Effects of atherectomy on major adverse limb events for femoropopliteal interventions: Vascular Quality Initiative registry

• Published in: Catheterization and cardiovascular interventions 2024-01, Vol.103 (1), p.106-114
• Main Authors: Effoe, Valery S., Mewissen, Mark W., Bajwa, Tanvir K., Khitha, Jayant, Kostopoulos, Louie, Ammar, Khawaja A., Nfor, Tonga K.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Amputation; Angioplasty, Balloon - adverse effects; atherectomy; Atherectomy - adverse effects; Balloon treatment; Femoral Artery - diagnostic imaging; femoropopliteal disease; Humans; major adverse limb events; Male; Males; Middle Aged; Patients; Peripheral Arterial Disease - diagnostic imaging; Peripheral Arterial Disease - therapy; peripheral intervention; Popliteal Artery - diagnostic imaging; Registries; Risk Factors; Treatment Outcome; Vascular Patency
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.30912

Background Atherectomy use in treatment of femoropopliteal disease has significantly increased despite scant evidence of benefit to long‐term clinical outcomes. Aims We investigated the clinical benefits of atherectomy over standard treatment for femoropopliteal interventions. Methods Using data from the Society of Vascular Surgery's Vascular Quality Initiative (VQI) registry, we identified patients who underwent isolated femoropopliteal interventions for occlusive disease. We compared 13,423 patients treated with atherectomy with 47,371 receiving standard treatment; both groups were allowed definitive treatment with a drug‐coated balloon or stenting. The primary endpoint was major adverse limb events (MALEs), which is a composite of target vessel re‐occlusion, ipsilateral major amputation, and target vessel revascularization. Results Mean age was 69 ± 11 years, and patients were followed for a median of 30 months. Overall rates of complications were slightly higher in the atherectomy group than the standard treatment group (6.2% vs. 5.9%, p