Different endovascular modalities of treatment for isolated atherosclerotic popliteal artery lesions (EMO-POP) registry
Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved..
BACKGROUND: The mid-term results after treatment of isolated popliteal lesions have been limited. The aim of the present study was to report the mid-term outcomes after endovascular treatment of isolated atherosclerotic popliteal artery lesions.
METHODS: A multicenter (15 hospitals in five countries) retrospective cohort study was performed. Between June 2016 and June 2021, 651 consecutive patients who had been treated for isolated popliteal lesions using endovascular methods exclusively were included in the present study. Six techniques were identified, including plain balloon angioplasty (PTA; n = 286; 43.9%), drug-coated balloon angioplasty (n = 98; 15.1%), stenting with low-chronic outward force (COF) stents (n = 84; 12.9%), stenting with high-COF stents (n = 76; 11.7%), atherectomy alone (n = 17; 2.6%), and directional atherectomy with drug-coated balloons (n = 90; 13.8%). The primary outcomes measures were primary and secondary patency and freedom from clinically driven target lesion revascularization (F-CDTLR).
RESULTS: The mean patient age was 74.5 years. Most of the patients (n = 409; 62.9%) had had chronic limb-threatening ischemia. Popliteal occlusion was found in 400 cases (61.4%). High-grade calcification was present in 36.7% of cases. Immediate technical success was 94.8%. The median follow-up was 26 months (range, 6-42 months). The actuarial rate for all patients at 26 months (per outcome measure) was as follows: primary patency, 73.9%; secondary patency, 88%; and F-CDTLR, 76.5%. When comparing PTA vs all other treatments in an adjusted regression analysis, the F-CDTLR was 75.2% for PTA vs 76.5% for all other treatment (hazard ratio, 1.06; 95% confidence interval, 0.75-1.48; P = .46, adjusted regression). The difference in secondary patency also was not statistically significant (85.7% for PTA vs 88%; P = .20). Adjusted Kaplan-Meier analysis revealed that the estimated primary patency was inferior for PTA in pairwise comparisons vs other treatments (P < .001 vs atherectomy; P = .002 vs directional atherectomy with drug-coated balloons; and P = .002 vs low-COF stenting).
CONCLUSIONS: The results from our study have shown that endovascular treatment of isolated popliteal lesions is safe and associated with acceptable patency and F-CDTLR in the mid-term.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:77 |
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| Enthalten in: |
Journal of vascular surgery - 77(2023), 1 vom: 15. Jan., Seite 231-240.e4 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Troisi, Nicola [VerfasserIn] |
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| Links: |
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| Themen: |
Coated Materials, Biocompatible |
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| Anmerkungen: |
Date Completed 26.12.2022 Date Revised 02.02.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.jvs.2022.07.170 |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Different endovascular modalities of treatment for isolated atherosclerotic popliteal artery lesions (EMO-POP) registry |
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| 500 | |a Date Revised 02.02.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: The mid-term results after treatment of isolated popliteal lesions have been limited. The aim of the present study was to report the mid-term outcomes after endovascular treatment of isolated atherosclerotic popliteal artery lesions | ||
| 520 | |a METHODS: A multicenter (15 hospitals in five countries) retrospective cohort study was performed. Between June 2016 and June 2021, 651 consecutive patients who had been treated for isolated popliteal lesions using endovascular methods exclusively were included in the present study. Six techniques were identified, including plain balloon angioplasty (PTA; n = 286; 43.9%), drug-coated balloon angioplasty (n = 98; 15.1%), stenting with low-chronic outward force (COF) stents (n = 84; 12.9%), stenting with high-COF stents (n = 76; 11.7%), atherectomy alone (n = 17; 2.6%), and directional atherectomy with drug-coated balloons (n = 90; 13.8%). The primary outcomes measures were primary and secondary patency and freedom from clinically driven target lesion revascularization (F-CDTLR) | ||
| 520 | |a RESULTS: The mean patient age was 74.5 years. Most of the patients (n = 409; 62.9%) had had chronic limb-threatening ischemia. Popliteal occlusion was found in 400 cases (61.4%). High-grade calcification was present in 36.7% of cases. Immediate technical success was 94.8%. The median follow-up was 26 months (range, 6-42 months). The actuarial rate for all patients at 26 months (per outcome measure) was as follows: primary patency, 73.9%; secondary patency, 88%; and F-CDTLR, 76.5%. When comparing PTA vs all other treatments in an adjusted regression analysis, the F-CDTLR was 75.2% for PTA vs 76.5% for all other treatment (hazard ratio, 1.06; 95% confidence interval, 0.75-1.48; P = .46, adjusted regression). The difference in secondary patency also was not statistically significant (85.7% for PTA vs 88%; P = .20). Adjusted Kaplan-Meier analysis revealed that the estimated primary patency was inferior for PTA in pairwise comparisons vs other treatments (P < .001 vs atherectomy; P = .002 vs directional atherectomy with drug-coated balloons; and P = .002 vs low-COF stenting) | ||
| 520 | |a CONCLUSIONS: The results from our study have shown that endovascular treatment of isolated popliteal lesions is safe and associated with acceptable patency and F-CDTLR in the mid-term | ||
| 650 | 4 | |a Multicenter Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Endovascular treatment | |
| 650 | 4 | |a Peripheral arterial disease | |
| 650 | 4 | |a Popliteal artery | |
| 650 | 7 | |a Coated Materials, Biocompatible |2 NLM | |
| 700 | 1 | |a Saratzis, Athanasios |e verfasserin |4 aut | |
| 700 | 1 | |a Katsogridakis, Emmanuel |e verfasserin |4 aut | |
| 700 | 1 | |a Stavroulakis, Konstantinos |e verfasserin |4 aut | |
| 700 | 1 | |a Berchiolli, Raffaella |e verfasserin |4 aut | |
| 700 | 1 | |a Zayed, Hany |e verfasserin |4 aut | |
| 700 | 1 | |a Torsello, Giovanni |e verfasserin |4 aut | |
| 700 | 0 | |a EMO-POP Registry Collaborative Group |e verfasserin |4 aut | |
| 700 | 1 | |a Brunschot, Denise Özdemir-van |e investigator |4 oth | |
| 700 | 1 | |a González, Teresa Martín |e investigator |4 oth | |
| 700 | 1 | |a Denisselle, Thomas |e investigator |4 oth | |
| 700 | 1 | |a Korosoglou, Grigorios |e investigator |4 oth | |
| 700 | 1 | |a Isernia, Giacomo |e investigator |4 oth | |
| 700 | 1 | |a Michelagnoli, Stefano |e investigator |4 oth | |
| 700 | 1 | |a Giordano, Antonio Nicola |e investigator |4 oth | |
| 700 | 1 | |a Daonas, Konstantinos P |e investigator |4 oth | |
| 700 | 1 | |a Pitoulias, Apostolos G |e investigator |4 oth | |
| 700 | 1 | |a Spiliopoulos, Stavros |e investigator |4 oth | |
| 700 | 1 | |a Martelli, Massimiliano |e investigator |4 oth | |
| 700 | 1 | |a Settembrini, Alberto Maria |e investigator |4 oth | |
| 700 | 1 | |a D'Oria, Mario |e investigator |4 oth | |
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