Early Results with the Use of Heparin-bonded Stent Graft to Rescue Failed Angioplasty of Chronic Femoropopliteal Occlusive Lesions: TASC D Lesions Have a Poor Outcome

Purpose To evaluate early patency rate of the heparin-bonded stent grafts in atherosclerotic long femoropopliteal occlusive disease, and to identify factors that affect outcome. Methods Heparin-bonded Viabahn stent grafts were placed in 33 limbs in 33 patients during 2009–2010. The stents were deployed to rescue failed conventional balloon angioplasty. Mean age was 69 (range 44–88) years, and 67 % (22 of 33) were men. Most procedures (21 of 33, 64 %) were performed for critical limb ischemia (33 % for rest pain, 30 % tissue loss). Kaplan–Meier plots and Cox regression analysis were used to identify significant risk factors. Results The average length of lesions treated was 25 ± 10 cm, and they were predominantly TASC (Transatlantic Intersociety Consensus) D ( n = 13) and C ( n = 17) lesions. The median primary patency was 5.0 months (95 % confidence interval 1.22–8.77). The mean secondary patency was 8.6 months (95 % confidence interval 6.82–10.42). Subsequently, 4 patients underwent bypass surgery and 5 patients underwent major amputation. One patient died. There were 5 in-stent or edge-stent stenoses. Cox multivariate regression analysis identified TASC D lesions to be a significant risk factor for early occlusion ( p = 0.035). Conclusion TASC D lesions of femoropopliteal occlusions have poor patency rates with the use of heparin-bonded stent grafts after failed conventional angioplasty. Alternative options should be considered for these patients.