AI Article Synopsis

  • The study compares the subintimal approach (SA) and the intraluminal approach (IA) in endovascular therapy for chronic total occlusion lesions in the femoropopliteal region, focusing on safety and efficacy.
  • It analyzed data from 500 patients, finding that the 1-year rates of restenosis were similar between the SA and IA groups (41.0% vs. 43.4%).
  • The study concluded that both approaches yielded comparable results after one year, but the subintimal wire passage (SWP) group had a higher rate of perioperative complications compared to the intraluminal wire passage (IWP) group (8.2% vs. 4.1%).

Article Abstract

Background The subintimal approach (SA) is widely used in endovascular therapy for femoropopliteal chronic total occlusion lesions. However, when compared with the intraluminal approach (IA), the safety and efficacy of SA in real-world practice are not well characterized. Furthermore, there is a paucity of data on the clinical impact of subintimal and intraluminal wire passage (SWP and IWP, respectively) assessed by intravascular ultrasound. Methods and Results From the IVORY (Intravascular Ultrasound-Supported Endovascular Therapy in Superficial Femoral Artery) registry, this study included 500 patients undergoing endovascular therapy for femoropopliteal chronic total occlusion lesions (SA, n=67; IA, n=433; and SWP, n=186; IWP, n=314). The primary end point was the cumulative 1-year incidence of restenosis. The rate of perioperative complications was also assessed. Propensity score matching analysis was performed to adjust for the intergroup differences. After propensity score matching, the final study population consisted of 59 pairs (SA, n=59; IA, n=348) and 170 pairs (SWP, n=170; IWP, n=293), respectively. Cumulative 1-year incidence of restenosis was comparable between the SA and IA groups (41.0% versus 43.4%, =0.40). No significant difference in 1-year restenosis rate between the SWP and IWP groups was observed (48.2% versus 40.8%, =0.40), although the SWP group tended to be a higher rate of perioperative complications than the IWP group (8.2% versus 4.1%, =0.07). Conclusions At 1 year, both SA and IA showed acceptable results for femoropopliteal chronic total occlusion lesions. Cumulative 1-year incidence of restenosis was not significantly different between SWP and IWP, whereas perioperative complications occurred more frequently in SWP than in IWP. Registration URL: https://www.umin.ac.jp; Unique identifier: UMIN000020472.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8751881PMC
http://dx.doi.org/10.1161/JAHA.121.021903DOI Listing

Publication Analysis

Top Keywords

femoropopliteal chronic
16
chronic total
16
swp iwp
16
endovascular therapy
12
total occlusion
12
occlusion lesions
12
cumulative 1-year
12
1-year incidence
12
incidence restenosis
12
perioperative complications
12

Similar Publications

The broad spectrum of clinical manifestations caused by peripheral arterial disease [PAD] and the morphologic heterogeneity of associated atherosclerotic lesions present a considerable management challenge. Endovascular interventions are recognized an effective treatment for PAD. Within this revascularization strategy the role of atherectomy debulking modalities continue to evolve.

View Article and Find Full Text PDF

Background: The impact of below-the-knee (BK) runoff after drug-coated balloon (DCB) treatment in femoropopliteal (FP) lesions has not been well investigated.

Methods: This retrospective multicenter observational study enrolled 291 consecutive patients with lower extremity artery disease who underwent endovascular therapy with DCBs for FP lesions between January 2018 and December 2021. Patients were classified into four groups based on the BK runoff.

View Article and Find Full Text PDF

RotarexS rotational atherectomy combined with drug-coated balloon angioplasty for treating femoropopliteal artery in-stent restenosis.

J Cardiothorac Surg

December 2024

Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, No. 45, Changchun Street, Beijing, 100053, China.

Objective: This study aimed to analyze the safety and mid-term outcomes of a hybrid treatment method combining rotational atherectomy (RA) with drug-coated balloon (DCB) angioplasty in patients with femoropopliteal artery in-stent restenosis (ISR).

Methods: This single-center retrospective study enrolled patients from January 2018 to March 2022 who had femoropopliteal artery in-stent restenosis treated by RA and DCB. Preoperative demographics, operative details, and postoperative 12-month follow-up outcomes were analyzed statistically.

View Article and Find Full Text PDF
Article Synopsis
  • - Drug-eluting therapies, especially the Eluvia stent, have significantly reduced restenosis rates in treating peripheral artery disease, but concerns over aneurysm formation following their use are emerging.
  • - An 80-year-old man developed a giant aneurysm 27 months after receiving the Eluvia stent for a blocked artery, which was identified through ultrasound and treated with endovascular-covered stents.
  • - The presence of a 'low echoic area' near the stent is a common ultrasound finding after Eluvia implantation; while typically benign for two years, it can lead to serious complications like aneurysms due to factors such as overlapping stents and mechanical stress.
View Article and Find Full Text PDF

Chronic total occlusion (CTO) lesions of the femoropopliteal artery have been shown to benefit from drug-coated balloon (DCB) angioplasty. However, because bailout stenting is often performed, the outcome of DCB angioplasty alone remains unknown, particularly the differences in outcomes between low-dose DCB (LD-DCB) and high-dose DCB (HD-DCB). To address these issues, we conducted a single-center, retrospective cohort study and enrolled 66 consecutive patients undergoing initial endovascular therapy with DCBs for femoropopliteal CTO lesions from June 2018 to February 2023.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!