Femoropopliteal Arteries: Immediate and Long-term Results with a Dacron-covered Stent-Graft

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Abstract
PURPOSE: To assess immediate and long-term outcome after femoropopliteal implantation of a Dacron-covered stent-graft in patients with peripheral arterial disease. MATERIALS AND METHODS: This prospective cohort study included 30 consecutive patients who underwent Dacron-covered stent-graft implantation because of recurrent stenosis after percutaneous transluminal angioplasty in the femoropopliteal segment. After interventional treatment, 100 mg of acetylsalicylic acid daily and oral anticoagulation therapy (therapeutic level, international normalized ratio, 2.0–3.0) were administered. Patients were followed up with ankle-brachial index measurement, color-coded duplex ultrasonography, and angiography. Primary and secondary patency rates and postintervention complications were documented as was initial technical success. Kaplan-Meier and life table analyses were used for calculation of patency rates. RESULTS: Initial technical success was achieved in all 30 patients, with significant improvement of ankle-brachial index from a preintervention mean of 0.5 ± 0.14 (SD) to a postintervention mean of 0.8 ± 0.17 (P < .001). Postimplantation noninfectious fever and leukocyte and C-reactive protein level elevation occurred in 12 patients (40%), and 17 patients (57%) reported persistent pain at the site of implantation for a mean of 5 days (range, 2–28 days). Early recurrent occlusion within the first 24 hours was found in five patients (17%). Within the mean follow-up period of 60 months ± 10, restenosis occurred in 25 patients (83%). At 6, 12, 36, and 72 months, respectively, primary patency rates were 27%, 23%, 17%, 17%, and secondary patency rates were 63%, 60%, 34%, 34%. CONCLUSION: Implantation of Dacron-covered stent-grafts for treatment of femoropopliteal lesions leads to high early and late restenosis rates, with a considerable rate of complications, such as fever and pain. © RSNA, 2002