Use of heparin coated vascular stents in femoropopliteal chronic total occlusions: Long term outcomes

Eur J Radiol. 2020 Sep:130:109163. doi: 10.1016/j.ejrad.2020.109163. Epub 2020 Jul 1.

Abstract

Purpose: To evaluate the long-term clinical efficacy of the Tigris © stent (Gore ©) in femoropopliteal chronic total occlusions (CTOs).

Material and methods: This single centre retrospective study included 29 patients treated with 47 Tigris© stents for CTOs. Lesion location, type, length, revascularisation method, smoking status and diabetes were reviewed. Clinical follow-up was performed. Primary safety points were complications and adverse events. Secondary efficacy points were symptom deterioration, freedom from target lesion revascularization (TLR) and amputation rate. Freedom from TLR was evaluated with Kaplan-Meier analysis; Cox multivariable logistic regression analysis of the factors associated with stent re-occlusion was also performed.

Results: All procedures were technically successful without any peri- or post-procedural complications and adverse events. Median follow-up was 48 months (range: 7-70). Lesions were located in the superficial femoral (19), popliteal (3) and femoropopliteal (7) arteries with mean lesion length 13.9 ± 7.6 cm. In 12 patients subintimal recanalization was performed. Freedom from TLR rates at 6, 12, 18, 24 and 36 months were 96.6 %, 85.7 %, 81.9 %, 78.2 % and 74.3 % respectively. No stent fracture was observed and no amputation was performed in any of the patients. Smoking status, the presence of diabetes, lesion localization and recanalization type were not associated with stent re-occlusion.

Conclusion: This study demonstrated that use of a heparin coated vascular stent for femoropopliteal CTOs appears to offer satisfactory long-term results.

Keywords: Atherosclerosis; Heparin; Peripheral arterial disease; Stents.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage
  • Anticoagulants / therapeutic use*
  • Chronic Disease
  • Drug-Eluting Stents*
  • Female
  • Femoral Artery / physiopathology
  • Femoral Artery / surgery*
  • Heparin / administration & dosage
  • Heparin / therapeutic use*
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Peripheral Arterial Disease / surgery*
  • Popliteal Artery / physiopathology
  • Popliteal Artery / surgery*
  • Prospective Studies
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Anticoagulants
  • Heparin