We evaluated outcomes of nitinol stent implantation for femoropopliteal lesions to determine risk factors of restenosis. Between 2006 and 2009, 54 patients with femoropopliteal occlusive disease underwent primary implantation of SMART Control. Initial success was achieved in all patients. Cumulative primary patency rates at 1 and 3 years were 84% and 69%, and secondary patency rates were 98% and 95%, respectively. In midterm, primary patency rates of nitinol stents were superior to those of stainless steel stents. Restenosis following nitinol stent implantation was associated with dyslipidemia, smaller reference diameter, and longer lesion length. For more excellent prognosis of patients with femoropopliteal diseases, management of comorbidities, cutting balloon angioplasty in small-diameter lesions, and conventional bypass in longer lesions should be considered. Strict surveillance including duplex ultrasonography of the patients with risk factors might optimize secondary patency through early detection and timely reintervention for restenosis.
A 33-year-old male complained of chest discomfort on exertion. Coronary CT angiogram (CTA) revealed aneurysmal right coronary artery (RCA) fistula (25 mm in diameter) to left ventricle. Reconstruction of RCA with RA/SVG composite graft under Cardiopulmonary bypass (CPB) support was successful. A 78 year-old female was referred to our hospital for assessment of heart murmur and cardiomegaly. Coronary CTA showed a giant RCA fistula (10 mm in diameter) to coronary sinus. One year later, she had dyspnea on exertion. Ligation of the drainage site was performed successfully under CPB support.