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Nitinol stent implantation for femoropopliteal disease in patients on hemodialysis: results of the 3-year retrospective multicenter APOLLON study

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Abstract

The clinical outcomes of nitinol stents for femoropopliteal arterial (FP) disease in patients on hemodialysis were assessed. Endovascular therapy (EVT) is accepted for symptomatic FP disease. However, the clinical outcomes of patients on dialysis are not well known. A multicenter retrospective study was conducted with data between November 2010 and August 2013. A total of 484 consecutive patients who successfully underwent EVT for FP disease with nitinol stents were recruited and analyzed. Patients were categorized into the hemodialysis group (N = 161) and non-hemodialysis group (N = 323). The primary measure was primary patency verified by duplex ultrasound at a rest peak systolic velocity (PSVR) of >2.5, and secondary measures were freedom from target lesion revascularization (TLR) and major amputation-free survival (AFS). Average follow-up duration was 19.5 ± 13.5 months. The primary patency rate at 3 years was significantly lower in the hemodialysis group than the non-hemodialysis group (33.8 vs. 43.7 %; p = 0.036). Freedom from TLR at 3 years was 55.0 % in the hemodialysis group and 66.1 % in the non-hemodialysis group (p = 0.032). The hemodialysis group showed a significantly lower AFS rate at 3 years than the non-hemodialysis group (86.4 vs. 58.2 %; p < 0.001). In hemodialysis patients, nitinol stent use resulted in a lower patency rate, higher TLR rate, and lower AFS rate compared to non-hemodialysis patients. These data suggest that nitinol stent implantation for FP arteries in hemodialysis patient needs to be reconsidered.

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Authors and Affiliations

  1. Department of Cardiology, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-cho, Kishiwada, Osaka, 596-8522, Japan

    Masahiko Fujihara, Akihiro Higashimori & Yoshiaki Yokoi

  2. Department of Cardiology, Saiseikai Noe Hospital, Osaka, Japan

    Yoshihiro Kato & Hiromasa Taniguchi

  3. Department of Cardiology, Osaka General Medical Center, Osaka, Japan

    Yusuke Iwasaki

  4. Department of Cardiology, Uji Tokushukai Hospital, Kyoto, Japan

    Tomonori Amano

  5. Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan

    Akinori Sumiyoshi

  6. Department of Cardiology, Higashi Sumiyoshi Morimoto Hospital, Osaka, Japan

    Daisuke Nishiya

Authors
  1. Masahiko Fujihara
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  2. Akihiro Higashimori
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  3. Yoshihiro Kato
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  4. Hiromasa Taniguchi
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  5. Yusuke Iwasaki
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  6. Tomonori Amano
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  7. Akinori Sumiyoshi
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  8. Daisuke Nishiya
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  9. Yoshiaki Yokoi
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Correspondence to Masahiko Fujihara.

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Fujihara, M., Higashimori, A., Kato, Y. et al. Nitinol stent implantation for femoropopliteal disease in patients on hemodialysis: results of the 3-year retrospective multicenter APOLLON study. Heart Vessels 31, 1476–1483 (2016). https://doi.org/10.1007/s00380-015-0740-7

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  • DOI: https://doi.org/10.1007/s00380-015-0740-7

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