Print this pageStatin Therapy Is Associated With Improved Outcomes Following Balloon Angioplasty and Stenting Of Superficial Femoral Artery Occlusive Disease
Matthew T Menard1, Karen J Ho2, Rodney Chan2, Edwin C Gravereaux1, Michael S Conte1, Louis L Nguyen1, Michael Belkin1
1Brigham and Women's Hospital, Boston, MA;2Brigham and Women's Hospital, Boston, MA
INTRODUCTION AND OBJECTIVES:
Statins have broad atherosclerotic properties and modulate the vascular injury response in experimental and clinical studies. We sought to determine the effects of statin therapy following balloon angioplasty and selective stenting of the superficial femoral artery for chronic limb ischemia.
METHODS:
From August, 2002 through December, 2004, 114 limbs in 102 consecutive patients were treated with balloon angioplasty +/- stenting of the superficial femoral artery for chronic limb ischemia. Patients were followed by clinical exam and non-invasive evaluation, and 38% of patients underwent late patency assessment by duplex scanning. Endpoints of angiographic, hemodynamic and clinical success (SVS reporting standards) were recorded, with clinical success defined as freedom from subsequent major amputation, repeat angioplasty or surgical bypass.
RESULTS:
There were 50% male patients, 52% diabetic, 61% on statin therapy and 18% with renal failure. TASC gradings were A(13%), B(34%), C(45%) and D(7%). Treatment indications were claudication(61%), rest pain(10%) and tissue loss(29%). Angioplasty alone was used in 39%. Angiographic and hemodynamic success rates per limb were 97% and 76% percent, respectively. At a mean follow-up of 8.7 months, clinical success at 6, 12 and 24 months was 85%+/-3.8%(SE), 81%+/-4.6% and 63%+/-10.9, while limb salvage was 94%, 91% and 87%. Duplex patency at 6 months was 86%+/-4.4%. Statin therapy and stenting significantly impacted clinical success by univariate Kaplan-Meier analysis, while coronary disease and tissue loss were negative predictors(p<.05). Statin therapy(p=.04,RR4.3) and smoking(p=.02,RR3.8) were positive and negative predictors of patency by multivariate analysis.
CONCLUSIONS:
Statin therapy is associated with improved outcomes following percutaneous treatment of superficial femoral artery occlusive disease.