Comparison of long-term outcomes after directional versus rotational atherectomy in peripheral artery disease
| Autor: | Wojciech Trendel, Radosław S. Kiesz, Aleksandra Kolarczyk-Haczyk, Piotr P. Buszman, Krzysztof Milewski, Paweł Buszman, Maciej Pruski, Adam Janas, Wojciech Wojakowski |
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| Rok vydání: | 2020 |
| Předmět: |
critical limb ischemia
medicine.medical_specialty medicine.medical_treatment atherectomy Revascularization law.invention Atherectomy Randomized controlled trial peripheral arterial disease law Internal medicine medicine Original Paper claudication business.industry Mortality rate Retrospective cohort study Critical limb ischemia Amputation Cardiology Medicine medicine.symptom Cardiology and Cardiovascular Medicine Claudication business |
| Zdroj: | Postępy w Kardiologii Interwencyjnej = Advances in Interventional Cardiology Advances in Interventional Cardiology, Vol 16, Iss 1, Pp 76-81 (2020) |
| ISSN: | 1734-9338 |
| Popis: | Introduction The rate of atherectomy utilization in peripheral artery diseases (PAD) is growing. The two atherectomy devices available on the market and used most frequently are the directional and rotational ones. Nonetheless, there is a lack of direct comparison between these two types of atherectomy in PAD. Aim To compare the long-term outcomes after PAD endovascular revascularization with two types of atherectomies: rotational (AR) (Phoenix Philips) and directional (AD) (SilverHawk Medtronic). Material and methods This was a single-center, retrospective study of obstructive and symptomatic PAD patients who underwent revascularization with atherectomy. The endpoints were considered as target lesion revascularization (TLR), death, amputations and bailout stenting (BS). Results The AR group consisted of 97 patients, while the AD group consisted of 85 individuals. There were no significant differences between the groups in terms of baseline characteristics except for an increased critical limb ischemia (CLI) prevalence in the AR group. The mean follow-up for AD and AR was 282.6 ±147.4 and 255.7 ±186.1 days, respectively (p = 0.44). There were no significant differences in the death rate (AD: 1 (1.7%) vs. AR: 5 (5.7%); p = 0.54), amputations (AD: 2 (2.3%) vs. AR: 5 (5.7%); p = 0.45) or bailout stenting (AD: 2 (2.3%) vs. AR: 3 (3.2%); p = 0.74), whereas TLR was more frequent in the AD group (AD: 25 (29%) vs. AR: 15 (15.9%; p = 0.03). The Kaplan-Meier analysis showed no significant differences between the groups in time to TLR, amputation or death. Conclusions In this hypothesis-generating study the AR had a lower rate of TLR when compared to the AD. Nevertheless, this should be confirmed in further controlled randomized trials. |
| Databáze: | OpenAIRE |
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