Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

Brodmann, Marianne; Rief, Peter; Froehlich, Harald; Dorr, Andreas; Tse, Gary; Eller, Philipp; Hafner, Franz; Deutschmann, Hannes; Seinost, Gerald; Pilger, Ernst

doi:10.1007/s00270-012-0479-9

Cited by 21 publications

(13 citation statements)

References 21 publications

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“…Currently, no consensus exists regarding the treatment of ISR lesions. 30 Targeted treatment of the mechanisms of restenosis is not yet available; therefore, unspecific adjunctive measures, such as cutting balloons, 31 excisional atherectomy, 32 excimer laser therapy, 33 stent grafts, 34 and drug-coated balloons, 35 have been applied to treat ISR. Nevertheless, modulation of factors that influence the vascular inflammatory reaction after stent implantation may become a key for the development of novel therapeutic approaches.…”

Section: Discussionmentioning

confidence: 99%

Six-month results of stenting of the femoropopliteal artery and predictive value of interleukin-6: Comparison with high-sensitivity C-reactive protein

et al. 2020

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Objectives To determine the association of pre- and postinterventional serum levels of interleukin-6 and high-sensitivity C-reactive protein at the six-month evaluation of restenosis after stenting of the femoropopliteal artery. Methods Sixty-eight consecutive patients with steno-occlusive femoropopliteal artery disease of Rutherford category III or IV who underwent stent implantation were included. Six-month patency was evaluated with color-coded duplex ultrasound. The association of in-stent restenosis with interleukin-6 and high-sensitivity C-reactive protein levels at baseline, and 24-h postintervention was assessed with a multivariate logistic regression analysis. Results In-stent restenosis was found in 15 patients (22.1%) within six months. Interleukin-6 and high-sensitivity C-reactive protein levels were significantly increased at 24-h postintervention compared to their preintervention values ( p < 0.001 and p = 0.002, respectively). Interleukin-6 values at baseline (odds ratio, 1.11; 95% confidence interval: 1.00, 1.23; p = 0.044) and 24-h postintervention (odds ratio, 1.04; 95% confidence interval: 1.02, 1.06; p < 0.001) were independently associated with six-month in-stent restenosis. Twenty-four-hour postinterventional high-sensitivity C-reactive protein levels were also found to be related to restenosis (odds ratio, 1.15; 95% confidence interval: 1.04, 1.26; p = 0.006), but high-sensitivity C-reactive protein levels at baseline did not show an independent association with in-stent restenosis (odds ratio, 0.57; 95% confidence interval: 0.35, 1.80; p = 0.667). Smoking, diabetes mellitus, and cumulative stent length were other parameters associated with an increased risk for in-stent restenosis. Conclusions Femoropopliteal artery angioplasty with stent placement induces an inflammatory response. Interleukin-6 is a powerful independent predictor of intermediate-term outcomes for stenting of the femoropopliteal artery, suggesting that its predictive value may be superior to that of high-sensitivity C-reactive protein.

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Section: Discussionmentioning

confidence: 99%

Six-month results of stenting of the femoropopliteal artery and predictive value of interleukin-6: Comparison with high-sensitivity C-reactive protein

et al. 2020

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“…The only RCT involving atherectomy, which utilized the SilverHawk™ (Covidien, Plymouth, MN) device in the femoropopliteal arterial territory, mandated 3-month DAPT. 20 Three RCTs studying cryoplasty in the femoropopliteal arteries required a minimum 2 months of DAPT. 9,21,22 Four RCTs studying use of BMS in the femoropopliteal arteries required DAPT duration varying between 1-3 months.…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Comparison of Dual-Antiplatelet Therapy Durations after Endovascular Revascularization of Infrainguinal Arteries

Sarode

Mohammad

Das

et al. 2015

Annals of Vascular Surgery

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“…Table 3 provides an overview of required DAPT durations specified within the design of RCT examining a myriad of devices available for endovascular revascularization. An RCT comparing atherectomy with PTA in femoropopliteal arteries required 3 months DAPT [46]. Cryoplasty was examined in two RCTs -both requiring a minimum of 2 months DAPT [47,48].…”

Section: Dual Antiplatelet Therapy For the Secondary Prevention Of Vamentioning

confidence: 99%

The role of antiplatelet therapy in patients with peripheral artery disease and lower extremity peripheral artery revascularization

Banerjee

Sarode

Vinas

et al. 2015

Current Opinion in Cardiology

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Eligible patients with symptomatic PAD or with a history of peripheral artery revascularization should be prescribed antiplatelet monotherapy for secondary prevention of both cardiovascular and limb events, using aspirin, clopidogrel, and/or vorapaxar. Given the significant overlap of PAD and coronary artery disease, the evidence presented in this article may have important implications for management of patients with coronary artery disease.

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Neointimal Hyperplasia after Silverhawk Atherectomy versus Percutaneous Transluminal Angioplasty (PTA) in Femoropopliteal Stent Reobstructions: A Controlled, Randomized Pilot Trial

Abstract: Although Silverhawk atherectomy provides good results at first sight, in the midterm follow-up of treatment of first instent restenosis it did not perform better than PTA as it showed elevated reoccurrence of intimal media hyperplasia.

Cited by 21 publications

References 21 publications

Six-month results of stenting of the femoropopliteal artery and predictive value of interleukin-6: Comparison with high-sensitivity C-reactive protein

Six-month results of stenting of the femoropopliteal artery and predictive value of interleukin-6: Comparison with high-sensitivity C-reactive protein

Comparison of Dual-Antiplatelet Therapy Durations after Endovascular Revascularization of Infrainguinal Arteries

The role of antiplatelet therapy in patients with peripheral artery disease and lower extremity peripheral artery revascularization

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