Periferik Arter Hastalarında Femoropopliteal Endovasküler Girişim Başarısını Belirleyen Faktörlerin Değerlendirilmesi

Abstract

Technical success in femoropopliteal endovascular interventions may be associated with preprocedurally assessable factors, including lesion length, calcification severity, anatomical extent and the distal vascular flow. This study aimed to evaluate clinical, laboratory, and anatomical variables associated with technical success in patients undergoing femoropopliteal endovascular interventions for peripheral artery disease and develop a preprocedural scoring system predicting technical failure risk. This single-center retrospective study included 146 patients. Technical success was achieved in 90 patients (61.6%), while technical failure occurred in 56 (38.4%). Components of technical failure included guidewire crossing failure, residual stenosis greater than 30%, dissection, thrombosis, perforation and poor distal flow. Multivariable analysis identified stenosis length, high mPACSS scores and combined popliteal and trifurcation involvement as independently associated with technical failure. Accordingly, a femoropopliteal intervention risk evaluation score ranging from 0 to 6 points and incorporating stenosis length, mPACSS, anatomical extent and distal extension was developed. The optimal cutoff value for this score was determined to be 3 points or higher, yielding a sensitivity of 66.1%, specificity of 86.7%, positive predictive value of 75.5%, negative predictive value of 80.4% and overall classification accuracy of 78.8%. AUC was 0.814 (95% CI: 0.739–0.890). Technical failure rates were 18.1%, 34.9% and 90.3% in low-risk (0–1 points), intermediate-risk (2–3 points) and high-risk (4–6 points) groups, respectively. These findings suggest that the pilot scoring system based on anatomical assessment may contribute to preprocedural prediction and stratification of technical failure risk.