The role of femoropopliteal calcification pattern on outcomes after endovascular treatment of patients with peripheral arterial disease
DOI:
https://doi.org/10.48750/acv.643Keywords:
Peripheral artery disease, calcification, endovascular, femoropopliteal, angioplastyAbstract
INTRODUCTION: Peripheral arterial calcification is typically most prominent in the femoropopliteal (FP) segment, and its effect on endovascular treatment (EVT) processes and outcomes is poorly understood. This study aimed to evaluate the impact of the pattern of FP calcification on EVT outcomes.METHODS: We designed a retrospective, single-center, comparative study. From January 2023 to February 2024, all patients with peripheral arterial disease who underwent EVT by a single operator as a first limb revascularization procedure for FP lesions only were considered. The calcification pattern was assessed through a qualitative fluoroscopic and angiographic evaluation. According to the degree of calcification, the patients were grouped into mild to moderate calcification (MC) and severe calcification (SC). Both groups were compared regarding the primary endpoints: reintervention rates, amputation and overall survival.
RESULTS: The study included 45 patients, of which 8 (18%) presented with intermittent claudication and 37 (82%) with chronic limb threatening ischemia. The median time of follow-up was 7 months. The MC group included 71% of the patients and the SV group included 29%. The median femoropopliteal GLASS classification was 4 in both groups. No statistically significant differences were found between groups in rates of reintervention (p=0.97), amputation (p=0.86) and overall survival (p=0.45). There were two major amputations in the MC group and one in SV group after eleven months of follow-up. Higher rates of subintimal angioplasty (38% vs. 12%, p=0.048) and contralateral retrograde access (54% vs. 22%, p=0.03) were found in the SC group.
CONCLUSIONS: In our cohort, highly calcified FP lesions were statistically related to contralateral retrograde access and subintimal cross-lesion pathway. However, the degree of calcification did not influence the most relevant clinical outcomes.
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References
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