Mortality After Paclitaxel Coated Balloon Angioplasty and Stenting of Superficial Femoral and Popliteal Artery in the Vascular Quality Initiative.


Journal

Circulation. Cardiovascular interventions
ISSN: 1941-7632
Titre abrégé: Circ Cardiovasc Interv
Pays: United States
ID NLM: 101499602

Informations de publication

Date de publication:
02 2020
Historique:
entrez: 19 2 2020
pubmed: 19 2 2020
medline: 1 9 2020
Statut: ppublish

Résumé

To compare mortality after treatment of superficial femoral-popliteal artery disease with paclitaxel and nonpaclitaxel devices using a multicenter vascular registry. Patients (N=8376) undergoing endovascular treatment of superficial femoral-popliteal artery disease in the Society for Vascular Surgery Vascular Quality Initiative were studied from October 2016 to December 2017. One-year mortality was compared between 3 groups; plain balloon angioplasty (N=2104) versus paclitaxel-coated balloon angioplasty (N=3543), bare-metal stenting (N= 2045) versus paclitaxel-eluting stents (N=684), and combined paclitaxel versus nonpaclitaxel devices. Mortality rates with hazard ratios (HR) and 95% CI were compared in unadjusted and propensity-matched cohorts and illustrated by Kaplan-Meier analysis with subgroup analysis for intermittent claudication, chronic limb-threatening ischemia, and secondary interventions. In propensity-matched analyses, mortality was similar after plain balloon angioplasty (12.6%) and paclitaxel-coated balloon angioplasty (9.6%; HR=0.84 [95% CI, 0.66-1.06], At 1 year, mortality was similar if not lower after treatment of femoral-popliteal occlusive disease with paclitaxel versus nonpaclitaxel devices. This work highlights the potential use of the Society for Vascular Surgery Vascular Quality Initiative for surveillance of the safety of new peripheral arterial devices.

Sections du résumé

BACKGROUND
To compare mortality after treatment of superficial femoral-popliteal artery disease with paclitaxel and nonpaclitaxel devices using a multicenter vascular registry.
METHODS
Patients (N=8376) undergoing endovascular treatment of superficial femoral-popliteal artery disease in the Society for Vascular Surgery Vascular Quality Initiative were studied from October 2016 to December 2017. One-year mortality was compared between 3 groups; plain balloon angioplasty (N=2104) versus paclitaxel-coated balloon angioplasty (N=3543), bare-metal stenting (N= 2045) versus paclitaxel-eluting stents (N=684), and combined paclitaxel versus nonpaclitaxel devices. Mortality rates with hazard ratios (HR) and 95% CI were compared in unadjusted and propensity-matched cohorts and illustrated by Kaplan-Meier analysis with subgroup analysis for intermittent claudication, chronic limb-threatening ischemia, and secondary interventions.
RESULTS
In propensity-matched analyses, mortality was similar after plain balloon angioplasty (12.6%) and paclitaxel-coated balloon angioplasty (9.6%; HR=0.84 [95% CI, 0.66-1.06],
CONCLUSIONS
At 1 year, mortality was similar if not lower after treatment of femoral-popliteal occlusive disease with paclitaxel versus nonpaclitaxel devices. This work highlights the potential use of the Society for Vascular Surgery Vascular Quality Initiative for surveillance of the safety of new peripheral arterial devices.

Identifiants

pubmed: 32069110
doi: 10.1161/CIRCINTERVENTIONS.119.008528
doi:

Substances chimiques

Cardiovascular Agents 0
Coated Materials, Biocompatible 0
Paclitaxel P88XT4IS4D

Types de publication

Comparative Study Journal Article Multicenter Study Research Support, U.S. Gov't, Non-P.H.S.

Langues

eng

Sous-ensembles de citation

IM

Pagination

e008528

Subventions

Organisme : FDA HHS
ID : U01 FD005478
Pays : United States

Auteurs

Daniel J Bertges (DJ)

Division of Vascular Surgery, University of Vermont Medical Center, Burlington, VT (D.J.B.).

Art Sedrakyan (A)

Department of Health Care Policy and Research, Cornell Weill College of Medicine, New York, NY (A.S., T.S.).

Tianyi Sun (T)

Department of Health Care Policy and Research, Cornell Weill College of Medicine, New York, NY (A.S., T.S.).

Mohammad H Eslami (MH)

Division of Vascular Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA (M.H.E.).

Marc Schermerhorn (M)

Division of Vascular Surgery, Beth Israel Deaconess Medical Center, Boston, MA (M.S.).

Philip P Goodney (PP)

Section of Vascular Surgery and the Dartmouth Institute, Dartmouth-Hitchcock Medical Center, Lebanon, NH (P.P.G., J.L.C.).

Adam W Beck (AW)

Division of Vascular Surgery, University of Alabama at Birmingham (A.W.B.).

Jack L Cronenwett (JL)

Section of Vascular Surgery and the Dartmouth Institute, Dartmouth-Hitchcock Medical Center, Lebanon, NH (P.P.G., J.L.C.).

Jens Eldrup-Jorgensen (J)

Division of Vascular Surgery, Maine Medical Center, Division of Vascular Surgery, Portland, ME (J.E.-J.).

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Classifications MeSH