Stent and non-stent based outcomes of infrainguinal peripheral artery interventions from the multicenter XLPAD registry

Subhash Banerjee, Gene Pershwitz, Karan Sarode, Atif Mohammad, Mazen S. Abu-Fadel, Mirza S. Baig, Shirling Tsai, Bertis B. Little, Osvaldo S. Gigliotti, Ediberto Soto-Cora, Mazin I. Foteh, Gerardo Rodriguez, Andrew Klein, Tayo Addo, Michael Luna, Nicolas W. Shammas, Anand Prasad, Emmanouil S. Brilakis

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background. There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD). Methods. We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice. Results. A total of 584 interventions (SFA, 82.5%; popliteal, 7.2%; BTK, 9.9%) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7%; Rutherford category 1-3, 73.5%; Rutherford category 4-6, 20.1%). Stents were deployed in 389 lesions (66.6%; SFA, 90.5%; popliteal, 5.1%; BTK, 4.1%) and non-stent strategy (atherectomy, 49%) in 195 lesions (33.4%; SFA, 66.7%; popliteal, 11.3%; BTK, 21.5%). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P<.001), chronic total occlusions (CTOs) constituted 63.0% and 49.7% (P<.01), and restenotic lesions were 12.6% and 32.3% (P<.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3% and 3.5% (P=.65), clinically indicated repeat revascularization was 17.5% and 14.9% (P=.42), and amputation was 4.6% and 9.2% (P<.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy. Conclusion. The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and occur in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.

Original languageEnglish (US)
Pages (from-to)14-18
Number of pages5
JournalJournal of Invasive Cardiology
Volume27
Issue number1
StatePublished - Jan 1 2015

Fingerprint

Femoral Artery
Stents
Registries
Arteries
Knee
Atherectomy
Amputation
Diabetes Mellitus
Balloon Angioplasty
Peripheral Arterial Disease
Therapeutics
Mortality

Keywords

  • Outcomes
  • Peripheral vascular disease
  • Plain old balloon angioplasty
  • Stenting
  • Superficial femoral artery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Stent and non-stent based outcomes of infrainguinal peripheral artery interventions from the multicenter XLPAD registry. / Banerjee, Subhash; Pershwitz, Gene; Sarode, Karan; Mohammad, Atif; Abu-Fadel, Mazen S.; Baig, Mirza S.; Tsai, Shirling; Little, Bertis B.; Gigliotti, Osvaldo S.; Soto-Cora, Ediberto; Foteh, Mazin I.; Rodriguez, Gerardo; Klein, Andrew; Addo, Tayo; Luna, Michael; Shammas, Nicolas W.; Prasad, Anand; Brilakis, Emmanouil S.

In: Journal of Invasive Cardiology, Vol. 27, No. 1, 01.01.2015, p. 14-18.

Research output: Contribution to journalArticle

Banerjee, S, Pershwitz, G, Sarode, K, Mohammad, A, Abu-Fadel, MS, Baig, MS, Tsai, S, Little, BB, Gigliotti, OS, Soto-Cora, E, Foteh, MI, Rodriguez, G, Klein, A, Addo, T, Luna, M, Shammas, NW, Prasad, A & Brilakis, ES 2015, 'Stent and non-stent based outcomes of infrainguinal peripheral artery interventions from the multicenter XLPAD registry', Journal of Invasive Cardiology, vol. 27, no. 1, pp. 14-18.
Banerjee, Subhash ; Pershwitz, Gene ; Sarode, Karan ; Mohammad, Atif ; Abu-Fadel, Mazen S. ; Baig, Mirza S. ; Tsai, Shirling ; Little, Bertis B. ; Gigliotti, Osvaldo S. ; Soto-Cora, Ediberto ; Foteh, Mazin I. ; Rodriguez, Gerardo ; Klein, Andrew ; Addo, Tayo ; Luna, Michael ; Shammas, Nicolas W. ; Prasad, Anand ; Brilakis, Emmanouil S. / Stent and non-stent based outcomes of infrainguinal peripheral artery interventions from the multicenter XLPAD registry. In: Journal of Invasive Cardiology. 2015 ; Vol. 27, No. 1. pp. 14-18.
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abstract = "Background. There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD). Methods. We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice. Results. A total of 584 interventions (SFA, 82.5{\%}; popliteal, 7.2{\%}; BTK, 9.9{\%}) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7{\%}; Rutherford category 1-3, 73.5{\%}; Rutherford category 4-6, 20.1{\%}). Stents were deployed in 389 lesions (66.6{\%}; SFA, 90.5{\%}; popliteal, 5.1{\%}; BTK, 4.1{\%}) and non-stent strategy (atherectomy, 49{\%}) in 195 lesions (33.4{\%}; SFA, 66.7{\%}; popliteal, 11.3{\%}; BTK, 21.5{\%}). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P<.001), chronic total occlusions (CTOs) constituted 63.0{\%} and 49.7{\%} (P<.01), and restenotic lesions were 12.6{\%} and 32.3{\%} (P<.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3{\%} and 3.5{\%} (P=.65), clinically indicated repeat revascularization was 17.5{\%} and 14.9{\%} (P=.42), and amputation was 4.6{\%} and 9.2{\%} (P<.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy. Conclusion. The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and occur in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.",
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author = "Subhash Banerjee and Gene Pershwitz and Karan Sarode and Atif Mohammad and Abu-Fadel, {Mazen S.} and Baig, {Mirza S.} and Shirling Tsai and Little, {Bertis B.} and Gigliotti, {Osvaldo S.} and Ediberto Soto-Cora and Foteh, {Mazin I.} and Gerardo Rodriguez and Andrew Klein and Tayo Addo and Michael Luna and Shammas, {Nicolas W.} and Anand Prasad and Brilakis, {Emmanouil S.}",
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T1 - Stent and non-stent based outcomes of infrainguinal peripheral artery interventions from the multicenter XLPAD registry

AU - Banerjee, Subhash

AU - Pershwitz, Gene

AU - Sarode, Karan

AU - Mohammad, Atif

AU - Abu-Fadel, Mazen S.

AU - Baig, Mirza S.

AU - Tsai, Shirling

AU - Little, Bertis B.

AU - Gigliotti, Osvaldo S.

AU - Soto-Cora, Ediberto

AU - Foteh, Mazin I.

AU - Rodriguez, Gerardo

AU - Klein, Andrew

AU - Addo, Tayo

AU - Luna, Michael

AU - Shammas, Nicolas W.

AU - Prasad, Anand

AU - Brilakis, Emmanouil S.

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background. There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD). Methods. We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice. Results. A total of 584 interventions (SFA, 82.5%; popliteal, 7.2%; BTK, 9.9%) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7%; Rutherford category 1-3, 73.5%; Rutherford category 4-6, 20.1%). Stents were deployed in 389 lesions (66.6%; SFA, 90.5%; popliteal, 5.1%; BTK, 4.1%) and non-stent strategy (atherectomy, 49%) in 195 lesions (33.4%; SFA, 66.7%; popliteal, 11.3%; BTK, 21.5%). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P<.001), chronic total occlusions (CTOs) constituted 63.0% and 49.7% (P<.01), and restenotic lesions were 12.6% and 32.3% (P<.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3% and 3.5% (P=.65), clinically indicated repeat revascularization was 17.5% and 14.9% (P=.42), and amputation was 4.6% and 9.2% (P<.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy. Conclusion. The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and occur in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.

AB - Background. There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD). Methods. We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice. Results. A total of 584 interventions (SFA, 82.5%; popliteal, 7.2%; BTK, 9.9%) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7%; Rutherford category 1-3, 73.5%; Rutherford category 4-6, 20.1%). Stents were deployed in 389 lesions (66.6%; SFA, 90.5%; popliteal, 5.1%; BTK, 4.1%) and non-stent strategy (atherectomy, 49%) in 195 lesions (33.4%; SFA, 66.7%; popliteal, 11.3%; BTK, 21.5%). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P<.001), chronic total occlusions (CTOs) constituted 63.0% and 49.7% (P<.01), and restenotic lesions were 12.6% and 32.3% (P<.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3% and 3.5% (P=.65), clinically indicated repeat revascularization was 17.5% and 14.9% (P=.42), and amputation was 4.6% and 9.2% (P<.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy. Conclusion. The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and occur in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.

KW - Outcomes

KW - Peripheral vascular disease

KW - Plain old balloon angioplasty

KW - Stenting

KW - Superficial femoral artery

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