Author + information
- Houman Khalilia,b,
- Haekyung Jeon-Slaughtera,b,
- Amutharani Baskara,b,
- Ehrin Armstronga,b,
- Nicolas Shammasa,b,
- Andrew Shammasa,b,
- Anand Prasada,b,
- Ian Cawicha,b,
- Gerardo Rodrigueza,b,
- Mazen Abu-Fadela,b,
- Emmanouil Brilakisa,b and
- Subhash Banerjeea,b
Background: There is scarce data to support use of atherectomy devices over other forms of lower extremity peripheral vascular interventions (PVI).
Methods: Data from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) were analyzed to examine predictors of atherectomy use and 12-month patency rates after balloon angioplasty vs. atherectomy + balloon angioplasty. We analyzed 2,353 PVI procedure data from 1,907 patients between January 2005 and October 2015.
Results: Atherectomy was used in 41.5% of PVIs. Chronic total occlusion (32% vs. 51%; p<0.0001) and heavy calcification (37% vs. 46%; p<0.0001) were not associated with use of atherectomy. There was no association between baseline comorbidities, in-stent restenosis, number of below-the-knee (BTK) vessel run-off, vessel diameter, location, or lesion length and atherectomy use in PVI. The use of atherectomy in the femoropopliteal (FP) region was not associated with a change in repeat intervention at 12 months (Figure 1A). There was a significant decrease in repeat intervention rate within 12 months with atherectomy use in the BTK interventions (Hazard Ratio 0.43, 95% Confidence Interval 0.23-0.81; p=0.01; Figure 1B).
Conclusions: Atherectomy use in the BTK interventions is associated with improved 12-month patency outcomes. There was no association between atherectomy use and patency for FP lesions. A future study of the cost effectiveness of atherectomy for PVI is warranted.
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: 1112-117
- 2017 American College of Cardiology Foundation