Polls

Expert's Opinion

Lorenzo Patrone MD

Vascular and Interventional Radiology Consultant
London North West Healthcare NHS Trust
London, United Kingdom

References

[1] Tosaka A, Soga Y et al Classification and clinical impact of restenosis after femoropopliteal stenting. J Am Coll Cardiol. 2012 Jan 3;59(1):16-23.

[2] Cassese S, Byrne et al. Paclitaxel-coated versus uncoated balloon angioplasty reduces target lesion revascularization in patients with femoropopliteal arterial disease: a meta-analysis of randomized trials. Circ Cardiovasc Interv 2012;5:582-9.

[3] Krankenberg H, Tübler T et al. Drug-coated balloon versus standard balloon for superficial femoral artery in-stent restenosis: the randomized Femoral Artery In-stent Restenosis (FAIR) trial. Circulation 2015;132:2230-6.

[4] Kinstner CM, Lammer J et al. Paclitaxel-eluting balloon versus standard balloon angioplasty in in-stent restenosis of the superficial femoral and proximal popliteal artery: 1-year results of the PACUBA trial. JACC Cardiovasc Interv 2016;9:1386-92.

[5] Stabile E, Virga V, Salemme L et al. Drug-eluting balloon for treatment of superficial femoral artery in- stent restenosis. J Am Coll Cardiol 2012;60:1739-42.

[6] Virga V, Stabile E et al. Drug-eluting balloons for the treatment of the superficial femoral artery in-stent restenosis: 2-year follow-up. JACC Cardiovasc Interv 2014;7:411-5.

[7] Liistro F, Angioli P et al. Paclitaxel-eluting balloon vs. standard angioplasty to reduce recurrent restenosis in diabetic patients with in-stent restenosis of the superficial femoral and proximal popliteal arteries: the DEBATE-ISR study. J Endovasc Ther 2014;21:1-8.

[8] Grotti S, Liistro F et al. Paclitaxel-eluting balloon vs standard angioplasty to reduce restenosis in diabetic patients with in-stent restenosis of the superficial femoral and proximal popliteal arteries: three-year results of the DEBATE-ISR study. J Endovasc Ther 2016;23:52-7.

[9] Brodmann M, Keirse K et al. Drug-coated balloon treatment for femoropopliteal artery disease: the IN.PACT global study de novo in-stent restenosis imaging cohort. JACC Cardiovasc Interv 2017;10:2113-23.

[10] Sixt S, Carpio Cancino et al. Drug-coated balloon angioplasty after directional atherectomy improves outcome in restenotic femoropopliteal arteries. J Vasc Surg 2013;58:682-6.

[11] Gandini R, Del Giudice C et al. Treatment of chronic SFA in-stent occlusion with combined laser atherectomy and drug-eluting balloon angioplasty in patients with critical limb ischemia: a single- center, prospective, randomized study. J Endovasc Ther 2013;20:805-14.

[12] Kim W, Choi D Treatment of Femoropopliteal Artery In-stent Restenosis. Korean Circ J. 2018 Mar;48(3):191-197.

[13] Miller AJ, Takahashi EA Treatment of Superficial Femoral Artery Restenosis. J Vasc Interv Radiol. 2017 Dec;28(12):1681-1686.

[14] Kim W, Gandhi RT et al. The Influence of Statin Therapy on Restenosis in Patients Who Underwent Nitinol Stent Implantation for de Novo Femoropopliteal Artery Disease: Two-Year Follow-up at a Single Center. J Vasc Interv Radiol. 2016; 27(10):1494–501.

Polling Station

Question #1

Does the Tosaka Class of the ISR influence your treatment strategy?

Yes
No
I am not familiar with the Tosaka Classification

Question #2

Which would be your primary revascularization method for focal SFA ISR?

Bare Metal Stent
Stent Graft
Drug eluting stent
Plain Angioplasty
Drug coated balloon angioplasty
Vessel prep and drug coated balloon angioplasty

Question #3

Which would be your primary revascularization method for long SFA stent occlusion

Surgery
Endovascular

Question #4

Which would be your primary endovascular treatment option for a popliteal ISR?

Bare Metal Stent
Stent Graft
Drug eluting stent
Plain Angioplasty
Drug coated balloon angioplasty
Vessel prep and drug coated balloon angioplasty

Question #5

Which would be your antithrombotic treatment after endovascular treatment of an occluded bare metal stent in the femoropopliteal segment?

Acetylsalicylic acid
Clopidogrel
Dual antiplatelet therapy
Vitamin K antagonist
New oral anticoagulant
Antiplatelet + Anticoagulant
Antiplatelet + Vitamin K antagonist

Question #6

Would you treat an asymptomatic focal ISR in order to prevent an occlusion?

Question #7

How often do you perform follow up visits after endovascular treatment of an ISR?

3 months intervals
6 mon intervals
At 3, 6 and 12 months after the procedure
Only in case of symptoms worsening

Polling Station

The femoropopliteal In-Stent-Restenosis