Development and validation of a prognostic model for 4 years risk of Peripheral arterial disease restenosis following endovascular therapy

Abstract

Abstract Objectives: This study sought to investigate factors associated with restenosis after endovascular therapy (EVT) and established a novel nomogram integrating the Trans-Atlantic Inter-Society Consensus (TASC) II classification and clinicopathological characteristics to establish easy-to-use and efficient prognostic tool to predict the probability of risk of restenosis following EVT in subjects with PAD. Background: EVT’s common use, risk factors of restenosis have not been systematically studied. Arterial restenosis after EVT is a difficult problem to solve, requiring further attempts at revascularization with associated poorer clinical outcomes and increased cost. Methods: Between January 2018 and December 2021, we studied 240 limbs from 486 original patients who were diagnosed Peripheral arterial disease (PAD). Predictors for restenosis in patients with PAD were assessed using a Cox proportional hazards model. A nomogram was constructed by using variables defined in the all data, which was validated in predictive discriminative, accuracy and clinical application. Results: In the study, optimal independent factors included older age (hazard ratio [HR], 0.97; 95% CI: 0.94–1.00); poor BTK runoff (hazard ratio [HR], 2.41; 95% CI: 1.36–4.29); and TASC Ⅱ Class D in the femoropopliteal artery vs others classes (hazard ratio [HR], 2.59; 95% CI: 1.32–5.08), which were included in the nomogram predicting the vascular restenosis risk (all P < 0.05). The C-index values for restenosis risk in PAD with EVT were 0.732. Calibration curves indicated good consistency between predicted and actual outcomes. DCA confirmed the clinical utility of the diagnostic model. Conclusions: In conclusion, the current study constructed an easy-going nomogram that plays a convincing role in the evaluation of the risk of progression of the restenosis risk in PAD patients following EVT. Meanwhile, FIB and Cr also are interesting idea to study the predictors in restenosis. Anyway, further study with larger sample sizes and multiple centers are essential to verify our conclusions.