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Vascular Inflammation and Percutaneous Transluminal Angioplasty of the Femoropopliteal Artery: Association with Restenosis¹

¹ From the Departments of Angiology (M.S., R.A., S.S., M.H., E.M.) and Laboratory Medicine (M.E., W.M., H.R., O.W.), University of Vienna Medical School, Vienna General Hospital, Währinger Gürtel 18-20/6J, A-1090 Vienna, Austria. Received November 9, 2001; revision requested December 17; revision received February 8, 2002; accepted April 2. Address correspondence to M.S. (e-mail: martin.schillinger@akh-wien.ac.at).

PURPOSE: To determine the association of pre- and postprocedural serum levels of C-reactive protein (CRP), serum amyloid A (SAA), and fibrinogen at 6-month evaluation of restenosis after percutaneous transluminal angioplasty (PTA) of the femoropopliteal artery.

MATERIALS AND METHODS: In a prospective cohort study, 172 consecutive patients with peripheral artery disease of Fontaine stage IIa, IIb, or III who underwent successful PTA of the superficial femoral and popliteal arteries were included. Patency at 6 months was evaluated by using oscillography, ankle-brachial index, and color-coded duplex ultrasonography. The association of restenosis and CRP, SAA, and fibrinogen levels at baseline, 24 hours, and 48 hours after intervention was assessed by means of multivariate analysis with adjustment for known risk factors for restenosis.

RESULTS: Restenosis was found in 56 patients (33%) within 6 months. CRP values at baseline (adjusted odds ratio, 2.2; 95% CI: 1.1, 4.2) and 48 hours after intervention (adjusted odds ratio, 2.3; 95% CI: 1.6, 3.1) were independently associated with 6-month restenosis. SAA and fibrinogen values at any time interval were not significantly associated with patency in the multivariate models.

CONCLUSION: The extent of vascular inflammation as measured by means of acute-phase reactants before and after PTA of the femoropopliteal artery is associated with 6-month restenosis. Baseline and 48-hour CRP levels were independent predictors of postangioplasty outcome.

© RSNA, 2002

Index terms: Arteries, femoral, 922.1282, 922.454, 922.721 • Arteries, popliteal, 924.1282, 924.454, 924.721 • Arteries, restenosis, 928.454, 928.458, 928.721 • Arteries, transluminal angioplasty, 928.1282, 928.454, 928.721 • Arteritis, 928.29, 928.454

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