ABSTRACT
Objective:
To establish a comprehensive and effective scoring model based on
ultrasonic characteristics for predicting the restenosis
risk after superficial
femoral artery stenting, in order to assess the possibility of in-
stent restenosis and to provide guidance for the selection of
therapeutic strategies.
Methods:
A retrospective
review of a database of 328
patients (381
limbs) undergoing superficial
femoral artery stents in Xuanwu
Hospital,
Capital Medical
University from January 2016 to January 2018 was made as a modeling group.In the modeling cohort, the multivariate
logistic regression analysis was performed to screen independent
risk factors for in-
stent restenosis. A predictive scoring model of restenosis
risk was established with weighted score of independent
risk factors according to the odd ratio values. Based on the best cut-off value of the
receiver operating characteristic (ROC) curves, the scoring table was divided into low-
risk and high-
risk groups of restenosis.
Results:
Multivariate
logistic regression analysis showed that 8 factors were included in the score system to establish the scoring model of in-
stent restenosis
risk prediction including calcified plaque, peak systolic velocity of
popliteal artery<40 cm/s,
runoff scores≥4,
ankle-brachial index<0.5,
female (1 point each); complicated
stroke, complicated
chronic renal disease, total lesion length 15.0-24.9 cm (2 points each); total lesion length≥25.0 cm (3 points), a total of 12 points in the model. The validation indicated that the scoring system had good predictive value(
AUC=0.775, 95% CI=0.727-0.824, P<0.001) and goodness of fit (Hosmer-Lemeshow χ 2=4.921, P=0.766). The agreement with
digital subtraction angiography(DSA) was good (Kappa value=0.609). The scoring system was further divided into the low-
risk restenosis (0-5 points) and high-
risk restenosis (6-12 points) according to the best cut-off value of 5.5, with a
sensitivity of 68.1%, a
specificity of 74.6%, and the accuracy of 72.7%.
Conclusions:
The superficial
femoral artery in-
stent restenosis
risk predicting score model based on
ultrasonic characteristics may accurately predict the restenosis preoperatively. It provides a theoretical basis for the precise surgical plans.
