title: Long-Term Outcomes After Percutaneous Lower Extremity Arterial Interventions With Atherectomy vs. Balloon Angioplasty　- Propensity Score-Matched Registry.
abstract: The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization.
  
  
  
  This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization. PTA was performed in 215 patients, and AT in 204 (Silver Hawk, EV3, n=125; CSI 360°, n=66; Pathway Medical Technologies, n=13). There were no significant between-group differences in baseline characteristics except for increased CAD, dialysis and CLI prevalence in the PTA group. Following propensity score analysis 131 well-matched pairs were included in analysis. Bail-out stenting was more frequent in the reference group (PTA, 6.1% vs. AT, 0%; P=0.004). At 6- and 12-month follow-up there were no differences in TLR between the groups (PTA, 8.3% vs. AT, 5.3%; P=0.47; and PTA, 16.7% vs. AT, 13.7%; P=0.73, respectively). The difference was in favor of AT at 24-month follow-up (PTA, 29.0% vs. AT, 16.7%; P=0.05). No difference was observed in amputation rate (PTA, 0.7% vs AT, 1.5%; P=0.62). On Kaplan-Meier analysis there were no significant differences between groups in time to TLR, amputation or death.
  
  
  
  AT was associated with lower risk of TLR, and this should be confirmed in randomized controlled trials.
authors.affiliation: Center of Cardiovascular Research and Development, American Heart of Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Janas
authors.forename: Piotr P
authors.initials: PP
authors.lastname: Buszman
authors.forename: Krzysztof P
authors.initials: KP
authors.lastname: Milewski
authors.forename: Szymon
authors.initials: S
authors.lastname: Wiernek
authors.forename: Ksenia
authors.initials: K
authors.lastname: Janas
authors.forename: Maciej
authors.initials: M
authors.lastname: Pruski
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wojakowski
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Błachut
authors.forename: Wojciech
authors.initials: W
authors.lastname: Picheta
authors.forename: Pawel
authors.initials: P
authors.lastname: Buszman
authors.forename: Stefan
authors.initials: S
authors.lastname: Kiesz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon; D017073:Atherectomy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D035002:Lower Extremity / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012042:Registries; D012189:Retrospective Studies; D015996:Survival Rate