Prognostic factors for restenosis of superficial femoral artery after endovascular treatment

Boc, Vinko (author), Kozak, Matija (author), Eržen, Barbara (author), Božič Mijovski, Mojca (author), Boc, Anja (author), Blinc, Aleš (author)

High incidence of superficial femoral artery (SFA) restenosis after percutaneous transluminal angioplasty (PTA) poses a persistent challenge in peripheral arterial disease (PAD) treatment. We studied how the patients' and lesions' characteristics, thrombin generation, overall haemostatic potential (OHP), and single nucleotide polymorphisms (SNPs) of the NR4A2 and PECAM1 genes affected the likelihood of restenosis. In total, 206 consecutive PAD patients with limiting intermittent claudication due to SFA stenosis who were treated with balloon angioplasty with bailout stenting when necessary were included. Patients' clinical status and patency of the treated arterial segment on ultrasound examination were assessed 1, 6, and 12 months after the procedure. Restenosis occurred in 45% of patients, with less than 20% of all patients experiencing symptoms. In the multivariate analysis, predictors of restenosis proved to be poor infrapopliteal runoff, higher lesion complexity, absence of treated arterial hypertension, delayed lag phase in thrombin generation, and higher contribution of plasma extracellular vesicles to thrombin concentration. Poor infrapopliteal runoff increased the risk of restenosis in the first 6 months, but not later. The negative effect of poor infrapopliteal runoff on SFA patency opens questions about the potential benefits of simultaneous revascularisation of below-knee arteries along with SFA revascularisation.

• Language: English
• Keywords: endovascular procedures, femoral artery, vascular patency, hemostasis, polymorphism
• Work type: Article
• Typology: 1.01 - Original Scientific Article
• Organization: FFA - Faculty of Pharmacy; MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2023
• Number of pages: 13 str.
• Numbering: Vol. 12, iss. 19, art. 6343
• PID: 20.500.12556/RUL-189760
• UDC: 616.1
• ISSN on article: 2077-0383
• DOI: 10.3390/jcm12196343
• COBISS.SI-ID: 169180931
• Publication date in RUL: 16.10.2026

Record is a part of a journal

• Title: Journal of clinical medicine
• Shortened title: J. clin. med.
• Publisher: MDPI
• ISSN: 2077-0383
• COBISS.SI-ID: 5405759

Licences

• License: CC BY 4.0, Creative Commons Attribution 4.0 International
• Link: http://creativecommons.org/licenses/by/4.0/
• Description: This is the standard Creative Commons license that gives others maximum freedom to do what they want with the work as long as they credit the author.

Secondary language

• Language: Slovenian
• Keywords: endovaskularni postopki, femoralna arterija, vaskularna prehodnost, hemostaza, polimorfizem

Projects

• Funder: ARIS - Slovenian Research and Innovation Agency
• Project number: P3-0308
• Name: Ateroskleroza in tromboza