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Inflammatory Response to Stent Implantation: Differences in Femoropopliteal, Iliac, and Carotid Arteries¹

¹ From the Departments of Angiology (M.S., W.M., M.H., R.A., E.M.) and Laboratory Medicine (M.E., H.R., O.W.), University of Vienna Medical School, Währinger Gürtel 18-20/6J, 1090 Vienna, Austria. Received July 23, 2001; revision requested September 12; revision received October 12; accepted December 10. Address correspondence to M.S. (e-mail: martin.schillinger@akh-wien .ac.at).

PURPOSE: To investigate the postintervention course of serum acute-phase reactants after stent implantation in the femoropopliteal, iliac, and carotid arteries.

MATERIALS AND METHODS: This prospective cohort study included 274 consecutive patients who underwent stent implantation in the femoropopliteal (n = 95), iliac (n = 70), and carotid (n = 109) arteries. C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen levels were measured at baseline and at 48 hours after intervention. Polynomial logistic regression analysis was applied to assess the independent association of the course of acute-phase reactants and the site of stent implantation.

RESULTS: Stent implantation in the femoropopliteal artery was associated with a higher postintervention increase in CRP (P = .01), SAA (P = .04), and fibrinogen (P = .01) values compared with values with iliac artery stent implantation, with adjustment for age, sex, fluoroscopy duration, contrast agent dose, complication occurrence, stenosis grade, total vessel occlusion, and stent cumulative length. No significant difference in the postintervention course of CRP (P = .9) and SAA (P = .1) levels was determined for stents implanted in the carotid artery compared with those implanted in the iliac artery; however, a higher increase in fibrinogen levels (P = .04) was noted.

CONCLUSION: Stent implantation in the muscular femoropopliteal artery was associated with a more extensive vascular inflammatory response than was stent implantation in the elastic iliac and carotid arteries, independent of lesion morphology and interventional factors.

© RSNA, 2002

Index terms: Arteries, stenosis or obstruction, 172.721, 9_*.721² • Stents and prostheses, 172.2079, 172.458, 172.629, 92.1268, 92.24, 98.1268, 98.24

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