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The Scientific World Journal
Volume 2013, Article ID 247102, 8 pages
http://dx.doi.org/10.1155/2013/247102
Clinical Study

Comparison of Immediate and 2-Year Outcomes between Excimer Laser-Assisted Angioplasty with Spot Stent and Primary Stenting in Intermediate to Long Femoropopliteal Disease

1Section of Cardiology, Department of Medicine, Taipei Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, 289 Jiang Kuo Road, Xindian District, New Taipei City 231, Taiwan
2Section of Cardiology, Department of Medicine, Chang Gung Memorial Hospital, 5 Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan
3Department of Ophthalmology, Chang Gung Memorial Hospital, 5 Fusing Street, Gueishan Township, Taoyuan County 333, Taiwan

Received 1 October 2013; Accepted 20 October 2013

Academic Editors: D. Noonan, M. K. Razavi, and E. Shagdarsuren

Copyright © 2013 Tien-Yu Wu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. To compare the clinical outcomes between excimer laser-assisted angioplasty (ELA) with spot stent (group A) and primary stenting (group B) in intermediate to long femoropopliteal disease. Methods. Outcomes of 105 patients totaling 119 legs treated with two different strategies were analyzed retrospectively in a prospectively maintained database. Results. Baseline characteristics were similar in both groups. Better angiographic results and lesser increase of serum C-reactive protein levels (0.60 ± 0.72 versus 2.98 ± 0.97 mg/dL, ) after the intervention were obtained in Group B. Group A had inferior 1-year outcomes due to higher rate of binary restenosis (67% versus 32%, ) and lower rate of primary patency (40% versus 58%, ). Rates of amputation-free survival, target vessel revascularization, assisted primary patency, and stent fracture at 24 months were similar in both groups (80% versus 82%, , 65% versus 45%, , 78% versus 80%, and 6.3% versus 6.8%, , resp.). Conclusion. Greater vascular inflammation after ELA with spot stent resulted in earlier restenosis and inferior 1-year clinical outcomes than primary stenting. This benefit was lost in the primary stenting group at 2 years due to late catch-up restenosis. Active surveillance with prompt intervention was required to maintain the vessel patency.