Endovascular Intravascular Lithotripsy in the Treatment of Calcific Common Femoral Artery Disease: A Case Series With an 18-Month Follow-Up.

Autor: Baig M; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA. Electronic address: Muhammad_baig@brown.edu., Kwok M; Department of Medicine, Alpert Medical School of Brown University, Providence, RI, USA., Aldairi A; Department of Medicine, Kent Hospital, RI, USA., Imran HM; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA., Khan MS; Department of Medicine, Division of Cardiology, University of Kentucky College of Medicine, Bowling Green, KY, USA., Moustafa A; Department of Medicine, Division of Cardiology, University of Toledo, OH, USA., Hyder ON; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA., Saad M; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA., Aronow HD; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA., Soukas PA; Department of Medicine, Division of Cardiology, Alpert Medical School of Brown University, The Miriam Hospital, Providence, RI, USA.
Jazyk: angličtina
Zdroj: Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2022 Oct; Vol. 43, pp. 80-84. Date of Electronic Publication: 2022 May 07.
DOI: 10.1016/j.carrev.2022.05.003
Abstrakt: Background: Intravascular lithotripsy (IVL) is a novel endovascular treatment for calcified common femoral artery disease (CFA). Data on midterm effectiveness for clinically driven target lesions revascularization (CD-TLR) is lacking. This study investigated CD-TLR during 18-month follow-up in patients requiring IVL for CFA disease treatment.
Methods: In a single-center retrospective cohort study, electronic medical record of patients undergoing IVL for CFA disease from January 2018 to March 2020 were reviewed. Primary outcome was CD-TLR estimated by Kaplan-Meier method during 18-month follow-up. Univariate logistic regression was used to compare differences in CD-TLR by the type of adjunct therapy used.
Results: Among 54 CFA lesions in 50 patients, mean age (SD) was 75(8) years, gender and race were predominantly male (74%, n = 37) and white (94%, n = 47), respectively. Rutherford class III claudication was most common (70%, n = 35) with mean ABI of 0.66 (0.26) and mean angiographic stenosis of 77% (13%). Adjunct use of drug-coated balloon (DCB) angioplasty was 83% (n = 45) and atherectomy was 39% (n = 21). Residual angiographic stenosis was <30% in all cases. Complications included dissection requiring stent placement (2%, n = 1). After 18-months, 18% (n = 9) died unrelated to procedural complications and 6% (n = 3) were lost to follow-up. 18-month cumulative freedom from CD-TLR was 80.6% (95% CI: 69.1%, 92%). Univariate logistic regression did not reveal a statistically significant difference in CD-TLR with type of adjunct therapy used (p > 0.05).
Conclusion: IVL with adjunct use of DCB and/or atherectomy is safe and effective in treatment of calcified CFA disease. Randomized studies are required to confirm these findings.
Competing Interests: Declaration of competing interest Dr. Peter Soukas is a site principal investigator for Shockwave Medical Company. Dr. Herbert Aronow is a consultant for Data Safety and Monitoring Board for the Philips ILLUMENATE studies. All other authors have no declaration of interests.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: