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Pan J, Guo L, Fang X, Feng Z, Li Q, He C, Sang H, Shi W, Shi Z, Wang B, Qiu C, Wu Z, Ye M. Protocol of the evolution study: A prospective, multicenter, observational study evaluating the effect and health economics of endovascular treatment in patients with moderate and severe calcification of femoropopliteal artery. Front Cardiovasc Med 2022; 9:1039313. [PMID: 36330013 PMCID: PMC9622936 DOI: 10.3389/fcvm.2022.1039313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/04/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives Peripheral artery disease with calcification is extremely prevalent in the elderly. Due to the calcification, it requires a different clinical approach than the more common arteriosclerosis obliterans of the lower extremity. The introduction of novel technologies such as the drug-coated balloon, directional atherectomy, supera and drug-eluting stent has improved the prognosis of these patients. This study will contribute to the development of higher-quality evidence-based medicine for clinical treatment by assessing the quality of life (QOL), clinical treatment effect, and health economics of patients with calcification. Method and analysis The Evolution study is designed as a prospective, multicenter, observational, real-world study. From January 2021 to December 2022, 600 patients with moderate to severe femoropopliteal artery calcification will be recruited from ten locations in China. After discharge, information on demographics, disease history, procedure details, imaging findings, and follow-up will be collected. Patients will undergo follow-up at 1, 6, 12, 18, and 24 months after operation. Technical success rate, vascular quality of life questionnaire, primary patency rate of the target lesion, clinically driven target lesion revascularization rate (CD-TLR), and health economics evaluation are all included as outcome measures. Conclusions The Evolution study helps to investigate the clinical and financial results of various endovascular therapy modalities for patients with moderate and severe femoropopliteal artery calcification. These actual facts may help to harmonize therapy recommendations for peripheral artery disease. Clinical trial registration The study protocol was registered at www.clinicaltrials.gov (registration number: NCT04716361).
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Affiliation(s)
- Jun Pan
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lianrui Guo
- Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing, China
| | - Xin Fang
- Department of Vascular Surgery, Affiliated Hangzhou First People's Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zibo Feng
- Department of Vascular Surgery, Liyuan Hospital Affiliated Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Qiang Li
- Department of Vascular Surgery, Qingdao Haici Hospital Affiliated to Qingdao University, Qingdao, China
| | - Chunshui He
- Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongfei Sang
- Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Weihao Shi
- Department of Vascular Surgery, School of Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenyu Shi
- Department of Vascular Surgery, School of Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Bing Wang
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Chenyang Qiu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ziheng Wu
- Department of Vascular Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- *Correspondence: Ziheng Wu
| | - Meng Ye
- Department of Vascular Surgery, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Shanghai, China
- Meng Ye
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Starodubtsev V, Karpenko A, Lenko E, Ignatenko P. Better treatment option in chronic superficial femoral artery occlusive disease: comparison of methods (meta-analysis). J Cardiovasc Thorac Res 2019; 11:224-229. [PMID: 31579463 PMCID: PMC6759610 DOI: 10.15171/jcvtr.2019.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Accepted: 07/19/2019] [Indexed: 11/09/2022] Open
Abstract
Introduction: The objective is to evaluate the frequency of primary obstruction events (PrO) during one-year follow-up after performing excisional atherectomy with the SilverHawk/TurboHawk atherectomy device (S/TH) or remote superficial femoral artery endarterectomy (RSFAE) in patients with the chronic superficial femoral artery occlusive disease (СSFAOD).
Methods: We included all randomized clinical trials (RCTs) and not-RCTs concerning the treatment of patients with СSFAOD after S/TH and RSFAE without duration.
Results: Twenty-nine items (1990-2017) were discovered; 27 articles on the levels of evidence were included in qualitative synthesis; 9 studies (meta-analysis) were included in quantitative synthesis. The results of 2762 patients’ treatment were summed up in our analysis (1422 patients S/TH; 1340 patients RSFAE). All included reports were at low risk of bias. According to the criterion "frequency of PrO" during one-year follow-up, the pooled Hazard Ratios indicate significant favours of S/TH if compared it with RSFAE (HR= 0.66 (0.57 to 0.76, P < 0.00001), I2 = 9%).
Conclusion: Our study showed that S/TH with the SpiderFX device (distal embolic protection) are safe and effective treatment option for short lesion (<15 cm) in patients with СSFAOD. The usage of S/TH methods significantly reduced number of PrO if compared it with RSFAE. In long-segment lesion (>15 cm) in patients with СSFAOD, RSFAE may be considered better than an endovascular procedure. But still it is necessary to conduct well-planned randomized studies to determine effectiveness and safety of the compared methods (S/TH and RSFAE) in patients with long-segment lesion (>15 cm).
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Affiliation(s)
- Vladimir Starodubtsev
- Siberian Federal Biomedical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russian Federation
| | - Andrey Karpenko
- Siberian Federal Biomedical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russian Federation
| | - Evgeniy Lenko
- Siberian Federal Biomedical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russian Federation
| | - Pavel Ignatenko
- Siberian Federal Biomedical Research Center, Ministry for Public Health Care of Russian Federation, Novosibirsk, Russian Federation
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Hall TC, Habib S. A Novel Intervention to Treat Failed Angio-Seal Footplate Deployment: Two Case Series. CLINICAL MEDICINE INSIGHTS-CASE REPORTS 2019; 12:1179547619828714. [PMID: 30792582 PMCID: PMC6376524 DOI: 10.1177/1179547619828714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 01/14/2019] [Indexed: 11/15/2022]
Abstract
Introduction Vascular closure devices are commonly used to achieve rapid haemostasis and early ambulation following arterial puncture for endovascular procedures. Although device failure rates are low, the consequences of arterial occlusion include severe limb ischaemia. We describe a novel endovascular technique for the treatment of Angio-Seal arterial closure device (Terumo, Europe NV) failure causing femoral artery occlusion. Materials and methods We describe 2 cases of lower limb angioplasty performed for critical limb ischaemia where the access site was closed using an Angio-Seal according to the manufacturer instructions for use (IFU). In both cases, however, ultrasound could not be used during deployment of the Angio-Seal due to body habitus and small subcutaneous haematoma. In both cases, the device failed and occluded the femoral artery. Results Access was achieved via a retrograde approach from the contralateral limb in one case and a retrograde approach from the ipsilateral profunda artery in the other case. Angiography confirmed that the footplate of the Angio-Seal had occluded the femoral artery. Subsequently, the occlusion was crossed and a short balloon-mounted bare metal stent placed to push the footplate against the arterial wall that resulted in resolution of the occlusion and haemorrhage control. Conclusions Crossing the occlusion caused by failure of the Angio-Seal closure device and subsequent stenting resulted in satisfactory relief of the femoral artery occlusion and haemostasis without the added risks of open surgical revascularisation and general anaesthetic.
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Affiliation(s)
- Thomas C Hall
- Department of Radiology, Queen's Medical Centre (QMC), Nottingham University Hospitals NHS Trust, Nottingham, UK
| | - Said Habib
- Department of Radiology, Queen's Medical Centre (QMC), Nottingham University Hospitals NHS Trust, Nottingham, UK
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