TY - JOUR
T1 - Clinical outcomes of patients with and without chronic kidney disease undergoing endovascular revascularization of infrainguinal peripheral artery disease
T2 - Insights from the XLPAD registry
AU - Kabir, Ryan
AU - Vuppala, Suchith
AU - Liu, Yulun
AU - Tejani, Ishita
AU - Weideman, Rick
AU - Banerjee, Avantika
AU - Tsai, Shirling
AU - Huffman, Lynn
AU - Niazi, Khusrow
AU - Brilakis, Emmanouil S.
AU - Shishehbor, Mehdi H.
AU - Banerjee, Subhash
N1 - Publisher Copyright:
© 2021 Wiley Periodicals LLC.
PY - 2021/8/1
Y1 - 2021/8/1
N2 - Objectives: The purpose of the present study was to define clinical outcomes of chronic kidney disease (CKD) patients undergoing endovascular revascularization of infrainguinal peripheral artery disease (PAD). Background: CKD is an established predictor of advanced PAD. However, clinical outcomes for these patients following endovascular revascularization remain inadequately defined. Methods: Using the ongoing multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851), we analyzed all-cause death, target limb amputation, and need for repeat revascularization for patients with and without CKD undergoing infrainguinal endovascular revascularization between the years 2005 and 2018. Results: Of 3,699 patients, 15.1% (n = 559) had baseline CKD. CKD patients had significantly higher incidence of heavily calcified lesions (48.4% vs. 38.1%, p <.001) and diffuse disease (66.9% vs. 61.5%, p =.007). Kaplan–Meier analysis showed significant differences between CKD and non-CKD patient outcomes at 12 months for freedom from target limb amputation (79.9% vs. 92.7%, p <.001) and all-cause death (90.1% vs. 97.6%, p <.001). However, freedom from target vessel revascularization was similar between the groups. After adjusting for baseline comorbidities in the CKD and non-CKD groups, the hazard ratios for target limb amputation and death at 12 months were 2.28 (95% confidence interval or CI 1.25–4.17, p <.001) and 4.38 (95% CI 2.58–7.45, p <.001), respectively. Conclusions: Following endovascular revascularization for infrainguinal PAD, CKD was an independent predictor of all-cause death and target limb amputation at 12 months.
AB - Objectives: The purpose of the present study was to define clinical outcomes of chronic kidney disease (CKD) patients undergoing endovascular revascularization of infrainguinal peripheral artery disease (PAD). Background: CKD is an established predictor of advanced PAD. However, clinical outcomes for these patients following endovascular revascularization remain inadequately defined. Methods: Using the ongoing multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851), we analyzed all-cause death, target limb amputation, and need for repeat revascularization for patients with and without CKD undergoing infrainguinal endovascular revascularization between the years 2005 and 2018. Results: Of 3,699 patients, 15.1% (n = 559) had baseline CKD. CKD patients had significantly higher incidence of heavily calcified lesions (48.4% vs. 38.1%, p <.001) and diffuse disease (66.9% vs. 61.5%, p =.007). Kaplan–Meier analysis showed significant differences between CKD and non-CKD patient outcomes at 12 months for freedom from target limb amputation (79.9% vs. 92.7%, p <.001) and all-cause death (90.1% vs. 97.6%, p <.001). However, freedom from target vessel revascularization was similar between the groups. After adjusting for baseline comorbidities in the CKD and non-CKD groups, the hazard ratios for target limb amputation and death at 12 months were 2.28 (95% confidence interval or CI 1.25–4.17, p <.001) and 4.38 (95% CI 2.58–7.45, p <.001), respectively. Conclusions: Following endovascular revascularization for infrainguinal PAD, CKD was an independent predictor of all-cause death and target limb amputation at 12 months.
KW - amputation
KW - chronic kidney disease
KW - critical limb ischemia
KW - endovascular treatment/therapy
KW - infrainguinal arteries
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U2 - 10.1002/ccd.29491
DO - 10.1002/ccd.29491
M3 - Article
C2 - 33527684
AN - SCOPUS:85100133550
SN - 1522-1946
VL - 98
SP - 310
EP - 316
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 2
ER -