Division of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan.
Catheter Cardiovasc Interv. 2013 May;81(6):1031-41. doi: 10.1002/ccd.24502. Epub 2012 Nov 14.
To (1) compare the outcome of self-expandable stents with versus without jailed deep femoral artery (DFA) for proximal superficial femoral artery (SFA) lesions, and to (2) ascertain the fate of jailed DFA.
Complex SFA lesions involving the femoral bifurcation (FB) was mostly treated surgically, and the role played by endovascular procedures is uncertain.
We retrospectively identified 104 consecutive, de novo lesions involving the SFA ostium, stented between April 2005 and September 2010. Depending on the proximal stent edge location, the sample was divided between 60 distal common femoral artery (CFA) stenting with jailed DFA and 44 ostial SFA stenting without jailed DFA. The FB was the segment beginning in the distal CFA, 10 mm proximal to the DFA ostium and ending in the SFA and 10 mm distal to the carina. Stented CFA lesions proximal to the FB were excluded. The bifurcation was classified as patent when free of restenosis and repeat revascularization.
The overall 12-month bifurcation and primary patency rates were 72.5% and 52.0%, respectively. Predictors of loss of bifurcation patency were ostial SFA stenting and a small stent in the FB. Bifurcation patency (83.3% vs. 56.3%; P < 0.01) and primary patency of the SFA (56.2% vs. 37.5%; P = 0.088) were higher after distal CFA than after ostial SFA stenting. In 95.7% of distal CFA and 100% of ostial SFA stenting, DFA remained patent at 12-month follow-up (P = 0.237).
The 12-month fate of jailed DFA after distal CFA stenting was acceptable, and the bifurcation patency rate was higher than after ostial SFA stenting.
（1）比较带或不带深股动脉（DFA）嵌顿的自膨式支架治疗近端股浅动脉（SFA）病变的结果，并（2）确定嵌顿 DFA 的结局。
涉及股动脉分叉（FB）的复杂 SFA 病变多采用手术治疗，血管内治疗的作用尚不确定。
我们回顾性地确定了 104 例连续的、新出现的 SFA 口部病变，这些病变于 2005 年 4 月至 2010 年 9 月期间接受支架置入治疗。根据近端支架边缘位置，样本分为 60 例远端股总动脉（CFA）支架置入伴 DFA 嵌顿和 44 例 SFA 口部支架置入无 DFA 嵌顿。FB 始于远端 CFA，距 DFA 口 10mm 处，止于 SFA，距嵴 10mm 处。FB 近端的 CFA 支架置入病变被排除在外。分叉无再狭窄和再血运重建时被认为是通畅的。
总的 12 个月分叉和主要通畅率分别为 72.5%和 52.0%。分叉通畅率丧失的预测因素是 SFA 口部支架置入和 FB 中的小支架。远端 CFA 组的分叉通畅率（83.3%比 56.3%；P <0.01）和 SFA 主要通畅率（56.2%比 37.5%；P=0.088）均高于 SFA 口部支架置入组。在 95.7%的远端 CFA 和 100%的 SFA 口部支架置入中，DFA 在 12 个月随访时仍保持通畅（P=0.237）。
远端 CFA 支架置入后 DFA 嵌顿的 12 个月结局是可以接受的，且分叉通畅率高于 SFA 口部支架置入。
