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Introduction: Endovascular treatment for peripheral vascular disease (PAD) includes the use of balloon angioplasty and provisional stent implantation for stabilization of the vessel wall and prevention of re-occlusion. Novel stents made of bioresobable vascular scaffold (BVS) are currently approved for coronary use. We investigated BVS use for the treatment of symptomatic PAD.
Methods: We performed a systematic search through Pub Med and Chochrane database using all clinical data that reported outcomes of BVS use for the treatment of femoropopliteal disease and infra-popliteal disease. Primary endpoints included target lesion revascularization (TLR), target vessel revascularization (TVR), primary and secondary patency. Secondary outcomes included binary restenosis, scaffold thrombosis, amputation and mortality.
Results: A total of 6 studies were included in the analysis a provided 233 patients (142 in the femoropopliteal group and 91 in the infra-popliteal group). Mean follow up in the femoropopliteal group was 12 months. Remedy, Spirit BVS and Igaki –Tamal were the BVS used. Primary patency rate was 51%, secondary patency was 86 %, TLR was 31% and TVR 25%. There was 34% of binary restenosis, 2 % of both amputation and mortality and 6% of scaffold thrombosis.
The mean follow up in the infra-popliteal group was 4 months. Biotronic and Absorb were the BVS used. Primary patency was 87%, secondary 100%, TLR 14% of and TVR 23%. Binary restenosis was 5%, amputation and mortality was 1% each. Scaffold thrombosis was 8%.
Conclusions: Our study suggests that BVS might be safe and efficacious for the endovascular treatment of symptomatic PAD. Scaffold thrombosis rate were very low. An in-depth analysis including RCT's is necessary to determine the clinical application of this modality compared to the current standard therapy.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-129
- 2017 American College of Cardiology Foundation