Scoring System Proposed to Classify Patterns of Restenosis After Femoropopliteal Interventions
September 6, 2017—A proposed scoring system for the angiographic classification of patterns of restenosis after femoropopliteal artery intervention was published by Lawrence A. Garcia, MD, et al online ahead of print in Catheterization and Cardiovascular Interventions.
The investigators noted that despite myriad endovascular technologies available to treat peripheral artery disease of the femoropopliteal arteries, restenosis remains a common failure mode. They stated that characterizing common patterns of restenosis is important to discern the potential impact of baseline patient, lesion, and procedural characteristics, as well as treatment modalities on either the primary success or the failure patterns associated with restenosis.
As summarized in Catheterization and Cardiovascular Interventions, the investigators included studies that were from previous core laboratory–adjudicated femoropopliteal artery disease trials and registries reflecting a wide array of treatment modalities.
There were 403 total angiograms for analysis and adjudication from the patients enrolled and analyzed. Target lesion revascularization images of the 32 validation cases were evaluated for index treated length, diameter stenosis, and lesion morphology characteristics.
The investigators proposed the following lesion types:
- Type 1: “Focal” pattern, which may be “Edge Proximal” or “Edge Distal” depending on location
- Type 2: “Multifocal” pattern which may also exhibit edge restenosis, but may also be “Edge Bilateral”
- Type 3: “Moderate” pattern
- Type 4: “Diffuse” pattern
- Type 5: “Occlusion”
A classification system that enables health care professionals to anticipate and describe failures following the index procedure, thereby impacting the choice of options for retreatment, may facilitate consistency and standardization within the heterogeneous field of endovascular device treatments for the femoropopliteal artery, concluded the investigators in Catheterization and Cardiovascular Interventions.