Smoking status ‘should not deter nor delay’ endovascular intervention in femoropopliteal vessels

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Smoking does not seem to affect reocclusion rates, interval to reintervention and the total number of interventions in peripheral arterial disease (PAD) patients with stents in the femoropopliteal segment, new research showed.

These were among the findings delivered by Sascha Wodoslawsky, BA, a medical student at Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia during the Eastern Vascular Society (EVS) annual meeting (Sept. 23–26) in Charleston, South Carolina.

Wodoslawsky and colleagues set out to assess the relationship between smoking status and various different variables, probing three groups: current smokers, former smokers and never smokers.

They were operating against a backdrop of two decades’ worth of published studies showing “completely polarizing views,” she said—from those indicating that smoking 10 or more cigarettes was beneficial in reducing the rate of restenosis, to a more conventional view around smoking increasing the risk of graft failure or increased restenosis rates.

The 10-year retrospective chart review looked at the records of 287 patients, 36.6% of whom were current smokers, 48.8% former smokers and 14.5% never smokers.

The researchers found no significant difference in the likelihood of reintervention for in-stent restenosis, total number of reinterventions and interval to stent reocclusion between the three smoking status categories. Furthermore, they detected no significant association between the number of pack-years smoked and the interval to stent reocclusion.

“So, although there are many benefits of smoking cessation, and of course we should actively work with our patients to encourage smoking cessation, patient smoking status should not deter nor delay endovascular intervention,” Wodoslawsky concluded.

Referring to similar findings established by a research team on which he was senior author, Alan Dietzik, MD, chief of vascular and endovascular surgery at Danbury Health Systems in Danbury, Connecticut, commented: “What we also found was that when you intervened on these patients, and improved their quality of life, they’re actually more likely to quit smoking.”

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