PMID- 35066986
OWN - NLM
STAT- MEDLINE
DCOM- 20220421
LR  - 20220512
IS  - 1522-726X (Electronic)
IS  - 1522-1946 (Linking)
VI  - 99
IP  - 4
DP  - 2022 Mar
TI  - Contemporary treatment of below-the-knee peripheral arterial disease in patients 
      with chronic limb threatening ischemia: Observations from the Vascular Quality 
      Initiative.
PG  - 1289-1299
LID - 10.1002/ccd.30063 [doi]
AB  - OBJECTIVE: We sought to determine trends in percutaneous transluminal angioplasty 
      (PTA) versus non-PTA interventions over time, as well as factors that influence 
      the decision for non-PTA intervention. BACKGROUND: Although the optimal strategy 
      for revascularization in patients with below-the-knee (BTK) chronic 
      limb-threatening ischemia (CLTI) remains under investigation, PTA has been the 
      preferred endovascular approach. Recently, there has been an increase in the use 
      of non-PTA approaches for revascularization. METHODS: We performed a 
      retrospective analysis of the Vascular Quality Initiative. Between 2011 and 2020, 
      a total of 23,850 procedures corresponding to 33,098 arteries in 19,404 patients 
      with CLTI were included. After application of exclusion criteria and removal of 
      missing variables, 18,644 arteries were included in the study cohort. The primary 
      analysis was factors associated with receiving non-PTA intervention. Secondary 
      analysis included trends in PTA versus non-PTA intervention over time. RESULTS: 
      Throughout the study period, the majority of interventions (72%) were PTA alone. 
      The percentage of non-PTA interventions, on a per-artery basis, increased over 
      the study period from 18% to 33%, p < 0.01. Advanced age, increasing 
      TransAtlantic Inter-Society Consensus classification, and concomitant 
      above-the-knee disease were associated with an increased likelihood for non-PTA 
      intervention. In contrast, longer lesion length, insulin-dependent diabetes 
      mellitus, bilateral disease, and discharge to location other than home were 
      associated with an increased likelihood of PTA. CONCLUSIONS: We observed a 
      significant increase in the percentage of non-PTA interventions for patients with 
      CLTI requiring BTK interventions over the last decade, with lesion- and 
      patient-specific characteristics associated with the type of endovascular 
      approach.
CI  - (c) 2022 Wiley Periodicals LLC.
FAU - Singh, Nikhil
AU  - Singh N
AUID- ORCID: 0000-0002-2550-3830
AD  - Section of Cardiology, Department of Medicine, University of Chicago, Chicago, 
      Illinois, USA.
FAU - Ding, Li
AU  - Ding L
AD  - Department of Population and Public Health Sciences, University of Southern 
      California Keck School of Medicine, Los Angeles, California, USA.
FAU - Magee, Gregory A
AU  - Magee GA
AD  - Division of Vascular Surgery and Endovascular Therapy, University of Southern 
      California Keck School of Medicine, Los Angeles, California, USA.
FAU - Shavelle, David M
AU  - Shavelle DM
AD  - MemorialCare Heart and Vascular Institute, Long Beach Memorial Medical Center, 
      Long Beach, California, USA.
LA  - eng
GR  - UL1TR001855/TR/NCATS NIH HHS/United States
GR  - UL1TR001855/TR/NCATS NIH HHS/United States
PT  - Journal Article
DEP - 20220123
PL  - United States
TA  - Catheter Cardiovasc Interv
JT  - Catheterization and cardiovascular interventions : official journal of the 
      Society for Cardiac Angiography & Interventions
JID - 100884139
SB  - IM
MH  - *Angioplasty, Balloon/adverse effects
MH  - Chronic Limb-Threatening Ischemia
MH  - Humans
MH  - Ischemia/diagnostic imaging/therapy
MH  - Limb Salvage/methods
MH  - *Peripheral Arterial Disease/diagnostic imaging/therapy
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Vascular Patency
OTO - NOTNLM
OT  - chronic limb threatening ischemia (CLTI)
OT  - peripheral artery disease (PAD)
OT  - peripheral vascular intervention (PVI)
EDAT- 2022/01/24 06:00
MHDA- 2022/04/22 06:00
CRDT- 2022/01/23 20:39
PHST- 2021/11/27 00:00 [revised]
PHST- 2021/10/06 00:00 [received]
PHST- 2021/12/26 00:00 [accepted]
PHST- 2022/01/24 06:00 [pubmed]
PHST- 2022/04/22 06:00 [medline]
PHST- 2022/01/23 20:39 [entrez]
AID - 10.1002/ccd.30063 [doi]
PST - ppublish
SO  - Catheter Cardiovasc Interv. 2022 Mar;99(4):1289-1299. doi: 10.1002/ccd.30063. 
      Epub 2022 Jan 23.