Background:The risk of restenosis after intervention is higher in femoropopliteal than in aortoiliac lesions. However, the appropriate endovascular therapy (EVT) for preventing restenosis after intervention for femoropopliteal lesions remains unknown. This study aimed to elucidate the relationship between lesion characteristics and patency after EVT using intravascular ultrasound (IVUS) measurement and to determine the predictors of restenosis on IVUS.

Methods and Results:This prospective observational study was performed at 18 Japanese centers. We evaluated the lesion characteristics before and after EVT for femoropopliteal lesion using IVUS. Angiographic or duplex ultrasound follow-up was performed at 1 year after EVT. A total of 263 lesions underwent EVT between December 2016 and December 2017. In total, 20 lesions (8 cases of isolated common femoral artery lesion and 12 cases of restenosis lesion) were excluded, and 243 lesions were enrolled in this study. A total of 181 lesions were treated with stent placement, and 62 lesions were treated only with balloon angioplasty. In the case of stent use, a larger distal plaque burden was associated with restenosis, while a lower calcification angle was associated with higher patency in the case of balloon angioplasty alone.

Conclusions:The factors related to patency differed depending on the treating modality. The findings suggest that IVUS is a useful tool for predicting patency because it can provide a more accurate evaluation after EVT for femoropopliteal lesions.

背景：股pop动脉介入后再狭窄的风险高于主动脉病变。然而，尚无合适的血管内疗法（EVT）用于预防股pop病变介入后的再狭窄。这项研究旨在通过血管内超声（IVUS）测量来阐明EVT后病变特征与通畅之间的关系，并确定IVUS再狭窄的预测因子。

方法和结果：这项前瞻性观察研究在日本的18个中心进行。我们使用IVUS评估了股静脉病变EVT前后的病变特征。EVT后1年进行血管造影或双工超声检查。在2016年12月至2017年12月之间，共有263个病变接受了EVT。总共排除了20个病变（8例孤立的股总动脉病变和12例再狭窄病变），并纳入243个病变。总共181个病变通过支架置入治疗，而62个病变仅通过球囊血管成形术治疗。在使用支架的情况下，仅在球囊血管成形术的情况下，远端斑块负担较大与再狭窄有关，而较低的钙化角与较高的通畅性有关。

结论：通畅的相关因素因治疗方式而异。研究结果表明，IVUS是预测通畅性的有用工具，因为它可以在EVT后对股lesions皮病变提供更准确的评估。