Risk Factors Analysis Of Stent Fracture After Superficial Femoral Artery And Proximal Popliteal Artery Stenting

Objective : To investigate the correlation between stent fracture and in-stent restenosis,and risk factors of stent fracture in patients with superficial femoral artery and proximal popliteal artery stenting due to arteriosclerosis obliterans.Methods:From March 2012 to March 2016,97 consecutive patients(mean age 73.4±8.7 years,76 men,107 limbs)who underwent endovascular stenting therapy in superficial femoral artery and proximal popliteal artery were followed up by the methods of Doppler ultrasound scanning,X-ray scanning,computed tomographic angiography or digital subtraction angiography at Department of Vascular Surgery,Shanghai Renji Hospital.Kaplan Meier analysis,Logistic regression analysis and ROC curve analysis were performed by using SPSS.Results:During the follow-up period,71 patients(72 limbs)had in-stent restenosis and the incidence of restenosis was 67.3%.The incidence of restenosis was 84.2%(32/38)in the fracture group and 58.0%(40/69)in the non-fracture group.The incidence of restenosis in the patients with stent fracture was significantly higher than that in the patients without stent fracture(P = 0.01).Overall,38 limbs had stent fracture and the incidence of stent fracture was 35.8%.The highest incidence of fracture type was ? type stent fracture(44.7%),and the highest incidence of the targeted arterial segment was the superficial femoral artery adductor canal segment(47.4%).Respectively,patients with TASC D femoropopliteal lesions in the facture group and the un-fracture group were 23(60.5%)and 16(23.2%)(P<0.01).The total stent length of each limb in the fracture group and the un-fracture group are 259.5±99.9mm and 187.5±104.2mm(P<0.01),respectively.Overlapping zones were found in 28 limbs(52.8%)in the fracture group,while only 10 limbs(18.5%)with overlapping zones in the un-fracture group(P<0.01).Conclusion:Stent fracture was associated with higher in-stent restenosis,and it is one of the risk factors of in-stent restenosis in femoral artery and proximal popliteal artery.This study also suggests that TASC D femoropopliteal lesion,total length of stent,and overlapping zones were risk factors of stent fracture after femoral arterial and proximal popliteal arterial stenting.