Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry
Background. There is limited “real-world” evidence examining treatment modalities and outcomes in patients with symptomatic peripheral arterial disease undergoing endovascular treatment of femoropopliteal (FP) in-stent restenosis (ISR). Materials and Methods. We compared outcomes in 2,895 patients f...
Saved in:
| Main Authors: | , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2022-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2022/5935039 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832558378682941440 |
|---|---|
| author | Michael H. Vu Glaiza-Mae Sande-Docor Yulun Liu Shirling Tsai Mitul Patel Chris Metzger Mehdi H. Shishehbor Emmanouil S. Brilakis Nicolas W. Shammas Peter Monteleone Subhash Banerjee |
| author_facet | Michael H. Vu Glaiza-Mae Sande-Docor Yulun Liu Shirling Tsai Mitul Patel Chris Metzger Mehdi H. Shishehbor Emmanouil S. Brilakis Nicolas W. Shammas Peter Monteleone Subhash Banerjee |
| author_sort | Michael H. Vu |
| collection | DOAJ |
| description | Background. There is limited “real-world” evidence examining treatment modalities and outcomes in patients with symptomatic peripheral arterial disease undergoing endovascular treatment of femoropopliteal (FP) in-stent restenosis (ISR). Materials and Methods. We compared outcomes in 2,895 patients from the XLPAD registry (NCT01904851) between 2006 and 2019 treated for FP ISR (n = 347) and non-ISR (n = 2,548) lesions. Primary endpoint included major adverse limb events (MALE) at 1 year, a composite of all-cause death, target limb repeat revascularization, or major amputation. Results. ISR patients were more frequently on antiplatelet (94.5% vs 89.4%, p=0.007) and statin (68.9% vs 60.3%, p=0.003) therapies. Lesion length was similar (ISR: 145 ± 99 mm vs. non-ISR: 142 ± 99 mm, p=0.55). Fewer treated ISR lesions were chronic total occlusions (47.3% vs. 53.7%, p=0.02) and severely calcified (22.4% vs. 44.7%, p<0.001). Atherectomy (63.5% vs. 45.0%, p<0.001) and drug-coated balloons (DCB; 4.7% vs. 1.7%, p<0.001) were more frequently used in ISR lesions. The distal embolization rate was higher in ISR lesions (2.4% vs. 0.9%, p=0.02). Repeat revascularization (21.5% vs. 16.7%, p=0.04; Figure) was higher and freedom from MALE at 1 year was significantly lower (87% vs. 92.5%, p<0.001) in the ISR group. Conclusion. Atherectomy and DCB are more frequently used to treat FP ISR lesions. Patients with FP ISR have more intraprocedural distal embolization, higher repeat revascularization procedures, and lower freedom from MALE at 1 year. |
| format | Article |
| id | doaj-art-3853f7dc3dc04316b30a863a93308d83 |
| institution | Kabale University |
| issn | 1540-8183 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-3853f7dc3dc04316b30a863a93308d832025-02-03T01:32:28ZengWileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/5935039Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD RegistryMichael H. Vu0Glaiza-Mae Sande-Docor1Yulun Liu2Shirling Tsai3Mitul Patel4Chris Metzger5Mehdi H. Shishehbor6Emmanouil S. Brilakis7Nicolas W. Shammas8Peter Monteleone9Subhash Banerjee10Methodist Health System of DallasUniversity of Texas Southwestern Medical CenterUniversity of Texas Southwestern Medical CenterUniversity of Texas Southwestern Medical CenterUniversity of California San Diego Sulpizio Cardiovascular CenterBallad Health/Holston Valley Medical CenterCase Western Reserve University and Harrington Heart and Vascular InstituteMinneapolis Heart InstituteUnityPoint Health-Trinity BettendorfAscension Seton Medical Center AustinUniversity of Texas Southwestern Medical CenterBackground. There is limited “real-world” evidence examining treatment modalities and outcomes in patients with symptomatic peripheral arterial disease undergoing endovascular treatment of femoropopliteal (FP) in-stent restenosis (ISR). Materials and Methods. We compared outcomes in 2,895 patients from the XLPAD registry (NCT01904851) between 2006 and 2019 treated for FP ISR (n = 347) and non-ISR (n = 2,548) lesions. Primary endpoint included major adverse limb events (MALE) at 1 year, a composite of all-cause death, target limb repeat revascularization, or major amputation. Results. ISR patients were more frequently on antiplatelet (94.5% vs 89.4%, p=0.007) and statin (68.9% vs 60.3%, p=0.003) therapies. Lesion length was similar (ISR: 145 ± 99 mm vs. non-ISR: 142 ± 99 mm, p=0.55). Fewer treated ISR lesions were chronic total occlusions (47.3% vs. 53.7%, p=0.02) and severely calcified (22.4% vs. 44.7%, p<0.001). Atherectomy (63.5% vs. 45.0%, p<0.001) and drug-coated balloons (DCB; 4.7% vs. 1.7%, p<0.001) were more frequently used in ISR lesions. The distal embolization rate was higher in ISR lesions (2.4% vs. 0.9%, p=0.02). Repeat revascularization (21.5% vs. 16.7%, p=0.04; Figure) was higher and freedom from MALE at 1 year was significantly lower (87% vs. 92.5%, p<0.001) in the ISR group. Conclusion. Atherectomy and DCB are more frequently used to treat FP ISR lesions. Patients with FP ISR have more intraprocedural distal embolization, higher repeat revascularization procedures, and lower freedom from MALE at 1 year.http://dx.doi.org/10.1155/2022/5935039 |
| spellingShingle | Michael H. Vu Glaiza-Mae Sande-Docor Yulun Liu Shirling Tsai Mitul Patel Chris Metzger Mehdi H. Shishehbor Emmanouil S. Brilakis Nicolas W. Shammas Peter Monteleone Subhash Banerjee Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry Journal of Interventional Cardiology |
| title | Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry |
| title_full | Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry |
| title_fullStr | Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry |
| title_full_unstemmed | Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry |
| title_short | Endovascular Treatment and Outcomes for Femoropopliteal In-Stent Restenosis: Insights from the XLPAD Registry |
| title_sort | endovascular treatment and outcomes for femoropopliteal in stent restenosis insights from the xlpad registry |
| url | http://dx.doi.org/10.1155/2022/5935039 |
| work_keys_str_mv | AT michaelhvu endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT glaizamaesandedocor endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT yulunliu endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT shirlingtsai endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT mitulpatel endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT chrismetzger endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT mehdihshishehbor endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT emmanouilsbrilakis endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT nicolaswshammas endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT petermonteleone endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry AT subhashbanerjee endovasculartreatmentandoutcomesforfemoropoplitealinstentrestenosisinsightsfromthexlpadregistry |