INCIDENCE AND RISK FACTORS OF PERIPHERAL ARTERY DISEASE RECURRENCE IN PATIENTS WHO UNDERWENT ANGIOPLASTY OR STENTING

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Dr Muhammad Umar Iqbal
Dr Mudassar Iqbal
Dr Muhammad Sarwar Khalid
Dr Muhammad Irfan
Dr Fouzia Goher
Dr Anwaar ul Hassan

Keywords

Peripheral Artery Disease, Angioplasty, Stenting, Risk factors of PAD

Abstract

This study was conducted to assess the incidence and risk factors of peripheral artery disease recurrence in patients who underwent angioplasty or stent. A retrospective study was conducted in the Department of Cardiology of PIC/ Quaid-e-Azam Medical College, Bahawalpur from January 2024 to January 2025. A total of 100 patients presenting at the hospital with lower extremity peripheral artery disease diagnosed by ankle-brachial index or ultrasound were included in the study by consecutive sampling. Inguinal region was percutaneously accessed via iliac artery and a balloon expandable stent was deployed followed by additional stenting with dynamic balloon stent. A drop of more than 0.1 in the ankle-brachial index and >50% degree of stenosis at follow up indicated recurrence which was evaluated by angiography. Twelve patients (12%) showed restenosis on follow-up and 88 (88%) had a successful procedure, free of recurrence. The rate of recurrence insignificantly related to gender (OR = 9.0, 95% CI 1.42–57.1, p=0.68), smoking (OR = 9.0, 95% CI 1.42–57.1, p=0.09), diabetes (OR = 15.0, 95% CI 2.03–111.1, p = 0.09), hypertension (OR = 9.0, 95% CI 1.42–57.1, p=0.22) and dyslipidemia (p=0.47). The significant predictors of PAD recurrence were external iliac and common iliac involvement (p=0.05) and use of balloon retransmitted stent (p=0.008). It is concluded that the incidence of peripheral artery disease recurrence was low in patients undergoing angioplasty or stenting. It was significantly associated with type of vessel involved and endovascular revascularization technique.

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References

1. Divya P, Ahmed MA, Anmol M, Rakesh GV. Peripheral Arterial Disease: A Narrative Review. Cureus. 2023;15(6).
2. Bierowski M, Galanis T, Majeed A, Mofid A. Peripheral artery disease: treatment of claudication and surgical management. Medical Clinics. 2023;107(5):823-7.
3. Bernatchez J, Fortin W, Boisvert A, Douville Y, et al. Peripheral Arterial Disease: What You Need to Know. Cardiovascular Explants: Biofunctionality, Biodurability and Biocompatibility: Springer; 2025. p. 91-139.
4. Lempesis IG, Varrias D, Sagris M, Attaran RR, et al. Obesity and peripheral artery disease: current evidence and controversies. Current obesity reports. 2023;12(3):264-79.
5. Heiss C, Olinic D-M, Belch JJ, Brodmann M, et al. Management of chronic peripheral artery disease patients with indication for endovascular revascularization. Vasa. 2022.
6. Choi BG, Hong J-Y, Rha S-W, Choi CU, et al. Long-term outcomes of peripheral arterial disease patients with significant coronary artery disease undergoing percutaneous coronary intervention. Plos one. 2021;16(5):e0251542.
7. Eleshra A, Abdelgawwad M, Regal S, Soliman M, et al. Short-term outcome of primary stent graft for peripheral artery aneurysm in patients with Behçet disease. Journal of Vascular Surgery. 2021;73(1):279-84.
8. Marzlin N, Jan MF, Kostopoulos L, Moreno ACP, et al. Peripheral Artery Disease Intervention: Drug‐Coated Balloon vs Drug‐Eluting Stent, A Long‐Term Comparison. Journal of interventional cardiology. 2022;2022(1):5175607.
9. Gouëffic Y, Torsello G, Zeller T, Esposito G, et al. Efficacy of a drug-eluting stent versus bare metal stents for symptomatic femoropopliteal peripheral artery disease: primary results of the EMINENT randomized trial. Circulation. 2022;146(21):1564-76.
10. Sayfo S, Rosol ZP, Vazquez DF, Mamawala M, et al. Clinical Outcomes of Non–Stent-Based Interventions for Symptomatic Below-the-Knee Peripheral Artery Disease in the Excellence in Peripheral Artery Disease (XLPAD) Registry. The American journal of cardiology. 2024;228:38-47.
11. AbuRahma AF, Beasley M, Davis M, Adams E, et al. Use of drug-eluting stents in patients with critical limb ischemia and infrapopliteal arterial disease: a real-world single-center experience. Journal of Vascular Surgery. 2021;74(5):1619-25.
12. Changal K, Patel M, Devarasetty PP, Royfman R, et al. Drug-eluting stents versus conventional endovascular therapies in symptomatic infrapopliteal peripheral artery disease: a meta-analysis. Journal of the Society for Cardiovascular Angiography & Interventions. 2022;1(2):100024.
13. Gressler LE, Ramkumar N, Marinac‐Dabic D, dosReis S, et al. The association of major adverse limb events and combination stent and atherectomy in patients undergoing revascularization for lower extremity peripheral artery disease. Catheterization and Cardiovascular Interventions. 2023;102(4):688-700.
14. Darling JD, Caron E, van Galen I, Park J, et al. Outcomes following drug-coated balloons and drug-eluting stents in patients with peripheral arterial disease. Journal of Vascular Surgery. 2025.
15. Bekken JA, Geensen R, Kok R, Kuijper M, et al. Covered stents vs. angioplasty for common iliac artery in stent restenosis: a retrospective comparison. European Journal of Vascular and Endovascular Surgery. 2022;63(2):315-22.
16. Atasoy MS, Guven H. Evaluation of 24-Month Follow-up Outcomes of Patients Undergoing Combined Rotational Atherectomy and Drug-coated Balloon for Lower Extremity Peripheral Arterial Disease. Indian Journal of Surgery. 2025:1-6.
17. Evans P, Sobieszczyk P, Eisenhauer AC, Ostrowski S, et al. Risk of mortality related to recurrent limb events after endovascular revascularization of the superficial femoral artery for peripheral artery disease: the Boston Femoral Artery Endovascular Revascularization Outcomes (Boston FAROUT) study. The American journal of cardiology. 2023;205:425-30.
18. Soyoye DO, Abiodun OO, Ikem RT, Kolawole BA, et al. Diabetes and peripheral artery disease: A review. World journal of diabetes. 2021;12(6):827.
19. Tsujimura T, Takahara M, Iida O, Soga Y, et al. Clinical outcomes of polymer-free, paclitaxel-coated stents vs stent grafts in peripheral arterial disease patients with femoropopliteal artery lesions. Journal of Vascular Surgery. 2021;73(6):1998-2008. e1.
20. Kinlay S, Sobieszczyk P, Eisenhauer AC, Ostrowski S, et al. Patient and limb outcomes 10 years after endovascular revascularization of the superficial femoral artery for peripheral artery disease: the Boston Femoral Artery Endovascular Revascularization Outcomes (Boston FAROUT) study. Vascular Medicine. 2023;28(4):290-8.

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