Are flow-mediated vasodilatation and intima-media thickness of the brachial artery associated with restenosis after endovascular treatment of peripheral arterial occlusive disease?

Eur Radiol. 2010 Oct;20(10):2533-40. doi: 10.1007/s00330-010-1801-z. Epub 2010 Apr 30.

Abstract

Objective: Restenosis after percutaneous angioplasty of peripheral arteries is still an unsolved matter. Previous studies reported an association between flow-mediated dilatation (FMD), a marker of endothelial dysfunction, and restenosis after coronary angioplasty. This study evaluates the influence of FMD and brachial intima-media thickness (B-IMT) on restenosis after angioplasty of peripheral arteries.

Methods: One hundred and eighty-four patients (124 male) with claudication related to peripheral arterial disease participated in this trial. FMD and B-IMT were assessed before endovascular revascularisation. In a 12-month follow-up duplex ultrasound examinations were performed to detect restenosis. Finally 128 patients (91male, 37 female) were eligible for statistical analysis.

Results: Restenosis was found in 54 patients (42.2%). Mean FMD was 3.53 ± 3.56%, with no difference between the patients with restenosis (3.55 ± 3.64%) and those without (3.52 ± 3.48%; p = 0.716). B-IMT had a mean value of 0.326 ± 0.134 mm. B-IMT significantly differed between the patients with restenosis (0.326 ± 0.134 mm) and those without (0.256 ± 0.133 mm; p = 0.007). We confirmed that a B-IMT over 0.21 mm was an independent risk factor for restenosis [OR 2.9 (1.3-6.3)].

Conclusion: Endothelial dysfunction is not associated with restenosis. Conversely patients with enlarged B-IMT are at risk of restenosis after angioplasty of peripheral arteries.

MeSH terms

  • Angioplasty / methods*
  • Angioplasty, Balloon / methods
  • Brachial Artery / pathology
  • Endothelium, Vascular / pathology*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Odds Ratio
  • Peripheral Vascular Diseases / pathology*
  • Prospective Studies
  • Risk
  • Risk Factors
  • Tunica Intima / pathology*
  • Tunica Media / pathology*
  • Vasodilation*