Long-term outcomes after percutaneous lower extremity arterial interventions with atherectomy vs. Balloon angioplasty ― Propensity score-matched registry ―

Adam Janas, Piotr P. Buszman, Krzysztof P. Milewski, Szymon Wiernek, Ksenia Janas, Maciej Pruski, Wojciech Wojakowski, Aleksandra Błachut, Wojciech Picheta, Pawel Buszman, Stefan Kiesz

Research output: Contribution to journalArticle

2 Scopus citations

Abstract

Background: The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization. Methods and Results: This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization. PTA was performed in 215 patients, and AT in 204 (Silver Hawk, EV3, n=125; CSI 360°, n=66; Pathway Medical Technologies, n=13). There were no significant between-group differences in baseline characteristics except for increased CAD, dialysis and CLI prevalence in the PTA group. Following propensity score analysis 131 well-matched pairs were included in analysis. Bail-out stenting was more frequent in the reference group (PTA, 6.1% vs. AT, 0%; P=0.004). At 6- and 12-month follow-up there were no differences in TLR between the groups (PTA, 8.3% vs. AT, 5.3%; P=0.47; and PTA, 16.7% vs. AT, 13.7%; P=0.73, respectively). The difference was in favor of AT at 24-month follow-up (PTA, 29.0% vs. AT, 16.7%; P=0.05). No difference was observed in amputation rate (PTA, 0.7% vs AT, 1.5%; P=0.62). On Kaplan-Meier analysis there were no significant differences between groups in time to TLR, amputation or death. Conclusions: AT was associated with lower risk of TLR, and this should be confirmed in randomized controlled trials.

Original languageEnglish (US)
Pages (from-to)376-382
Number of pages7
JournalCirculation Journal
Volume81
Issue number3
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • Atherectomy
  • Claudication
  • Critical limb ischemia
  • Percutaneous transluminal angioplasty
  • Peripheral artery disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Janas, A., Buszman, P. P., Milewski, K. P., Wiernek, S., Janas, K., Pruski, M., Wojakowski, W., Błachut, A., Picheta, W., Buszman, P., & Kiesz, S. (2017). Long-term outcomes after percutaneous lower extremity arterial interventions with atherectomy vs. Balloon angioplasty ― Propensity score-matched registry ―. Circulation Journal, 81(3), 376-382. https://doi.org/10.1253/circj.CJ-16-0856