Stenting versus balloon angioplasty alone in patients with below-the-knee disease: A propensity score-matched analysis
Percutaneous transluminal angioplasty (PTA) is considered an effective treatment in patients with critical limb ischemia (CLI). However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus ba...
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| Veröffentlicht in: | PloS one 2021-06, Vol.16 (6), p.e0251755 |
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| creator | Ahn, Jihun Byeon, JinSu Choi, Byoung Geol Choi, Se Yeon Byun, Jae Kyeong Cha, Jinah Yu, HyeYon Lee, Cheolho Na, Jin Oh Choi, Cheol Ung Kim, Eung Ju Park, Chang Gyu Seo, Hong Seog Choi, Woong-Gil Rha, Seung-Woon |
| description | Percutaneous transluminal angioplasty (PTA) is considered an effective treatment in patients with critical limb ischemia (CLI). However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus balloon angioplasty alone in BTK lesions. This study included 357 consecutive patients (400 limbs, 697 lesions) with BTK lesions who underwent PTA from September 2010 to December 2016. All enrolled patients were treated either by stenting (stent group; 111 limbs of 102 patients) or plain old balloon angioplasty (POBA group; 289 limbs of 255 patients). Stent group includes both primary and provisional stenting. Angiographic outcomes, procedural success, complications, and clinical outcomes were compared between the two groups up to 1 year. After propensity score matching (PSM) analysis, 56 pairs were generated, and the baseline and angiographic characteristics were balanced. The procedural success and complications were similar between the two groups; however, the incidence of procedure-related perforation was higher in the POBA group than in the stenting group [5(11.9%) vs.1 (0.9%), P = 0.009]. Six- to 9-month computed tomography or angiographic follow-up showed similar incidences of binary restenosis, primary patency, and secondary patency. In the 1-year clinical follow-up, there were similar incidences of individual hard endpoints, including mortality, myocardial infarction, limb salvage, and amputation rate, with the exception of target extremity revascularization (TER), which tended to be higher in the stenting group than in the POBA group [21 (20.8%) vs. 11 (10.9%), P = 0.054]. Although there was a trend toward a higher incidence of TER risk in the stenting group, stent implantation, particularly in bail-out stenting seemed to have acceptable 1-year safety and efficacy compared to POBA alone in patients undergoing BTK PTA. |
| doi_str_mv | 10.1371/journal.pone.0251755 |
| format | Article |
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However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus balloon angioplasty alone in BTK lesions. This study included 357 consecutive patients (400 limbs, 697 lesions) with BTK lesions who underwent PTA from September 2010 to December 2016. All enrolled patients were treated either by stenting (stent group; 111 limbs of 102 patients) or plain old balloon angioplasty (POBA group; 289 limbs of 255 patients). Stent group includes both primary and provisional stenting. Angiographic outcomes, procedural success, complications, and clinical outcomes were compared between the two groups up to 1 year. After propensity score matching (PSM) analysis, 56 pairs were generated, and the baseline and angiographic characteristics were balanced. The procedural success and complications were similar between the two groups; however, the incidence of procedure-related perforation was higher in the POBA group than in the stenting group [5(11.9%) vs.1 (0.9%), P = 0.009]. Six- to 9-month computed tomography or angiographic follow-up showed similar incidences of binary restenosis, primary patency, and secondary patency. In the 1-year clinical follow-up, there were similar incidences of individual hard endpoints, including mortality, myocardial infarction, limb salvage, and amputation rate, with the exception of target extremity revascularization (TER), which tended to be higher in the stenting group than in the POBA group [21 (20.8%) vs. 11 (10.9%), P = 0.054]. Although there was a trend toward a higher incidence of TER risk in the stenting group, stent implantation, particularly in bail-out stenting seemed to have acceptable 1-year safety and efficacy compared to POBA alone in patients undergoing BTK PTA.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0251755</identifier><identifier>PMID: 34111147</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accumulation ; Aged ; Aged, 80 and over ; Amputation ; Angioplasty ; Angioplasty, Balloon - methods ; Balloon treatment ; Biology and Life Sciences ; Cardiovascular system ; Care and treatment ; Clinical trials ; Comparative studies ; Complications and side effects ; Diseases ; Drug delivery ; Female ; Heart attacks ; Hospitals ; Humans ; Implantation ; Implants ; Ischemia ; Ischemia - therapy ; Knee ; Lesions ; Male ; Medical equipment ; Medical imaging ; Medicine ; Medicine and Health Sciences ; Middle Aged ; Patient outcomes ; Patients ; Peripheral Arterial Disease - therapy ; Propensity Score ; Research and Analysis Methods ; Retrospective Studies ; Statistical analysis ; Stent (Surgery) ; Stents ; Surgery ; Surgical implants ; Transluminal angioplasty ; Treatment Outcome ; University graduates</subject><ispartof>PloS one, 2021-06, Vol.16 (6), p.e0251755</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Ahn et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Ahn et al 2021 Ahn et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-e59afa2c8f5f7ddfcbe9c9e3c05f85515659c8210a5f6883cf95dad4dc5db9c23</citedby><cites>FETCH-LOGICAL-c692t-e59afa2c8f5f7ddfcbe9c9e3c05f85515659c8210a5f6883cf95dad4dc5db9c23</cites><orcidid>0000-0001-9456-9852 ; 0000-0002-4706-2298</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191955/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191955/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,861,882,2096,2915,23847,27905,27906,53772,53774,79349,79350</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34111147$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Paul, Timir</contributor><creatorcontrib>Ahn, Jihun</creatorcontrib><creatorcontrib>Byeon, JinSu</creatorcontrib><creatorcontrib>Choi, Byoung Geol</creatorcontrib><creatorcontrib>Choi, Se Yeon</creatorcontrib><creatorcontrib>Byun, Jae Kyeong</creatorcontrib><creatorcontrib>Cha, Jinah</creatorcontrib><creatorcontrib>Yu, HyeYon</creatorcontrib><creatorcontrib>Lee, Cheolho</creatorcontrib><creatorcontrib>Na, Jin Oh</creatorcontrib><creatorcontrib>Choi, Cheol Ung</creatorcontrib><creatorcontrib>Kim, Eung Ju</creatorcontrib><creatorcontrib>Park, Chang Gyu</creatorcontrib><creatorcontrib>Seo, Hong Seog</creatorcontrib><creatorcontrib>Choi, Woong-Gil</creatorcontrib><creatorcontrib>Rha, Seung-Woon</creatorcontrib><title>Stenting versus balloon angioplasty alone in patients with below-the-knee disease: A propensity score-matched analysis</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Percutaneous transluminal angioplasty (PTA) is considered an effective treatment in patients with critical limb ischemia (CLI). However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus balloon angioplasty alone in BTK lesions. This study included 357 consecutive patients (400 limbs, 697 lesions) with BTK lesions who underwent PTA from September 2010 to December 2016. All enrolled patients were treated either by stenting (stent group; 111 limbs of 102 patients) or plain old balloon angioplasty (POBA group; 289 limbs of 255 patients). Stent group includes both primary and provisional stenting. Angiographic outcomes, procedural success, complications, and clinical outcomes were compared between the two groups up to 1 year. After propensity score matching (PSM) analysis, 56 pairs were generated, and the baseline and angiographic characteristics were balanced. The procedural success and complications were similar between the two groups; however, the incidence of procedure-related perforation was higher in the POBA group than in the stenting group [5(11.9%) vs.1 (0.9%), P = 0.009]. Six- to 9-month computed tomography or angiographic follow-up showed similar incidences of binary restenosis, primary patency, and secondary patency. In the 1-year clinical follow-up, there were similar incidences of individual hard endpoints, including mortality, myocardial infarction, limb salvage, and amputation rate, with the exception of target extremity revascularization (TER), which tended to be higher in the stenting group than in the POBA group [21 (20.8%) vs. 11 (10.9%), P = 0.054]. Although there was a trend toward a higher incidence of TER risk in the stenting group, stent implantation, particularly in bail-out stenting seemed to have acceptable 1-year safety and efficacy compared to POBA alone in patients undergoing BTK PTA.</description><subject>Accumulation</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Amputation</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon - methods</subject><subject>Balloon treatment</subject><subject>Biology and Life Sciences</subject><subject>Cardiovascular system</subject><subject>Care and treatment</subject><subject>Clinical trials</subject><subject>Comparative studies</subject><subject>Complications and side effects</subject><subject>Diseases</subject><subject>Drug delivery</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Implantation</subject><subject>Implants</subject><subject>Ischemia</subject><subject>Ischemia - therapy</subject><subject>Knee</subject><subject>Lesions</subject><subject>Male</subject><subject>Medical equipment</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Middle Aged</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Peripheral Arterial Disease - therapy</subject><subject>Propensity Score</subject><subject>Research and Analysis Methods</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Stent (Surgery)</subject><subject>Stents</subject><subject>Surgery</subject><subject>Surgical implants</subject><subject>Transluminal angioplasty</subject><subject>Treatment Outcome</subject><subject>University 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Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ahn, Jihun</au><au>Byeon, JinSu</au><au>Choi, Byoung Geol</au><au>Choi, Se Yeon</au><au>Byun, Jae Kyeong</au><au>Cha, Jinah</au><au>Yu, HyeYon</au><au>Lee, Cheolho</au><au>Na, Jin Oh</au><au>Choi, Cheol Ung</au><au>Kim, Eung Ju</au><au>Park, Chang Gyu</au><au>Seo, Hong Seog</au><au>Choi, Woong-Gil</au><au>Rha, Seung-Woon</au><au>Paul, Timir</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Stenting versus balloon angioplasty alone in patients with below-the-knee disease: A propensity score-matched analysis</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2021-06-10</date><risdate>2021</risdate><volume>16</volume><issue>6</issue><spage>e0251755</spage><pages>e0251755-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Percutaneous transluminal angioplasty (PTA) is considered an effective treatment in patients with critical limb ischemia (CLI). However, the long-term durability of below-the-knee (BTK) PTA is known to be limited. This study sought to compare the 1-year clinical outcomes following stenting versus balloon angioplasty alone in BTK lesions. This study included 357 consecutive patients (400 limbs, 697 lesions) with BTK lesions who underwent PTA from September 2010 to December 2016. All enrolled patients were treated either by stenting (stent group; 111 limbs of 102 patients) or plain old balloon angioplasty (POBA group; 289 limbs of 255 patients). Stent group includes both primary and provisional stenting. Angiographic outcomes, procedural success, complications, and clinical outcomes were compared between the two groups up to 1 year. After propensity score matching (PSM) analysis, 56 pairs were generated, and the baseline and angiographic characteristics were balanced. The procedural success and complications were similar between the two groups; however, the incidence of procedure-related perforation was higher in the POBA group than in the stenting group [5(11.9%) vs.1 (0.9%), P = 0.009]. Six- to 9-month computed tomography or angiographic follow-up showed similar incidences of binary restenosis, primary patency, and secondary patency. In the 1-year clinical follow-up, there were similar incidences of individual hard endpoints, including mortality, myocardial infarction, limb salvage, and amputation rate, with the exception of target extremity revascularization (TER), which tended to be higher in the stenting group than in the POBA group [21 (20.8%) vs. 11 (10.9%), P = 0.054]. Although there was a trend toward a higher incidence of TER risk in the stenting group, stent implantation, particularly in bail-out stenting seemed to have acceptable 1-year safety and efficacy compared to POBA alone in patients undergoing BTK PTA.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>34111147</pmid><doi>10.1371/journal.pone.0251755</doi><tpages>e0251755</tpages><orcidid>https://orcid.org/0000-0001-9456-9852</orcidid><orcidid>https://orcid.org/0000-0002-4706-2298</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-06, Vol.16 (6), p.e0251755 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2539882986 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Accumulation Aged Aged, 80 and over Amputation Angioplasty Angioplasty, Balloon - methods Balloon treatment Biology and Life Sciences Cardiovascular system Care and treatment Clinical trials Comparative studies Complications and side effects Diseases Drug delivery Female Heart attacks Hospitals Humans Implantation Implants Ischemia Ischemia - therapy Knee Lesions Male Medical equipment Medical imaging Medicine Medicine and Health Sciences Middle Aged Patient outcomes Patients Peripheral Arterial Disease - therapy Propensity Score Research and Analysis Methods Retrospective Studies Statistical analysis Stent (Surgery) Stents Surgery Surgical implants Transluminal angioplasty Treatment Outcome University graduates |
| title | Stenting versus balloon angioplasty alone in patients with below-the-knee disease: A propensity score-matched analysis |
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