Atheroma, Popliteal Artery Stenosis
Conditions
Keywords
Popliteal artery, Drug-coated balloon, Supera stent, Directional atherectomy
Brief summary
The purpose of this study was to compare the results of directional atherectomy with antirestenotic therapy (DAART technique) and angioplasty/Supera stenting for the treatment of popliteal atherectomy lesions.
Detailed description
Atherectomy offers a way to improve the chances to avoid stent placement, although it did not show superiority in terms of vessel patency or limb salvage compared with POBA. Nevertheless, atherectomy can modify the plaque morphology and the mechanical properties of the baseline disease, which allows better drug penetration and diffusion into the vessel wall. Moreover, the combination of directional atherectomy devices and drug coated balloons (directional atherectomy with antirestenotic therapy, DAART), theoretically might further improve the clinical outcomes of drug coated angioplasty. The leave nothing behind strategies have gained support among interventionalist. Many studies claim that atherectomy improves results when combined with adjunctive DCB. The Supera stent, when compared with other self-expanding nitinol stents, has proven to deforms less with knee flexion and exhibits less strain. It mimics the natura structure and movement of the anatomy and optimizes luminal gain maintaining a round open lumen in challenging anatomies, as the popliteal artery. Mechanical scaffolding is often required owing to elastic recoil and flow-limiting dissections in complex popliteal lesions. The purpose to this study was to retrospectively evaluate the efficacy of both techniques for endovascular treatment of atherosclerotic lesions of the popliteal artery.
Interventions
DEVICEDAART
DEVICEATP/Supera stenting
Sponsors
Vascular Investigation Network Spanish Society for Angiology and Vascular Surgery
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* patients with lifestyle limiting intermittent claudication ischemic rest pain, ischemic ulcers or gangrene (Rutherford class 3 to 6) who presented atherosclerotic lesions in the popliteal artery undergoing endovascular treatment by DAART of PTA/Supera stenting and at least a 12-months of follow-up
Exclusion criteria
*
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Primary latency 12-months | 12 months | primary patency at 12-months follow-up, defined as absence of binary restenosis or reocclusion on duplex ultrasound examination without repeat target lesion interventions |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Mortality | 12-months | Patients dead all-cause during follow-up |
| Amputation rate | 12-months | Patients with minor or mayor amputation during follow-up |
| Clinical status | 12-months | Rutherford classification clinical scale after 12-month follow-up |
| Secondary Patency | 12-months | Secondary patency was defined as requiring a secondary intervention to restore patency after occlusion of the treated segment |
| Stent fracture | 12-months | Stent fracture and implantation defects were assessed by high-resolution radiographic imaging performed on the stents of every limb |
| Primary-assisted patency | 12-months | Primary assisted patency was defined as a patent popliteal segment that underwent further intervention within the inflow, treated vessel segment, or outflow of the treated vessel segment to improve patency |
| ABI measurement | 12-months | Ankle/Brachial index measurement. |
Outcome results
None listed