[MO-33] Can IVUS predict restenosis after balloon angioplasty for femoropopliteal artery stenosis?
Background: Treatment strategy for femoropopliteal (FP) artery stenosis is still unsolved problem. The aim of this study was to evaluate the predictor of restenosis of plain old balloon angioplasty (POBA) using intravascular ultrasound (IVUS).
Method: FP stenotic lesions underwent IVUS guided balloon angioplasty without stent implantation were enrolled and 1-year restenosis rate (defined as duplex ultrasound-derived peak systolic velocity ratio more than 2.4) was evaluated. Patient, lesion, IVUS, and procedural parameters were compared between restenosis group (RG) and non-restenosis group (non-RG).
Result: Seventy-eight lesions were enrolled. The average lesion length was 59.8mm and 1year restenosis rate was 36.0%. Lesion length was significantly longer and pre-intervention reference vessel area was significantly smaller in RG compared with non-RG (80.0mm vs 47.8mm, p=0.03, 36.3mm2 vs 42.0mm2, p=0.03, respectively). Among post-intervention parameters, lumen area at minimal lumen area was smaller and the maximum angle of dissection was larger in RG (9.52mm2 vs 12.2mm2, p=0.03, 102.0degree vs 70.1degree, p=0.007, respectively). Multivariate analysis revealed the only independent factor of restenosis was the maximum angle of dissection. By, ROC analysis, the best cut-off value predicting 1-year restenosis was 56.4 degree (sensitivity: 82.8%, specificity: 49.0%, AUC: 0.68, p=0.009).
Conclusion: Long lesion, small reference vessel, post-intervention small minimal lumen area, and large dissection were the predictors of 1-year restenosis after POBA for FP stenotic lesions. The maximum angle of dissection was the only independent predictor for restenosis.
Method: FP stenotic lesions underwent IVUS guided balloon angioplasty without stent implantation were enrolled and 1-year restenosis rate (defined as duplex ultrasound-derived peak systolic velocity ratio more than 2.4) was evaluated. Patient, lesion, IVUS, and procedural parameters were compared between restenosis group (RG) and non-restenosis group (non-RG).
Result: Seventy-eight lesions were enrolled. The average lesion length was 59.8mm and 1year restenosis rate was 36.0%. Lesion length was significantly longer and pre-intervention reference vessel area was significantly smaller in RG compared with non-RG (80.0mm vs 47.8mm, p=0.03, 36.3mm2 vs 42.0mm2, p=0.03, respectively). Among post-intervention parameters, lumen area at minimal lumen area was smaller and the maximum angle of dissection was larger in RG (9.52mm2 vs 12.2mm2, p=0.03, 102.0degree vs 70.1degree, p=0.007, respectively). Multivariate analysis revealed the only independent factor of restenosis was the maximum angle of dissection. By, ROC analysis, the best cut-off value predicting 1-year restenosis was 56.4 degree (sensitivity: 82.8%, specificity: 49.0%, AUC: 0.68, p=0.009).
Conclusion: Long lesion, small reference vessel, post-intervention small minimal lumen area, and large dissection were the predictors of 1-year restenosis after POBA for FP stenotic lesions. The maximum angle of dissection was the only independent predictor for restenosis.