Restenosis after percutaneous transluminal angioplasty in the femoropopliteal segment: The role of inflammation

Purpose: To determine the value of baseline C-reactive protein (CPR), fibri nogen, and white blood cell (WBC) counts in predicting 1-year patency after percutaneous transluminal angioplasty (PTA) in the femoropopliteal segment . Methods: In a retrospective cohort study, 168 consecutive patients (103 men ; median age 70 years, interquartile range 61-77) who underwent successful PTA of the femoral and/or popliteal arteries were analyzed. Twelve-month pa tency was evaluated using oscillography, ankle brachial index, duplex sonog raphy, and angiography. The predictive value of inflammatory markers was as sessed in a multivariate model controlling for cardiovascular risk factors, technical success, and hemodynamic factors. Results: Transient WBC elevation was found 6 hours after PTA, but this retu rned to baseline after 24 hours. Fibrinogen was elevated at 24 hours. Duple x scanning disclosed restenosis in 66 (39%) patients within the first 12 mo nths after PTA. Only residual postdilation stenosis (greater than or equal to 30%) in the target segment (odds ratio 3.6, p = 0.001) and baseline CRP levels (odds ratio 4.2, p = 0.02) were independent predictors of outcome; n either WBC counts nor fibrinogen levels at any time point was associated wi th restenosis. Conclusions. Primary technical success and postinterventional hemodynamic f low at the dilated segment seem to be more important for intermediate-term patency than atherogenic risk factors. The predictive value of preprocedura l serum CRP levels on restenosis should be further investigated.