Percutaneous mechanical thrombectomy and angioplasty for femoropopliteal artery stent restenosis

Objective To evaluate percutaneous mechanical thrombectomy and angioplasty in patients with femoropopliteal artery stent restenosis. Methods The clinical data of 41 cases with critical limb ischemia caused by femoropopliteal artery stent restenosis were analyzed retrospectively from Jun 2015 to May 2017, who were treated by percutaneous mechanical thrombectomy(PMT)+ percutaneous angioplasty (PTA) simultaneously. Clinical status assessment, ankle brachial index (ABI) test and color duplex ultrasonography (CDU) were administered at 3rd, 6th and 12th month during follow-up; and computed tomography angiography (CTA) or digital subtraction angiography (DSA) was performed at 6th and 12th month after discharged. Results Procedures were successful in all patients. 27 cases were under PTA after PMT, other 14 cases were under PTA+ stenting after PMT. The average ABI increased from 0.34±0.28 to 0.84±0.32(P=0.00)immediately. There was no perioperative death and major limb amputation.36 cases (36/41, 87.8%) were followed-up from 169 to 698 days (mean 426 days). During follow-up of 12 months, there were 18 cases with in-stent restenosis and/or thrombosis. PMT+ PTA were performed again in 14 cases and 4 cases accepted medication; no case encountered major amputation. The primary patency and second patency were 82.9%and 97.6% respectively at 6th month; Which were 49.8% and 88.8% respectively at 12th month, and the ABI was 0.65±0.10 (P=0.01). Conclusion Percutaneous mechanical thrombectomy and angioplasty is safe, miniinvasive and effective for femoropopliteal artery stent restenosis. Key words: Arterial occlusive diseases; Lower extremity; Stents; Endometrial hyperplasia; Vascular surgical procedures