Viabahn for femoropopliteal in-stent restenosis

BACKGROUND AND OBJECTIVES: In-stent restenosis in the femoropopliteal artery is common (20%–40%). Treatment of in-stent restenosis is challenged by poor patency rate. An ePTFE-covered stent-graft (Viabahn) is inert with a very small pore size that does not allow for significant tissue in-growth. Use of a Viabahn stent-graft may improve the patency rate in the treatment of in-stent restenosis. DESIGN AND SETTING: A retrospective chart review of the use of Viabahn stent grafts implanted in patients with symptomatic femoropopliteal artery in-stent restenosis performed from January 2004 to December 2008. PATIENTS AND METHODS: We measured the primary patency rate using duplex ultrasound at 1 year and 3 years. We also examined the rate of secondary patency, acute limb ischemia and amputation. RESULTS: Twenty-seven cases with in-stent restenosis of the femoropopliteal artery treated by Viabahn stent-graft were identified. The average lesion length was 24.5 cm; 52% of the lesions were total occlusion and 37% had critical limb ischemia. The 1- and 3-year primary patency rates were 85.1% and 81.4%, respectively. The secondary patency rate was 96%. All recurrent in-stent restenoses were focal at the proximal and distal edges and none had stent fracture. CONCLUSION: Our single center experience in a small number of patients showed a favorable patency of ePTFE-covered stent-graft for treatment of patients with in-stent restenosis in the femoropopliteal artery.