Peripheral Artery Stent Thrombosis: Report From the Excellence in Peripheral Artery Disease (Xlpad) Registry

Banerjee, Subhash; Sarode, Karan; Mohammad, Atif; Gigliotti, Osvaldo; Luna, Michael; Addo, Tayo; Baig, Mirza Barjees; Tsai, Shirling; Shammas, Nicolas W.; Prasad, Anand; Abu‐Fadel, Mazen; Klein, Andrew J.; Brilakis, Emmanouil S.

doi:10.1016/s0735-1097(15)61696-5

Cited by 36 publications

(56 citation statements)

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“…In a retrospective registry, 27 limbs were treated for ISR (average length 215 mm, 78% TASC D), with 63% of limbs remaining free of restenosis (mean follow‐up of 22 months) . Stent thrombosis resulting in acute limb ischemia occurs more frequently following covered stent‐grafts compared to BMS; covered stent oversizing, loss of collaterals and edge restenosis have been implicated as the contributing factors to stent graft failure . The concerns regarding stent thrombosis and acute limb ischemia as the failure mode for covered stents have resulted in limited utilization of these devices as first‐line definitive therapy for most de novo FP lesions (Table ).…”

Section: Methodsmentioning

confidence: 99%

SCAI consensus guidelines for device selection in femoral‐popliteal arterial interventions

Feldman

Armstrong

Aronow

et al. 2018

Cathet Cardio Intervent

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136

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Section: Methodsmentioning

confidence: 99%

SCAI consensus guidelines for device selection in femoral‐popliteal arterial interventions

Feldman

Armstrong

Aronow

et al. 2018

Cathet Cardio Intervent

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136

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“…The XLPAD registry catalogs procedural information and outcomes of consecutive infrainguinal peripheral artery interventions performed at 15 centers in the United States. Details of this registry have previously been published . All 1906 patients in the registry were screened.…”

Section: Methodsmentioning

confidence: 99%

“…Vessel or stent thrombosis were adjudicated based on angiographic appearance and procedural findings that included presentation, crossing strategy, aspiration of thrombotic material, and/or the presence of embolic debris …”

Section: Methodsmentioning

confidence: 99%

Atherectomy in below‐the‐knee endovascular interventions: One‐year outcomes from the XLPAD registry

Khalili

Jeon–Slaughter

Armstrong

et al. 2018

Cathet Cardio Intervent

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Background Use of atherectomy for the treatment of peripheral arterial disease (PAD) is increasing as an adjunctive treatment to either conventional or drug‐coated balloon angioplasty. There is limited data on atherectomy outcomes in below‐the‐knee (BTK) endovascular interventions. Methods Data from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry (NCT01904851) were analyzed to examine predictors of atherectomy use and its associated 1‐year patency rate. We analyzed 518 BTK procedures performed between January 2005 and December 2016. Results Overall a total of 518 BTK procedures were treated in 430 patients, and 43% of interventions used atherectomy. African American patients were less likely (13% vs 25%; |standard residual| = 3.41) to be treated with atherectomy. Use of atherectomy was lower in chronic total occlusive (CTO) lesions (48% vs 58%; P = 0.02). There were no significant associations of baseline comorbidities, critical limb ischemia (CLI), ankle‐brachial index, number of BTK vessel run‐off, or vessel location with atherectomy use. Compared with patients without atherectomy, use of atherectomy was associated with lower incidence of repeat target limb intervention at 1 year after adjusting for age, CLI, in‐stent restenosis, heavy calcification, presence of diffuse disease, and CTO lesion traits (Hazard Ratio 0.41, 95% confidence interval 0.23‐0.72; P < 0.01). Conclusions Compared with no atherectomy, use of atherectomy in BTK interventions is associated with lower rates of 1‐year repeat target limb revascularization. These findings require confirmation in prospective, randomized clinical studies.

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“…Stent thrombosis is a serious complication next to percutaneous coronary intervention (PCI) in patients with acute coronary syndrome and endovascular intervention in patients with peripheral artery disease [1][2][3]. To prevent the stent thrombosis after PCI, dual antiplatelet therapy is recommended by the guideline and widely used as a standard of care [4].…”

Section: Introductionmentioning

confidence: 99%

“…To prevent the stent thrombosis after PCI, dual antiplatelet therapy is recommended by the guideline and widely used as a standard of care [4]. As a result, the rate of stent thrombosis is significantly reduced; however, the definite stent thrombosis still occurred 0.8 or 1.4% in patients receiving drug eluting stents after PCI [1,2] and 3.5% after femoropopliteal stent implantation [3]. Thus, the additional antithrombotic therapy might be warranted without increasing bleeding complications.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Stent Thrombosis in Rats by a Direct Oral Factor Xa Inhibitor Edoxaban

2018

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Background/Aims: Stent thrombosis is a serious complication after percutaneous coronary intervention and femoropopliteal endovascular intervention. The aim of this study was to determine the antithrombotic effects of a direct factor Xa inhibitor edoxaban alone or in combination with antiplatelet agents in a rat model of stent thrombosis. Methods: Stainless steel stents (4 stents per rat) were placed in an extracorporeal arteriovenous shunt. The shunt was inserted into the carotid artery and the jugular vein in each rat to circulate blood. Stent thrombosis was induced by exposing the stents to arterial blood for 30 min. Protein content of the thrombus was measured. Edoxaban and antiplatelet agents (aspirin, clopidogrel, and ticagrelor) were orally administered before the thrombus induction. Results: Edoxaban (0.3–3 mg/kg), clopidogrel (1–10 mg/kg), aspirin (10–100 mg/kg), and ticagrelor (0.3–3 mg/kg) exerted significant and dose-dependent antithrombotic effects in a rat stent thrombosis model. The effect of edoxaban was comparable to that of antiplatelet agents. The combination of submaximal doses of edoxaban and clopidogrel or aspirin significantly potentiated the antithrombotic effects compared with antiplatelet agents alone. Conclusion: These results suggest that edoxaban alone and in combination with clopidogrel or aspirin are promising antithrombotic therapies for the prevention of stent thrombosis.

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Peripheral Artery Stent Thrombosis: Report From the Excellence in Peripheral Artery Disease (Xlpad) Registry

Cited by 36 publications

References 0 publications

SCAI consensus guidelines for device selection in femoral‐popliteal arterial interventions

SCAI consensus guidelines for device selection in femoral‐popliteal arterial interventions

Atherectomy in below‐the‐knee endovascular interventions: One‐year outcomes from the XLPAD registry

Prevention of Stent Thrombosis in Rats by a Direct Oral Factor Xa Inhibitor Edoxaban

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