Author + information
- Micah Steinbrecher1,
- Bo Sun2,
- Ehrin Armstrong3,
- Haekyung Jeon-Slaughter1,
- Nicolas W. Shammas4,
- Khusrow Niazi5,
- Scott Kinlay6,
- Mazen Abu-Fadel7,
- Anand Prasad8,
- Houman Khalili9,
- Mujtaba Ali1,
- Bala Ramanan9 and
- Emmanouil Brilakis10
- 1University of Texas Southwestern Medical Center, Dallas, Texas, United States
- 2VA North Texas Health Care System, Dallas, Texas, United States
- 3University of Colorado, Denver, Colorado, United States
- 4Midwest Cardiovascular Research Foundation, Davenport, Iowa, United States
- 5Emory University, Atlanta, Georgia, United States
- 6VA Boston Healthcare System; Brigham and Women's Hospital, Boston, Massachusetts, United States
- 7University of Oklahoma HSC, Oklahoma City, Oklahoma, United States
- 8UT Health San Antonio, San Antonio, Texas, United States
- 9University of Texas Southwestern Medical Center; VA North Texas Health Care System, Dallas, Texas, United States
- 10Minneapolis Heart Institute, UT Southwestern Medical Center/VA North Texas Health Care System, Minneapolis, Minnesota, United States
A wide variety of treatment options exist for endovascular treatment of femoropopliteal (FP) peripheral artery disease. Herein, we compare primary sustained clinical improvement defined as freedom from death, target limb amputation and target vessel revascularization (TVR; endovascular or surgical) between stent and non-stent strategies of FP revascularization.
These data are from the multicenter Excellence in PAD (XLPAD; NCT01904851) registry collected between 2005-2016 and include consecutive cases with core laboratory adjudication and 12-month follow-up.
2,447 FP interventions were performed on 1,728 patients with mean age 66±10 years, 22% women, 52% diabetics and 70% with Rutherford class I-III symptoms. Mean ankle brachial index was 0.73±0.20. Mean lesion length was 129.00±94.61 mm and 52% chronic total occlusions. Combination of treatment modalities involving, atherectomy, drug-coated balloon and stenting was employed in 72% cases. Stenting was more prevalent until 2014, surpassed by the non-stent approach in subsequent years (Figure 1a). Overall in the study cohort, 1-year mortality was 3%, amputation 3% and TVR 17%. Kaplan-Meier plot comparing primary sustained clinical improvement between the stent and non-stent groups demonstrate similar outcomes at 1 year (Figure 1b).
Although a stent-based approach to endovascular FP revascularization remains prevalent, it has more recently become less frequent, with no difference in 1-year primary sustained clinical improvement compared with a non-stent approach.
ENDOVASCULAR: Peripheral Vascular Disease and Intervention