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Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions.

Publication ,  Journal Article
Krawisz, AK; Raja, A; Jones, WS; Schneider, P; Shen, C; Schermerhorn, M; Secemsky, EA
Published in: EuroIntervention
April 3, 2023

BACKGROUND: The use of atherectomy during peripheral endovascular interventions (PVI) has increased dramatically, but data regarding its safety and effectiveness are lacking.  Aims: This study sought to determine the long-term safety of atherectomy in contemporary practice.  Methods: Medicare fee-for-service beneficiaries who underwent femoropopliteal artery PVI from 2015-2018 were identified in a 100% sample of inpatient, outpatient, and carrier file data using procedural claims codes. The primary exposure was the use of atherectomy. Inverse probability of treatment weighting was used to adjust for measured differences in patient populations. Kaplan-Meier methods and multivariable Cox proportional hazards regression were used to compare outcomes.  Results: Among 168,553 patients who underwent PVI, 59,142 (35.1%) underwent atherectomy. The mean patient age was 77.0±7.6 years, 44.9% were female, 81.9% were white, and 46.7% had chronic limb-threatening ischaemia. Over a median follow-up time of 993 days (interquartile range 319-1,377 days), atherectomy use was associated with no difference in the risk of either the composite endpoint of death and amputation (adjusted hazard ratio [aHR] 0.99, 95% confidence interval [CI]: 0.97-1.01; p=0.19) or of major adverse limb events (aHR 1.02, 95% CI: 0.99-1.05; p=0.26). Patients who underwent atherectomy had a modest reduction in the risk of subsequently undergoing amputation or surgical revascularisation (aHR 0.92, 95% CI: 0.90-0.94; p<0.01) but an increase in the risk of undergoing a subsequent PVI (aHR 1.19, 95% CI: 1.16-1.21; p<0.01). CONCLUSIONS: The use of atherectomy during femoropopliteal artery PVI was not associated with an increase in the risk of long-term adverse safety outcomes among patients with peripheral artery disease.

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Published In

EuroIntervention

DOI

EISSN

1969-6213

Publication Date

April 3, 2023

Volume

18

Issue

16

Start / End Page

e1378 / e1387

Location

France

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Peripheral Arterial Disease
  • Medicare
  • Male
  • Humans
  • Femoral Artery
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
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Krawisz, A. K., Raja, A., Jones, W. S., Schneider, P., Shen, C., Schermerhorn, M., & Secemsky, E. A. (2023). Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions. EuroIntervention, 18(16), e1378–e1387. https://doi.org/10.4244/EIJ-D-22-00609
Krawisz, Anna K., Aishwarya Raja, W Schuyler Jones, Peter Schneider, Changyu Shen, Marc Schermerhorn, and Eric A. Secemsky. “Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions.EuroIntervention 18, no. 16 (April 3, 2023): e1378–87. https://doi.org/10.4244/EIJ-D-22-00609.
Krawisz AK, Raja A, Jones WS, Schneider P, Shen C, Schermerhorn M, et al. Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions. EuroIntervention. 2023 Apr 3;18(16):e1378–87.
Krawisz, Anna K., et al. “Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions.EuroIntervention, vol. 18, no. 16, Apr. 2023, pp. e1378–87. Pubmed, doi:10.4244/EIJ-D-22-00609.
Krawisz AK, Raja A, Jones WS, Schneider P, Shen C, Schermerhorn M, Secemsky EA. Long-term outcomes of peripheral atherectomy for femoropopliteal endovascular interventions. EuroIntervention. 2023 Apr 3;18(16):e1378–e1387.

Published In

EuroIntervention

DOI

EISSN

1969-6213

Publication Date

April 3, 2023

Volume

18

Issue

16

Start / End Page

e1378 / e1387

Location

France

Related Subject Headings

  • United States
  • Treatment Outcome
  • Risk Factors
  • Retrospective Studies
  • Peripheral Arterial Disease
  • Medicare
  • Male
  • Humans
  • Femoral Artery
  • Female