Femoropopliteal artery stent placement: Evaluation of long-term success

PURPOSE: To evaluate the longterm success of femoropopliteal artery stent placement after technical failure of balloon angioplasty and to determine potential factors predictive of stent failure. MATERIALS AND METHODS: In 80 patients, flexible tantalum stents were implanted for treatment of residual stenosis greater than 30% after balloon angioplasty of femoropopliteal artery stenoses (n = 33) or occlusions (n = 47). Follow-up examinations were performed at 1-72 months to evaluate early and late stent failure according to risk factors such as lesion type, anatomic location, stent length, runoff quality, and restenosis after balloon angioplasty. RESULTS: Early stent thrombosis occurred within 10 days after stent placement in four (5%) patients; the frequency was higher (P < .01) in stents longer than 4 cm (14%) versus that in stents 4 cm or shorter (2%). For all stents, the 2-year primary patency rate was 51% and the 3-year rate was 48%. The 2-year primary patency rate was significantly better (P < .05) for shorter stents (59%) versus that for longer stents (30%) and for treated stenoses (73%) versus treated occlusions (33%). Multivariate analysis revealed that lesion type and lesion length were the most reliable factors predictive of stent failure. CONCLUSION: Successful stent therapy does not seem to depend on the type of stent used but rather on lesion type, lesion length, and other predisposing factors.