Aortic & peripheral vascular disease
Outcomes of atherectomy in patients undergoing lower extremity revascularisation
Main finding · Major amputationResult — go to the resultAdjusted hazard ratio 0.67 95% CI 0.51–0.85Authors' conclusion
The use of atherectomy during PVI is common and is not associated with an increase in IH adverse events. Longitudinally, patients treated with atherectomy undergo repeat endovascular reintervention more frequently but experience a reduced risk of amputation and surgical revascularisation.
Study context
- Population
- Patients undergoing lower extremity peripheral vascular intervention (PVI), NCDR PVI Registry, 2014–20196,889 with out-of-hospital data
- Participants
- 30,847 patients
- Exposure
- PVI with atherectomy vs without atherectomy
- Atherectomyn = 10,971
- Outcome
- Major amputation
- Follow-up
- 1 year
Methodological detailsregistry-based
- Registry-based
Main finding
As reported in the abstract
Adjusted hazard ratio
0.67
95% CI 0.51–0.85
P < 0.01
Atherectomyvs Non-atherectomy
aHR 0.67 (95% CI 0.51–0.85); P < 0.01
Observational data: associations, not effects.
Secondary outcomes
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| Surgical revascularisation · 1 year | 0.63 (0.44–0.89) | P = 0.017 | |
| Endovascular revascularisation · 1 year | 1.21 (1.06–1.39) | P < 0.01 | |
| 0.512Adjusted hazard ratio (log scale) |
Death · 1 year
- No difference in death rates
- P = 0.10
Safety
IH composite (procedural complications, bleeding or thrombosis) · in-hospital · rates per procedure, unadjusted
- In-hospital (IH) composite (procedural complications, bleeding or thrombosis) — Unadjusted difference
- p=0.07
- IH composite (procedural complications, bleeding or thrombosis) — After adjustment, atherectomy not associated with increased risk
- p=0.68
Original publication
Outcomes of atherectomy in patients undergoing lower extremity revascularisation. EuroIntervention. Published 18 December 2023. doi:10.
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