Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease

Bosiers, Marc; Scheinert, Dierk; Peeters, Patrick; Torsello, Giovanni; Zeller, Thomas; Deloose, Koen; Schmidt, Andrej; Teßarek, J.; Vinck, Erwin; Schwartz, Lewis B.

doi:10.1016/j.jvs.2011.07.099

Cited by 239 publications

(210 citation statements)

References 34 publications

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“…[14,15,[25][26][27][28][29][30][31]. These devices are associated with significantly better primary patency, primaryassisted patency, and fewer secondary interventions at 3-year follow-up than balloon angioplasty.…”

Section: Infrapopliteal Stentingmentioning

confidence: 99%

“…Arteriographically severe IP stenosis is defined as a luminal reduction of 70-99% or occlusion in at least one IP artery [6,14,15]. Moderate IP stenoses is defined as a luminal reduction of 50-69% and mild IP stenosis is defined as a luminal reduction of <50%.…”

Section: Clinical Considerationsmentioning

confidence: 99%

“…Primary patency (85% vs. 54%), late lumen loss, mean in-stent diameter stenosis, and target lesion revascularization were all significantly in favor of DES treatment. However, neither final Rutherford class 0 or 1 at 1 year, nor 1-year survival, was different between the groups [14]. Limitations of balloon expandable stents include: their lack of significant flexibility, the potential for fracture or compression from external trauma (particularly in the distal anterior and posterior tibial artery), and their high-cost expense (particularly when using multiple stents for long lesions).…”

mentioning

confidence: 92%

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SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Gray

Díaz‐Sandoval

Dieter

et al. 2014

Cathet Cardio Intervent

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Intervention to treat infrapopliteal arterial disease can be challenging because the patients' comorbidities, the anatomic variables, and the limitations of our techniques. Clinical scenarios based on anatomic and clinical variables are presented. Recommendations regarding intervention (appropriate care, may be appropriate care, rarely appropriate care) are made based on best evidence. V C 2014 Wiley Periodicals, Inc.Key words: peripheral intervention; appropriate use; peripheral arterial disease INTRODUCTION Infrapopliteal (IP) arterial disease or "below the knee" arterial disease is commonly seen in patients with long-standing diabetes mellitus, chronic kidney disease, or the elderly. The most concerning manifestation of peripheral arterial disease (PAD) in these high risk patients is the development of critical limb ischemia (CLI: ischemic rest pain or ischemic ulcers). This arterial bed consists of relatively small caliber vessels, which are often calcified and associated with diffuse, multilevel disease. Due to the complexity of this patient population, their co-morbidities, and severity of vascular disease, there is a paucity of scientific evidence for the generalizability of percutaneous revascularization.In general, non-ambulatory patients with a short life expectancy and extensive necrosis or gangrene should undergo primary amputation. Ambulatory patients who are acceptable surgical candidates, expected to survive more than two years with a patent IP artery that provides direct flow to the foot (considered to be a good distal target), and an adequate autologous venous conduit should be considered for surgical bypass. Patients with significant medical co-morbidities that limit life expectancy, those at increased risk for surgery, those without an adequate distal target for bypass, or with poor venous conduit should be considered for an endovascular-first approach.This document was developed to guide physicians in clinical decision-making in the modern practical application of endovascular intervention for patients with IP arterial disease. ANATOMIC CONSIDERATIONSPatients with CLI typically have disease involving multiple levels (i.e., aorto-iliac, femoropopliteal (FP) and IP), but less than 10% of patients with CLI have hemodynamically significant disease in all three levels [1][2][3] (Table I). Infrainguinal disease (FP and IP) can be further subdivided into those with predominantly isolated IP disease ( 33%) and those with both FP and IP disease ( 67%) [4][5][6][7].Additional Supporting Information may be found in the online version of this article. Catheterization and Cardiovascular Interventions 84:539-545 (2014) Isolated IP disease is mainly seen in the elderly (>80-years old), diabetic, or dialysis-dependent patients [5]. These patients are at higher risk for amputation and have a shorter amputation-free survival compared to those with FP and IP disease (median amputation-free survival: 17 months (95% CI ¼ 9-24 m) versus 37 months (95% CI ¼ 28-44 m), P ¼ 0.001) [6]. Clinical and non-invasive cr...

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Section: Infrapopliteal Stentingmentioning

confidence: 99%

Section: Clinical Considerationsmentioning

confidence: 99%

mentioning

confidence: 92%

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SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Gray

Díaz‐Sandoval

Dieter

et al. 2014

Cathet Cardio Intervent

View full text Add to dashboard Cite

show abstract

“…To date, a total of 5 randomized trials 16,[21][22][23][24] have been performed, comparing either DES with BMS 16,[22][23][24] or DES with POBA 21) ( Table 1). Throughout all trials, DES was superior when compared to its counterparts with respect to arterial patency.…”

Section: Concepts Of Improvement Of Restenosis Rates After Endovasculmentioning

confidence: 99%

“…Throughout all trials, DES was superior when compared to its counterparts with respect to arterial patency. 16,[21][22][23][24] Of note, the use of DES was shown to be associated with improved clinial outcomes when compared to the use of BMS in one randomized study. 9) …”

Section: Concepts Of Improvement Of Restenosis Rates After Endovasculmentioning

confidence: 99%

Does Patency Matter in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization?

Baumann

Groechenig

Diehm

2014

Annals of Vascular Diseases

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Endoluminal stents for iliac and infrainguinal arterial disease

Walker

Paraskevas

Stansby

et al. 2017

Cochrane Database of Systematic Reviews

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Randomized comparison of everolimus-eluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease

Abstract: Treatment of the infrapopliteal occlusive lesions of critical limb ischemia with everolimus-eluting stents reduces restenosis and the need for reintervention compared with bare metal stents.

Cited by 239 publications

References 34 publications

SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Does Patency Matter in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization?

Endoluminal stents for iliac and infrainguinal arterial disease

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