Among patients who had endovascular revascularization of the superficial femoral artery, stent thrombosis occurred in more than 7% of patients, with a 5-year probability of more than 13%, researchers reported.
The researchers retrospectively analyzed 717 patients (mean age, 71 years; 65% men; 34% with critical limb ischemia) who had 1,264 stents placed in 984 SFA lesions.
Most stents implanted in the cohort were bare-metal stents, with 93% of patients receiving either the Smart Control (Cordis/Cardinal Health) or Everflex (Medtronic) nitinol self-expanding stents. Less than 1% received a drug-eluting stent (Zilver PTX, Cook Medical).
Stent thrombosis was observed in 7.5% of patients, with 14% of cases occurring within 30 days, 51% occurring between 31 days and 1 year and 35% occurring later than 1 year, Christian Bradaric, MD, from Klinik und Poliklinik für Innere Medizin I, Klinikum rechts der Isar, Technische Universität München, Munich, and colleagues wrote.
The estimated 5-year probability of stent thrombosis was 13.4% (95% CI, 10-16.7), according to the researchers.
Bradaric and colleagues determined the following were independent predictors of stent thrombosis: longer stent length (HR = 1.09; 95% CI, 1.06-1.11), longer lesion length (HR = 1.1; 95% CI, 1.08-1.13), female gender (HR = 1.79; 95% CI, 1.12-2.86), chronic total occlusion (HR = 4.21; 95% CI, 2.51-7.05), implantation of two stents (HR = 6.06; 95% CI, 3.35-11), implantation of three or more stents (HR = 16.83; 95% CI, 9.43-30) and TASC-II C or D lesions (HR = 17.7; 95% CI, 5.56-56.1).
“Future studies are warranted to evaluate whether a closer follow-up, an intensification or
prolongation of [dual antiplatelet therapy] or anticoagulant therapy, or modifications of endovascular strategies might mitigate the incidence of stent thrombosis and translate into better patency rates after stenting of femoropopliteal [peripheral artery disease],” the researchers wrote. – by Erik Swain
Disclosure: The authors report no relevant financial disclosures.