TY - JOUR
T1 - Comparative assessment of patient outcomes with intraluminal or subintimal crossing of infrainguinal peripheral artery chronic total occlusions
AU - Kondapalli, Ananya
AU - Jeon-Slaughter, Haekyung
AU - Lu, Hua
AU - Xu, Hao
AU - Khalili, Houman
AU - Prasad, Anand
AU - Armstrong, Ehrin J.
AU - Brilakis, Emmanouil S.
AU - Banerjee, Subhash
N1 - Publisher Copyright:
© 2017, © The Author(s) 2017.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications. A subintimal crossing technique was necessary in 388 lesions (27% overall in 1335 lesions; 34% (n=351) in 1023 femoropopliteal lesions, and 12% (n=37) in 312 infrapopliteal lesions, p<0.01) with a lower procedural (p<0.01) and technical (p<0.01) success than the intraluminal in both femoropopliteal and infrapopliteal interventions. There were no significant differences in procedural complications, major adverse cardiac events, or clinically driven target limb revascularization at 1 year between the two groups, except a higher residual dissection rate in the subintimal crossing group than the intraluminal group in femoropopliteal target vessels (p = 0.04).
AB - This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications. A subintimal crossing technique was necessary in 388 lesions (27% overall in 1335 lesions; 34% (n=351) in 1023 femoropopliteal lesions, and 12% (n=37) in 312 infrapopliteal lesions, p<0.01) with a lower procedural (p<0.01) and technical (p<0.01) success than the intraluminal in both femoropopliteal and infrapopliteal interventions. There were no significant differences in procedural complications, major adverse cardiac events, or clinically driven target limb revascularization at 1 year between the two groups, except a higher residual dissection rate in the subintimal crossing group than the intraluminal group in femoropopliteal target vessels (p = 0.04).
KW - chronic total occlusions
KW - endovascular intervention
KW - one-year outcomes
KW - peripheral artery disease (PAD)
KW - subintimal crossing technique
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U2 - 10.1177/1358863X17735192
DO - 10.1177/1358863X17735192
M3 - Article
C2 - 29105577
AN - SCOPUS:85042877482
SN - 1358-863X
VL - 23
SP - 39
EP - 45
JO - Vascular Medicine (United Kingdom)
JF - Vascular Medicine (United Kingdom)
IS - 1
ER -