PMID- 34396865
OWN - NLM
STAT- MEDLINE
DCOM- 20220920
LR  - 20220922
IS  - 1708-539X (Electronic)
IS  - 1708-5381 (Print)
IS  - 1708-5381 (Linking)
VI  - 30
IP  - 5
DP  - 2022 Oct
TI  - Outcomes of endovascular treatment of patients with intermittent claudication due 
      to femoropopliteal disease.
PG  - 882-890
LID - 10.1177/17085381211039668 [doi]
AB  - OBJECTIVE: Our objective was to evaluate the outcomes of endovascular treatment 
      in patients with moderate and severe claudication due to femoropopliteal disease, 
      that is, disease of the superficial femoral and popliteal arteries. METHODS: A 
      retrospective review of all patients with moderate and severe claudication 
      (Rutherford 2 and 3) undergoing endovascular treatment for FP disease between 
      January 2012 and December 2017 at two university-affiliated hospitals was 
      performed. All procedures were performed by vascular surgeons. Primary outcomes 
      were mortality, freedom from reintervention, major adverse limb events defined as 
      major amputations, open surgical revascularization, or progression to chronic 
      limb-threatening ischemia (CLTI) at 30 days, 1 year, 2 years, and last follow-up. 
      Unadjusted odds ratios were calculated to identify variables associated with 
      adverse outcomes, and Kaplan-Meier survival curves were used to determine 
      mortality and freedom from reintervention. RESULTS: Eighty-five limbs in 74 
      patients were identified on review. Mean age was 69.6 +/- 9.8 years and 74.3% were 
      males. At a median follow-up of 49.0 +/- 25.5 months, all-cause mortality rate was 
      8.1% (6 patients) with 16.7% being due to cardiovascular causes. Reintervention 
      rates were 1.2%, 16.5%, and 21.2% at 30 days, 1 year, and 2 years, respectively. 
      Major adverse limb events occurred in 3 patients and rates were 0%, 1.2%, and 
      2.4% at 30 days, 1 year, and 2 years, respectively. Progression to CLTI was 0%, 
      1.2%, and 1.2% at 30 days, 1 year, and 2 years, respectively. Claudication had 
      improved or resolved in 55.6% (n = 34 patients), stable in 38.9% (n = 21 
      patients), and worse in 5.6% (n = 3 patients) Age >/= 70 years (OR = 4.09 
      (1.14-14.66), p = 0.027), TASCII A lesion (OR = 4.67 (1.14-19.17), p = 0.025), 
      and presence of 3-vessel runoff (OR = 3.70 (1.18-11.59), p = 0.022) predicted 
      symptoms' improvement. TASCII A lesions were less likely to require 
      reintervention (OR = 0.23 (0.06-0.86), p = 0.020). Reintervention within 1 year 
      (OR = 11.67 (0.98-138.94), p = 0.017), reintervention with a stent (OR = 14.40 
      (1.19-173.67), p = 0.008) and more than one reintervention (OR = 39.00 
      (2.89-526.28), p < 0.001) predicted major adverse limb events. CONCLUSIONS: 
      Careful patient selection is important when planning endovascular treatment in 
      patients with intermittent claudication and FP disease. This could result in 
      symptomatic improvement in more than half of the patients. Adverse outcomes such 
      as major adverse limb events, progression to CLTI, and amputations occur at low 
      rates.
FAU - Naiem, Ahmed A
AU  - Naiem AA
AUID- ORCID: 0000-0002-4544-0582
AD  - Division of Vascular Surgery, 5620McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - Doonan, Robert James
AU  - Doonan RJ
AD  - Division of Vascular Surgery, 5620McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - Steinmetz, Oren K
AU  - Steinmetz OK
AD  - Division of Vascular Surgery, 5620McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - MacKenzie, Kent S
AU  - MacKenzie KS
AD  - Division of Vascular Surgery, 5620McGill University Health Centre, Montreal, QC, 
      Canada.
FAU - Girsowicz, Elie
AU  - Girsowicz E
AD  - Division of Vascular Surgery, Jewish General Hospital, Montreal, QC, Canada.
FAU - Bayne, Jason P
AU  - Bayne JP
AD  - Division of Vascular Surgery, Jewish General Hospital, Montreal, QC, Canada.
FAU - Obrand, Daniel I
AU  - Obrand DI
AD  - Division of Vascular Surgery, Jewish General Hospital, Montreal, QC, Canada.
FAU - Gill, Heather L
AU  - Gill HL
AD  - Division of Vascular Surgery, 5620McGill University Health Centre, Montreal, QC, 
      Canada.
LA  - eng
PT  - Journal Article
DEP - 20210816
PL  - England
TA  - Vascular
JT  - Vascular
JID - 101196722
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - *Intermittent Claudication/diagnostic imaging/therapy
MH  - Ischemia/diagnostic imaging/surgery
MH  - Limb Salvage
MH  - Male
MH  - Middle Aged
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Vascular Patency
PMC - PMC9485338
OTO - NOTNLM
OT  - claudication
OT  - endovascular
OT  - outcomes
OT  - revascularization
COIS- Declaration of conflicting interests: The author(s) declared no potential 
      conflicts of interest with respect to the research, authorship, and/or 
      publication of this article.
EDAT- 2021/08/17 06:00
MHDA- 2022/09/21 06:00
PMCR- 2022/09/20
CRDT- 2021/08/16 08:43
PHST- 2021/08/17 06:00 [pubmed]
PHST- 2022/09/21 06:00 [medline]
PHST- 2021/08/16 08:43 [entrez]
PHST- 2022/09/20 00:00 [pmc-release]
AID - 10.1177_17085381211039668 [pii]
AID - 10.1177/17085381211039668 [doi]
PST - ppublish
SO  - Vascular. 2022 Oct;30(5):882-890. doi: 10.1177/17085381211039668. Epub 2021 Aug 
      16.