[MO-28] Clinical Outcome of Endovascular Therapy for Aortoiliac Artery In-stent Restenosis Lesions
OBJECTIVES:
Favorable results of endovascular therapy (EVT) for aortoiliac artery (AIA) lesions were reported. However, some cases needed additional treatment for in-stent restenosis (ISR) and there were few data of additional EVT for ISR of AIA lesion. This study aimed to investigate the clinical outcomes of EVT for AIA ISR lesions.
METHODS & RESULTS:
This study was a single-center, cohort study. Between January 2010 to June 2018, we treated 957 de novo AIA lesions by EVT. Fifty of 957 lesions needed additional EVT due to ISR and we studied these 50 ISR lesions. Mean follow up period was 1,216 days. Forty lesions (80%) were focal (≤ 50mm in length) ISR, 2 lesions (4%) were diffuse (>50mm in length) ISR and 8 lesions (16%) were in-stent occlusion (ISO). Twenty-three of 40 (57.5%) focal ISR, 1 of 2 (50%) diffuse ISR and 8 of 8 (100%) ISO lesions were performed adjunctive stenting. During follow-up period, 8 lesions (16%) needed repeat revascularization. Secondary patency, defined as no repeat revascularization in the treated vessel, at 1 to 5 each year after additional EVT was 96.0%, 90.0%, 88.0%, 84.0% and 84.0%. Comparing with the 957 de novo lesions (98.0%, 96.4%, 95.7%, 95.1% and 94.8% at 1 to 5 each year after EVT), ISR lesions showed poor outcome, respectively (log-rank p=0.0012, Fig). Three of 40 (7.5%) focal ISR, 2 of 2 (100%) diffuse ISR and 3 of 8 (37.5%) ISO lesions needed repeat revascularization. Furthermore, limited to the adjunctive stenting lesions, 0 of 23 (0%) focal ISR, 1 of 1 (100%) diffuse ISR and 3 of 8 (37.5%) ISO lesions needed repeat revascularization.
CONCLUSION:
Long term secondary patency of AIA ISR lesions was poor. More consideration and the choice of treatment method or device by each type of ISR might be important.
Favorable results of endovascular therapy (EVT) for aortoiliac artery (AIA) lesions were reported. However, some cases needed additional treatment for in-stent restenosis (ISR) and there were few data of additional EVT for ISR of AIA lesion. This study aimed to investigate the clinical outcomes of EVT for AIA ISR lesions.
METHODS & RESULTS:
This study was a single-center, cohort study. Between January 2010 to June 2018, we treated 957 de novo AIA lesions by EVT. Fifty of 957 lesions needed additional EVT due to ISR and we studied these 50 ISR lesions. Mean follow up period was 1,216 days. Forty lesions (80%) were focal (≤ 50mm in length) ISR, 2 lesions (4%) were diffuse (>50mm in length) ISR and 8 lesions (16%) were in-stent occlusion (ISO). Twenty-three of 40 (57.5%) focal ISR, 1 of 2 (50%) diffuse ISR and 8 of 8 (100%) ISO lesions were performed adjunctive stenting. During follow-up period, 8 lesions (16%) needed repeat revascularization. Secondary patency, defined as no repeat revascularization in the treated vessel, at 1 to 5 each year after additional EVT was 96.0%, 90.0%, 88.0%, 84.0% and 84.0%. Comparing with the 957 de novo lesions (98.0%, 96.4%, 95.7%, 95.1% and 94.8% at 1 to 5 each year after EVT), ISR lesions showed poor outcome, respectively (log-rank p=0.0012, Fig). Three of 40 (7.5%) focal ISR, 2 of 2 (100%) diffuse ISR and 3 of 8 (37.5%) ISO lesions needed repeat revascularization. Furthermore, limited to the adjunctive stenting lesions, 0 of 23 (0%) focal ISR, 1 of 1 (100%) diffuse ISR and 3 of 8 (37.5%) ISO lesions needed repeat revascularization.
CONCLUSION:
Long term secondary patency of AIA ISR lesions was poor. More consideration and the choice of treatment method or device by each type of ISR might be important.