English Polski
Vol 23, No 3 (2017)
Research paper
Published online: 2017-09-28

open access

Page views 1172
Article views/downloads 1528
Get Citation

Connect on Social Media

Connect on Social Media

Results of endovascular treatment of iliac and femoral symptomatic lesions. Identification of re-intervention risk factors

Wojciech Stecko1, Wojciech Rogala2, Marcin Feldo2, Marek Ilzecki2, Waclaw Karakula2, Aleksander Kasprzak3, Tomasz Zubilewicz2
Acta Angiologica 2017;23(3):115-123.


Introduction. The aim of the study was to assess a presence of peripheral arterial disease risk factors in patients with symptomatic femoral and iliac lesions treated with use of Jaguar and Supera nitinol stents and to estimate potential relation between these factors and reintervention rate.

Material and methods. The study group consisted of 60 patients between 46 and 85 years of age who presented with typical symptoms of intermittent claudication or critical limb ischemia and underwent percuta­neous transluminal angioplasty with stenting. We examined and divided group into two subgroups — patients who experienced or did not experience need of reintervention in treated lesion.

Results. During the follow-up 24 (40%) of patients underwent reintervention in treated artery due to re­current symptoms of disease. Need of target lesion revascularization occurred more frequent in patients with hypertension (OR = 2.5), patient older than 68 (OR = 1.75) and smokers (OR = 1.75). Patency of all three arteries below knee protected from reintervention.

Conclusions. Jaguar and Supera self-expanding nitinol stents has several advantages and its use were char­acterized by high procedural success and moderate frequency of reintervention correlated to some clinical findings like hypertension. Further studies are necessary to estimate factors disturbing and interfering with long-term patency.


  1. Fowkes FG, Rudan D, Rudan I, et al. Comparison of global estimates of prevalence and risk factors for peripheral artery disease in 2000 and 2010: a systematic review and analysis. Lancet. 2013; 382(9901): 1329–1340.
  2. Muller MD, Reed AB, Leuenberger UA, et al. Physiology in medicine: peripheral arterial disease. J Appl Physiol (1985). 2013; 115(9): 1219–1226.
  3. Vrsalovic M, Vucur K, Vrsalovic Presecki A, et al. Impact of diabetes on mortality in peripheral artery disease: a meta-analysis. Clin Cardiol. 2017; 40(5): 287–291.
  4. Norgren L, Hiatt WR, Dormandy JA, et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). Eur J Vasc Endovasc Surg. 2007; 33(1): S1–S75.
  5. Gerhard-Herman MD, Gornik HL, Barrett C, et al. 2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2017; 135(12): e686–e725.
  6. Tendera M, Aboyans V, Bartelink ML, et al. European Stroke Organisation, ESC Committee for Practice Guidelines. ESC Guidelines on the diagnosis and treatment of peripheral artery diseases: Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries: the Task Force on the Diagnosis and Treatment of Peripheral Artery Diseases of the European Society of Cardiology (ESC). Eur Heart J. 2011; 32(22): 2851–2906.
  7. Jones WS, Patel MR, Dai D, et al. High mortality risks after major lower extremity amputation in Medicare patients with peripheral artery disease. Am Heart J. 2013; 165(5): 809–815.
  8. Martini R, Andreozzi GM, Deri A, et al. Amputation rate and mortality in elderly patients with critical limb ischemia not suitable for revascularization. Aging Clin Exp Res. 2012; 24(3 suppl): 24–27.
  9. Swaminathan A, Vemulapalli S, Patel MR, et al. Lower extremity amputation in peripheral artery disease: improving patient outcomes. Vasc Health Risk Manag. 2014; 10: 417–424.
  10. Krankenberg H, Schlüter M, Steinkamp HJ, et al. Nitinol stent implantation versus percutaneous transluminal angioplasty in superficial femoral artery lesions up to 10 cm in length: the femoral artery stenting trial (FAST). Circulation. 2007; 116(3): 285–292.
  11. Chalmers N, Walker PT, Belli AM, et al. Randomized trial of the SMART stent versus balloon angioplasty in long superficial femoral artery lesions: the SUPER study. Cardiovasc Intervent Radiol. 2013; 36(2): 353–361.
  12. Laird JR, Katzen BT, Scheinert D, et al. RESILIENT Investigators. Nitinol stent implantation vs. balloon angioplasty for lesions in the superficial femoral and proximal popliteal arteries of patients with claudication: three-year follow-up from the RESILIENT randomized trial. J Endovasc Ther. 2012; 19(1): 1–9.
  13. Dick P, Wallner H, Sabeti S, et al. Balloon angioplasty versus stenting with nitinol stents in intermediate length superficial femoral artery lesions. Catheter Cardiovasc Interv. 2009; 74(7): 1090–1095.
  14. Dick P, Wallner H, Sabeti S, et al. Balloon angioplasty versus implantation of nitinol stents in the superficial femoral artery. N Engl J Med. 2006; 354(18): 1879–1888.
  15. Kordecki K, Lukasiewicz A, Nowicki M, et al. Assessment of effectiveness of endovascular treatment of common and external iliac artery stenosis/occlusion using self-expanding Jaguar SM stents. Pol J Radiol. 2012; 77(4): 22–29.
  16. Elmahdy MF, Buonamici P, Trapani M, et al. Long-Term Primary Patency Rate After Nitinol Self-Expandable Stents Implantation in Long, Totally Occluded Femoropopliteal (TASC II C & D) Lesions. Heart Lung Circ. 2017; 26(6): 604–611.
  17. Suzuki K, Mizutani Y, Soga Y, et al. Efficacy and Safety of Endovascular Therapy for Aortoiliac TASC D Lesions. Angiology. 2017; 68(1): 67–73.
  18. Bosch JL, Hunink MG. Meta-analysis of the results of percutaneous transluminal angioplasty and stent placement for aortoiliac occlusive disease. Radiology. 1997; 204(1): 87–96.
  19. Treiman G, Schneider P, Lawrence P, et al. Does stent placement improve the results of ineffective or complicated iliac artery angioplasty? J Vasc Surg. 1998; 28(1): 104–114.
  20. Powell RJ, Fillinger M, Walsh DB, et al. Predicting outcome of angioplasty and selective stenting of multisegment iliac artery occlusive disease. J Vasc Surg. 2000; 32(3): 564–569.
  21. Krol KL, Saxon RR, Farhat N, et al. Clinical evaluation of the Zilver vascular stent for symptomatic iliac artery disease. J Vasc Interv Radiol. 2008; 19(1): 15–22.
  22. Jaff MR, Katzen BT. Two-year clinical evaluation of the Zilver vascular stent for symptomatic iliac artery disease. J Vasc Interv Radiol. 2010; 21(10): 1489–1494.
  23. Duda SH, Pusich B, Richter G, et al. Sirolimus-eluting stents for the treatment of obstructive superficial femoral artery disease: six-month results. Circulation. 2002; 106(12): 1505–1509.
  24. Dake MD, Ansel GM, Jaff MR, et al. Zilver PTX Investigators. Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: twelve-month Zilver PTX randomized study results. Circ Cardiovasc Interv. 2011; 4(5): 495–504.
  25. Bonvini RF, Rastan A, Sixt S, et al. Endovascular treatment of common femoral artery disease: medium-term outcomes of 360 consecutive procedures. J Am Coll Cardiol. 2011; 58(8): 792–798.
  26. Yu JS, Park KM, Jeon YS, et al. Midterm Outcome of Femoral Artery Stenting and Factors Affecting Patency. Vasc Specialist Int. 2015; 31(4): 115–119.
  27. Bakken AM, Protack CD, Saad WE, et al. Impact of chronic kidney disease on outcomes of superficial femoral artery endoluminal interventions. Ann Vasc Surg. 2009; 23(5): 560–568.