title: Stent and Non-Stent Based Outcomes of Infrainguinal Peripheral Artery Interventions From the Multicenter XLPAD Registry.
abstract: BACKGROUND
  There are limited data regarding contemporary use of stent and non-stent based treatment strategies of infrainguinal peripheral artery disease (PAD).
  
  
  METHODS
  We analyzed data from the ongoing multicenter XLPAD registry between July 2005 and October 2013 to report on the use of non-stent (atherectomy ± balloon angioplasty) and stent-based treatment of superficial femoral artery (SFA), popliteal, and below-the-knee (BTK) vessels in contemporary clinical practice.
  
  
  RESULTS
  A total of 584 interventions (SFA, 82.5%; popliteal, 7.2%; BTK, 9.9%) were performed in 372 patients (mean age, 63.2 years; diabetes mellitus, 57.7%; Rutherford category 1-3, 73.5%; Rutherford category 4-6, 20.1%). Stents were deployed in 389 lesions (66.6%; SFA, 90.5%; popliteal, 5.1%; BTK, 4.1%) and non-stent strategy (atherectomy, 49%) in 195 lesions (33.4%; SFA, 66.7%; popliteal, 11.3%; BTK, 21.5%). In the stent and non-stent groups, mean lesion lengths were 133.9 mm and 86.0 mm (P<.001), chronic total occlusions (CTOs) constituted 63.0% and 49.7% (P<.01), and restenotic lesions were 12.6% and 32.3% (P<.001), respectively. At a mean follow-up of 260 ± 130 days, in the stent and non-stent treated patients, all-cause mortality was 4.3% and 3.5% (P=.65), clinically indicated repeat revascularization was 17.5% and 14.9% (P=.42), and amputation was 4.6% and 9.2% (P<.01), respectively. SFA lesion location, long lesion length, and CTO were associated with the use of stents. Advanced Rutherford class was associated with a non-stent treatment strategy.
  
  
  CONCLUSIONS
  The majority of endovascular peripheral arterial interventions are performed in the SFA; most include a CTO and in patients with diabetes mellitus. Operators use stents to primarily treat complex SFA lesions with overall similar outcomes, except for fewer amputations compared to a non-stent strategy.
authors.affiliation: University of Texas Southwestern Medical Center, Dallas, Texas, USA. subhash.banerjee@va.gov.
authors.forename: Subhash
authors.initials: S
authors.lastname: Banerjee
authors.forename: Gene
authors.initials: G
authors.lastname: Pershwitz
authors.forename: Karan
authors.initials: K
authors.lastname: Sarode
authors.forename: Atif
authors.initials: A
authors.lastname: Mohammad
authors.forename: Mazen S
authors.initials: MS
authors.lastname: Abu-Fadel
authors.forename: Mirza S
authors.initials: MS
authors.lastname: Baig
authors.forename: Shirling
authors.initials: S
authors.lastname: Tsai
authors.forename: Bertis B
authors.initials: BB
authors.lastname: Little
authors.forename: Osvaldo S
authors.initials: OS
authors.lastname: Gigliotti
authors.forename: Ediberto
authors.initials: E
authors.lastname: Soto-Cora
authors.forename: Mazin I
authors.initials: MI
authors.lastname: Foteh
authors.forename: Gerardo
authors.initials: G
authors.lastname: Rodriguez
authors.forename: Andrew
authors.initials: A
authors.lastname: Klein
authors.forename: Tayo
authors.initials: T
authors.lastname: Addo
authors.forename: Michael
authors.initials: M
authors.lastname: Luna
authors.forename: Nicolas W
authors.initials: NW
authors.lastname: Shammas
authors.forename: Anand
authors.initials: A
authors.lastname: Prasad
authors.forename: Emmanouil S
authors.initials: ES
authors.lastname: Brilakis
mesh_terms: D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017073:Atherectomy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D057186:Comparative Effectiveness Research; D005260:Female; D005263:Femoral Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011150:Popliteal Artery / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D012042:Registries; D012720:Severity of Illness Index; D015607:Stents; D013781:Texas; D016896:Treatment Outcome; D014654:Vascular Patency