Lipoproteins and the development of restenosis after stent implantation in the superficial femoral artery in patients with peripheral artery disease.

Purpose: High levels of apolipoprotein B (apo B) are a risk factor for the development of major vascular events. We evaluated the association between plasma lipoproteins and the development of superficial femoral artery (SFA) in-stent restenosis and reocclusion in patients with peripheral artery disease.

Materials And Methods: We included 139 patients with SFA stenting. Plasma lipoproteins were measured after stent implantation. Stent restenosis was assessed with duplex scan after 3, 6, and 12 months. A stenosis grade was considered relevant if >50%.

Results: Seventy-two patients experienced recurrence of their atherosclerotic disease, meaning restenosis of >50% within 1 year of follow-up. Ten of these patients had a stent occlusion. In the patients who experienced recurrence, the mean apo B level was 105.8 versus 94.9 mg/dl in patients without recurrence (P < 0.05). Patients without recurrence had higher high-density lipoprotein cholesterol levels than patients with recurrence (39.7 vs. 34.7 mg/dl, P < 0.05). Comparing patients with a stent occlusion (n = 10) and those with a restenosis of 75-99% (n = 28), the patients with a stent occlusion had higher levels of plasma cholesterol (234.1 vs. 185.9 mg/dl, P < 0.05), apo B (135.3 vs. 99.8 mg/dl, P < 0.05), low-density lipoprotein cholesterol (160.3 vs. 113.6 mg/dl, P < 0.05), and low-density lipoprotein apo B (115.5 vs. 82.4 mg/dl, P < 0.001) than the patients with restenosis of 75-99% (n = 28).

Conclusion: Changes in the lipid profile could be one reason for the development of restenosis and for the development of reocclusion after SFA stenting.