limited number of major publications on the outcome of interventions for isolated popliteal artery stenosis. The purpose of this study was to report our results on mid-term patency and predictors of restenosis.Patients and methodsThis single-center retrospective study included 61 symptomatic patients (males, N = 33; median age, 65.1 years [IQR, 60.7–71.9 years]; Rutherford grade 4–6, N = 14) with at least two patent crural arteries, whose atherosclerotic stenoses/occlusions were treated with percutaneous transluminal angioplasty (PTA) or stenting (using self-expanding bare-metal Astron Pulsar stents) between 2011 and 2018.ResultsTwenty-six patients had PTA, while 35 underwent stenting. The median follow-up was 29 months (IQR, 10–47 months). The primary patency rates were not significantly different (P = 0.629) between PTA and stenting groups. Restenosis developed in nine patients (34.6%) in the PTA group, and in 12 (34.3%) in the stenting group. Restenotic lesions required re-intervention in nine cases (100%) in the PTA group, and in eight (66.7%) in the stenting group. Restenosis developed significantly less frequently (P = 0.010) in patients with a popliteal/P1 stent; the primary patency rates were also significantly better (P = 0.018) in patients with a popliteal/P1 stent when compared to popliteal/P2 plus multi-segment stents. Cox regression analysis identified lesion location as a predictor of in-stent restenosis (HR, 2.5; 95% CI, 1.2–5.5; P = 0.019).ConclusionStenting was not superior when compared to PTA (if selective stenting was not considered as loss of patency). Follow-up should be more thorough in patients undergoing popliteal/P2 or multi-segment stenting.
Highlights
Popliteal artery steno-occlusive disease could be truly isolated if no stenosis or occlusion were present elsewhere in the ipsilateral lower extremity
Restenosis developed in nine patients (34.6%) in the percutaneous transluminal angioplasty (PTA) group, and in 12 (34.3%) in the stenting group
Stenting was not superior when compared to PTA
Summary
Popliteal artery steno-occlusive disease could be truly isolated if no stenosis or occlusion were present elsewhere in the ipsilateral lower extremity. The cause of a truly isolated popliteal artery luminal narrowing is from external compression due to e.g. entrapment syndrome or cystic adventitial disease. In the majority of studies, a presumed atherosclerotic popliteal artery stenosis is considered isolated if the patient has no ipsilateral femoral artery stenosis, requiring invasive therapy. Publications are heterogeneous in terms of arterial runoff and the type of radiological intervention used [1,2,3,4,5,6,7]. There is only a limited number of major publications on the outcome of interventions for isolated popliteal artery stenosis. The purpose of this study was to report our results on mid-term patency and predictors of restenosis
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