Comparison of long-term patency after endovascular therapy for superficial femoral artery occlusive disease between patients with and without hemodialysis

Catheter Cardiovasc Interv. 2016 May;87(6):1142-8. doi: 10.1002/ccd.26359. Epub 2015 Dec 23.

Abstract

Objective: To compare long-term patency after endovascular therapy (EVT) for superficial femoral artery (SFA) occlusive disease between patients with hemodialysis (HD; HD+) and those without HD (HD-).

Background: Long-term patency after EVT for SFA occlusive disease in HD+ remains unknown.

Methods: EVT to SFA was successfully performed in 382 consecutive patients during 2004-2011. Cox proportional hazard model estimated the hazard ratio (HR) for the loss of primary patency (PP), secondary patency (SP), and amputation-free survival (AFS) in HD+. Binominal logistic regression analysis calculated the propensity score (PS) for covariates with a P value of <0.2 for HD as a dependent variable. HRs were adjusted for PS in multivariate analysis using the Cox proportional hazard model.

Results: PP and SP in HD+ and HD- were 47.9 and 79.4% and 68.4 and 92.5%, respectively, 4 years after EVT. There were no procedure-related amputations or in-hospital deaths. Adjusted HRs for the loss of PP, SP, and AFS were as follows: loss of PP, adjusted HR 2.010, 95% CI 1.157-3.492, P = 0.013; loss of SP, adjusted HR 2.927, 95% CI 1.236-6.933, P = 0.015; and loss of AFS, adjusted HR 1.665, 95% CI 0.994-2.791, P = 0.053.

Conclusions: Although HD+ had more than double the risks for loss of PP and SP than HD-, EVT to SFA in HD+ was found to be safe with an acceptable PP and SP. © 2015 Wiley Periodicals, Inc.

Keywords: endovascular therapy; hemodialysis; superficial femoral artery.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Arterial Occlusive Diseases / complications
  • Arterial Occlusive Diseases / physiopathology
  • Arterial Occlusive Diseases / surgery*
  • Endovascular Procedures / methods*
  • Female
  • Femoral Artery / surgery*
  • Follow-Up Studies
  • Humans
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / therapy
  • Male
  • Renal Dialysis*
  • Retrospective Studies
  • Risk Factors
  • Stents*
  • Time Factors
  • Treatment Outcome
  • Vascular Patency*