Restenosis after Femoropopliteal PTA and Elective Stent Implantation: Predictive Value of Monocyte Counts

Abstract

Purpose:

To investigate the association of baseline peripheral blood monocyte counts and restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA) and PTA plus elective stent implantation.

Methods:

Three hundred thirty consecutive patients (170 men; median age 71 years, interquartile range 61–78) with peripheral artery disease underwent femoropopliteal PTA (n=258) or PTA plus elective stent implantation (n=72). Multivariate Cox regression analysis was used to determine the predictive value of baseline peripheral blood monocyte counts on the rate of restenosis (≥50% luminal reduction) in follow-up.

Results:

Cumulative patency at 6 and 12 months was 55% and 39% after PTA and 70% and 41% after elective stenting, respectively (p=0.19). Pretreatment monocyte counts (in tertiles) were associated with restenosis after PTA (p=0.002) and stent implantation (p=0.02). Compared to patients with monocyte counts <0.3×10⁹/L (lower tertile, n=128), patients with monocytes from 0.3 to 0.4×10⁹/L (middle tertile, n=91) had a 1.8-fold increased adjusted risk for restenosis (95% CI 1.1 to 2.8, p=0.01). Patients with monocytes >0.4×10⁹/L (upper tertile, n=87) had a 2.3-fold increased adjusted risk (95% CI 1.4 to 3.5, p<0.0001).

Conclusions:

Baseline monocyte counts were associated with restenosis after femoropopliteal PTA and elective stent implantation, suggesting that circulating monocytes play a pivotal role in the development of recurrent lumen narrowing.