{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T22:37:17Z","timestamp":1790289437682,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Research Association for Lower Limb Artery Revascularization"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>The guidelines recommend excimer laser atherectomy (ELA) for in-stent restenosis (ISR) lesions in femoropopliteal arteries. However, its efficacy is still unknown in ISR related to scaffolds other than bare-metal stent (BMS). This study aimed to evaluate the 1-year clinical outcomes in patients with femoropopliteal ISR lesions treated with endovascular therapy (EVT) using ELA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>This retrospective multicenter registry analyzed patients who presented with peripheral artery disease caused by femoropopliteal ISR lesions undergoing EVT with ELA between 2020 and 2024. The primary outcome was re-restenosis 1-year following EVT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, consecutive 166 patients with femoropopliteal ISR lesions were enrolled. The rates of in-stent occlusion and ISR related to scaffolds other than BMS were found in 88.6% and 52.4% of the lesions, respectively. Technical success was achieved in 83.7%. The 1-year Kaplan\u2013Meier estimate of freedom from re-restenosis was 67.6% (95% confidence interval [CI] 60.0-75.5). The primary-assisted patency and secondary patency rate was 72.7% (95% CI 65.8-80.3) and 81.5% (95% CI 76.6-88.0), respectively. In the multivariate analysis, slow flow observed in the completion angiography of EVT (adjusted hazard ratio, 2.32;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.024) and chronic renal failure requiring dialysis (1.72;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.036) were independently associated with re-restenosis risk. The accumulation of these factors was associated with a lower rate of freedom from re-restenosis; Kaplan\u2013Meier estimates of the rates were 46.6% in subgroups with 1 or 2 risk factors, whereas it was 77.8% in the absence of risk factors. The Kaplan\u2013Meier estimate shows a comparable primary patency rate between ISR related to BMS and drug-eluting stent at 1\u2009year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ELA provided acceptable technical success in current femoropopliteal ISR lesions; however, the long-term result was clinically suboptimal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This retrospective multicenter registry enrolled 166 patients with in-stent restenosis\/in-stent occlusion lesions in femoropopliteal arteries treated with endovascular therapy using excimer laser atherectomy. The technical success rate was acceptable at 83.7%; however, 1-year estimate of freedom from restenosis was clinically suboptimal at 67.6%. The multivariate analysis showed incomplete antegrade blood flow and dialysis-dependent chronic renal failure were independently associated with re-restenosis risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251363466","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T10:26:26Z","timestamp":1755685586000},"page":"2600-2608","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["The Endovascular Therapy Using Excimer Laser Atherectomy for Complex Femoropopliteal In-Stent Restenosis Lesions"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8614-7729","authenticated-orcid":false,"given":"Kazunori","family":"Horie","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsuyoshi","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Osaka University Graduate School of Medicine, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shin","family":"Takiuchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Higashi Takarazuka Satoh Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9178-5514","authenticated-orcid":false,"given":"Shin","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3619-3794","authenticated-orcid":false,"given":"Naoki","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Ogaki Municipal Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhito","family":"Kaneko","sequence":"additional","affiliation":[{"name":"Limb Salvage Center, Kasukabe Chuo General Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ogata","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Miyazaki Medical Association Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5860-3021","authenticated-orcid":false,"given":"Yoshiaki","family":"Shintani","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Ageo Central General Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Haraguchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniyasu","family":"Ikeoka","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, NHO Osaka National Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kyoto-Katsura Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Tokyo Saiseikai Central Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kuniyoshi","family":"Fukai","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Omihachiman Community Medical Center, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Shima","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kurashiki Central Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Iiya","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hiratsuka Kyosai Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Tada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Sendai Kousei Hospital, Miyagi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6829-7304","authenticated-orcid":false,"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Osaka Keisatsu Hospital, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2024.02.013"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.27635"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2023.03.032"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-017-1771-5"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.01.019"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/1358863X241228261"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.09.036"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2024.10.023"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.09.009"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1583\/13-4308MR.1"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.28636"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2021.01.004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2016.03.432"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-16-00735"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.04.012"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2021.07.056"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-020-02717-w"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12872-020-01805-6"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/1526602819836095"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.5551\/jat.64007"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/toxins10060218"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.3390\/toxins9040114"}],"container-title":["Journal of Endovascular Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028251363466","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/15266028251363466","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/15266028251363466","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T10:14:08Z","timestamp":1789553648000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/15266028251363466"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/15266028251363466"],"URL":"https:\/\/doi.org\/10.1177\/15266028251363466","relation":{},"ISSN":["1526-6028","1545-1550"],"issn-type":[{"value":"1526-6028","type":"print"},{"value":"1545-1550","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}