Cardiovascular and interventional radiology · 2026
Endovascular Therapy for Femoropopliteal Artery Lesions Involving the Popliteal Artery: 1-Year Outcomes from a Real-World Multicenter Registry.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Li Leixin, Zhu Youpeng, Yang Wenbo, Du Ye, Song Qiong, Wang Tingyu, Wang Xinyuan, Li Chunbo, Chen Zhimin, Feng Zibo
Аннотация
PURPOSE: To evaluate real-world outcomes of endovascular treatment for femoropopliteal lesions involving the popliteal artery and, in a post-hoc exploratory analysis, assess whether anatomical location (P3 vs. P1/P2 segments) was associated with clinical decision-making and prognosis.
MATERIALS AND METHODS: We conducted a retrospective, post-hoc analysis of 946 patients from the prospective PROMISING registry. For this exploratory analysis, patients were stratified according to distal (P3) versus proximal/mid (P1/P2) popliteal artery involvement. Predictors of stent implantation and clinical decision pathways were compared across groups.
RESULTS: Overall procedural success was 98.5%, and the 12-month freedom from major adverse events (MAE), defined as a composite of all-cause mortality, major amputation, or clinically driven target lesion revascularization, was 80.1%. Multivariable analysis indicated P3 involvement independently predicted reduced stent implantation (OR 0.66, 95% CI 0.46-0.95, p = 0.027). For vessel preparation, the P3 group more frequently utilized plain old balloon angioplasty (POBA, 67.8% vs. 54.8%, p < 0.001) rather than directional atherectomy or specialty balloons. Despite a lower stent implantation rate and greater use of POBA, 12-month freedom from MAE was comparable between the P3 and P1/P2 groups (78.0% vs. 81.2%, p = 0.481).
CONCLUSION: In this post-hoc analysis of real-world registry data, popliteal lesion location was associated with differences in operator treatment strategies. P3 involvement was associated with less frequent stent implantation and greater use of plain balloon angioplasty, while 1-year clinical outcomes were comparable between the P3 and P1/P2 groups. These exploratory findings require external validation before they can be used to inform clinical treatment strategies.
TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04826705 (Registered on March 29, 2021).
MATERIALS AND METHODS: We conducted a retrospective, post-hoc analysis of 946 patients from the prospective PROMISING registry. For this exploratory analysis, patients were stratified according to distal (P3) versus proximal/mid (P1/P2) popliteal artery involvement. Predictors of stent implantation and clinical decision pathways were compared across groups.
RESULTS: Overall procedural success was 98.5%, and the 12-month freedom from major adverse events (MAE), defined as a composite of all-cause mortality, major amputation, or clinically driven target lesion revascularization, was 80.1%. Multivariable analysis indicated P3 involvement independently predicted reduced stent implantation (OR 0.66, 95% CI 0.46-0.95, p = 0.027). For vessel preparation, the P3 group more frequently utilized plain old balloon angioplasty (POBA, 67.8% vs. 54.8%, p < 0.001) rather than directional atherectomy or specialty balloons. Despite a lower stent implantation rate and greater use of POBA, 12-month freedom from MAE was comparable between the P3 and P1/P2 groups (78.0% vs. 81.2%, p = 0.481).
CONCLUSION: In this post-hoc analysis of real-world registry data, popliteal lesion location was associated with differences in operator treatment strategies. P3 involvement was associated with less frequent stent implantation and greater use of plain balloon angioplasty, while 1-year clinical outcomes were comparable between the P3 and P1/P2 groups. These exploratory findings require external validation before they can be used to inform clinical treatment strategies.
TRIAL REGISTRATION: ClinicalTrials.gov identifier NCT04826705 (Registered on March 29, 2021).