Peripheral interventions

Incidence and predictors of stent thrombosis after endovascular revascularisation of the superficial femoral artery

EuroIntervention 2019;15:e1107-e1114. DOI: 10.4244/EIJ-D-19-00187

Christian Bradaric
Christian Bradaric1, MD; Tobias Koppara1, MD; Arne Müller1, MD; Bernhard Haller2, MD; Ilka Ott3, PhD, MD; Salvatore Cassese3, MD, PhD; Massimiliano Fusaro3, MD; Adnan Kastrati3,4, MD; Karl-Ludwig Laugwitz1,4, MD; Tareq Ibrahim1, MD
1. Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 2. Institut für Medizinische Informatik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; 3. Deutsches Herzzentrum München, Abteilung für Herz- und Kreislauferkrankungen, Technische Universität München, Munich, Germany; 4. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

Aims: The aims of this study were to assess the incidence and predictors of superficial femoral artery (SFA) stent thrombosis (ST) in a large patient cohort.

Methods and results: A total of 984 stented SFA lesions were retrospectively analysed in 717 patients. We observed an overall ST rate of 7.5% (74/984): 14% occurred early within 30 days after stenting, 51% during the first year thereafter and 35% later than one year. The estimated five-year probability of ST was 13.4% (95% confidence interval [CI]: 10.0% to 16.7%). Significant predictors of ST were stent length (hazard ratio [HR] 1.09, 95% CI: 1.06 to 1.11, p<0.001), lesion length (HR 1.10, 95% CI: 1.08 to 1.13, p<0.001), female gender (HR 1.79, 95% CI: 1.12 to 2.86, p=0.015), chronic total occlusion (CTO) (HR 4.21, 95% CI: 2.51 to 7.05, p<0.001), implantation of more than one stent (two stents: HR 6.06, 95% CI: 3.35 to 11.0, p<0.001; three or more stents: HR 16.83, 95% CI: 9.43 to 30.0, p<0.001) as well as lesion complexity criteria as expressed by TASC II C/D (HR 17.7, 95% CI: 5.56 to 56.1, p<0.001).

Conclusions: ST after SFA stenting was a common adverse event in our cohort and peaked during the first year after stent implantation. Independent predictors of ST included lesion length and stent length, female gender, presence of CTO, number of implanted stents and lesion complexity.

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