Evaluation of mortality following paclitaxel drug-coated balloon angioplasty of femoropopliteal lesions in patients with ulcerations and gangrene - a single center experience.
Vasa
; 50(2): 132-138, 2021 Feb.
Article
em En
| MEDLINE
| ID: mdl-33118425
ABSTRACT
Background:
A recent meta-analysis of randomized controlled trials suggested an increased long-term mortality risk following femoropopliteal angioplasty using paclitaxel coated devices. To assess the long-term mortality after paclitaxel drug-coated (DCB) and uncoated balloon angioplasty (POBA) of femoropopliteal lesions in patients with ulcerations and gangrene in real world practice. Patients andmethods:
A retrospective mortality analysis of patients with at least 3-year follow-up who underwent balloon based endovascular therapy of femoropopliteal lesions was performed.Results:
Overall 624 patients with femoropopliteal lesions were included in this study. Of those, 197 patients were treated with POBA without crossover to a paclitaxel coated device during follow-up and 427 patients with DCB angioplasty. Mean follow-up time was 33.3 ± 25.4 months. Mortality incidence was 81.7% (95% confidence interval [95% CI] 76.1-86.8) after POBA and 59.0% (95% CI 54.6-63.9) after DCB (p < 0.001). Multivariate logistic regression analysis revealed type of treatment (POBA vs. DCB, (hazard ratio [HR] 0.332, 95% CI 0.215-0.514, p < 0.001), age per year (HR 1.065, 95% CI 1.046-1.087, p < 0.001), coronary heart disease (HR 1.969, 95% CI 1.323-2.930, p = 0.001), renal insufficiency (HR 1.583, 95% CI 1.079-2.323, p = 0.019), stroke (HR 2.505, 95% CI 1.431-4.384, p = 0.001) as predictors for all-cause mortality. In the subgroup excluding octogenarians, mortality predictors were type of treatment (HR 0.463, 95% CI 0.269-0.796, p = 0.005), age per year (HR 1.035, 95% CI 1.002-1.069, p = 0.038), coronary heart disease (HR 2.082, 95% CI 1.274-3.400, p = 0.003), stroke (HR 2.203, 95% CI 1.156-4.197, p = 0.016) and renal insufficiency (HR 2.201, 95% CI 1.357-3.571, p < 0.001).Conclusions:
This monocentric retrospective analysis showed no survival disadvantage for patients in Rutherford-Becker stage 5 after treatment with paclitaxel-coated balloons.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Preparações Farmacêuticas
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Fármacos Cardiovasculares
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Angioplastia com Balão
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Doença Arterial Periférica
Tipo de estudo:
Observational_studies
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Prognostic_studies
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Risk_factors_studies
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Systematic_reviews
Limite:
Aged80
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Humans
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article