Τίτλος:
Incidence and Endovascular Treatment of Isolated Atherosclerotic Popliteal Artery Disease: Outcomes from the IPAD Multicenter Study
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Purpose: To report the incidence and long-term outcomes following endovascular treatment of symptomatic, atherosclerotic isolated popliteal artery disease (IPAD). Materials and Methods: This retrospective, multicenter study included all patients who underwent endovascular treatment of IPAD between January 2010 and December 2016 because of intermittent claudication or critical limb ischemia (CLI), in three tertiary University Hospitals. In total, 4717 peripheral arterial disease (PAD) procedures were analyzed. The study’s primary outcome measures were: IPAD incidence, binary restenosis rate and freedom from target lesion revascularization (TLR). Secondary outcome measures included technical success, limb salvage rate and the identification of predictors of outcomes. Results: The incidence of IPAD was 0.98% (46/4717 PAD procedures). In total, 46 patients (38 male; mean age 73 ± 12 years) underwent plain balloon (69.5%) or bail-out stenting (30.5%) procedures. Most patients suffered from CLI (65.2%). Mean lesion length was 52.5 ± 32.0 mm and 45.6% of the cases were occlusions. Severe calcifications were noted in 26.1%. Technical success was 100%. Mean time follow-up was 32.6 ± 25.6 months. According to Kaplan–Meier analysis, restenosis was 15.8, 40.9, 45.8% and TLR-free rate was 90.5, 79.0, 74.1%, at 1, 2 and 3 years, respectively. Survival and limb salvage rates were 73.6 and 88.1%, at 5 years, respectively. The major amputation rate for CLI patients was 10.0% (3/29 limbs), while no major amputations occurred in the claudication subgroup. Cox multivariable analysis detected baseline occlusion as an independent predictor of increased restenosis (HR 5.3; 95% CI 0.21–0.66, p = 0.02). Conclusions: Isolated popliteal lesions requiring treatment appear in nearly 1% of patients with PAD. Balloon angioplasty and bail-out stenting resulted in acceptable long-term clinical outcomes. Treatment of occlusions was correlated with increased restenosis rate. © 2018, Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).
Συγγραφείς:
Spiliopoulos, S.
Kitrou, P.
Galanakis, N.
Papadimatos, P.
Katsanos, K.
Konstantos, C.
Palialexis, K.
Reppas, L.
Kehagias, E.
Karnabatidis, D.
Brountzos, E.
Tsetis, D.
Περιοδικό:
CardioVascular and Interventional Radiology
Εκδότης:
Springer New York LLC
Λέξεις-κλειδιά:
adult; aged; amputation; artery calcification; Article; atherosclerotic isolated popliteal artery disease; atherosclerotic plaque; bail out stenting; clinical article; critical limb ischemia; disease severity; endovascular surgery; female; follow up; human; incidence; limb salvage; long term care; male; percutaneous transluminal angioplasty; prediction; priority journal; restenosis; retrospective study; target lesion revascularization; treatment outcome; atherosclerosis; clinical trial; endovascular surgery; graft occlusion; intermittent claudication; ischemia; Kaplan Meier method; middle aged; mortality; multicenter study; peripheral occlusive artery disease; popliteal artery; procedures; risk factor; statistics and numerical data; stent; time factor; very elderly, Aged; Aged, 80 and over; Atherosclerosis; Endovascular Procedures; Female; Graft Occlusion, Vascular; Humans; Incidence; Intermittent Claudication; Ischemia; Kaplan-Meier Estimate; Limb Salvage; Male; Middle Aged; Peripheral Arterial Disease; Popliteal Artery; Retrospective Studies; Risk Factors; Stents; Time Factors; Treatment Outcome
DOI:
10.1007/s00270-018-2028-7
