{"title":"Prognostic value of biomarkers of ischaemia in patients with peripheral arterial disease following endovascular revascularisation.","authors":"Nika Dobrilovič, Nuša Gerbec, Kevin Pelicon, Klemen Petek, Aleš Blinc, Vinko Boc, Borut Jug, Mojca Božič Mijovski, Joško Osredkar, Nataša Kejžar, Anja Boc","doi":"10.1024/0301-1526/a001170","DOIUrl":"10.1024/0301-1526/a001170","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Our aim was to evaluate the prognostic value of detectable high-sensitivity cardiac troponin I (hs-cTnI) and ischaemia-modified albumin (IMA) in predicting all-cause death or non-fatal ischaemic events in patients with PAD after endovascular revascularisation of the lower limbs. <i>Patients and methods:</i> Patients who underwent successful endovascular revascularisation for chronic limb-threatening ischaemia (CLTI) or disabling intermittent claudication (IC) were prospectively included. Pre-procedural levels of hs-cTnI and IMA were measured, and patients were followed for one year for the occurrence of the composite outcome of all-cause death, non-fatal myocardial infarction, new-onset angina, non-fatal ischaemic stroke, transient ischaemic attack, or progression of PAD. Outcomes were evaluated using survival analyses. <i>Results:</i> A total of 487 patients concluded the study, of whom 175 (35.9%) experienced the composite outcome. When considering only the clinical presentation of PAD and biomarker values, in patients with CLTI, hs-cTnI above the limit of detection (LoD) conferred an increased risk of the composite outcome compared to hs-cTnI below the LoD (p=0.004), while for IMA we found no significant difference. Outcomes of patients with CLTI and hs-cTnI or IMA below the LoD did not differ from those of patients with IC (p=0.07 and p=0.462, respectively). When adjusting for clinical characteristics and common cardiovascular risk factors in multivariate Cox survival analysis, neither biomarker improved prognostic performance, however IMA emerged as an independent predictor of the composite outcome in patients with CLTI. <i>Conclusions:</i> In patients with PAD who underwent successful endovascular procedure, neither IMA nor hs-cTnI improved risk stratification beyond clinical determinants. However, detection of IMA was an independent predictor of major cardiovascular events or death in patients with CLTI.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"106-112"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Marek Kaszuba, Jolanta Kościelniak, Agnieszka Śliwka, Rafał Piliński, Grażyna Bochenek, Paweł Maga, Roman Nowobilski
{"title":"The prevalence of chronic obstructive pulmonary disease in hospitalized tobacco smokers with peripheral artery disease.","authors":"Marek Kaszuba, Jolanta Kościelniak, Agnieszka Śliwka, Rafał Piliński, Grażyna Bochenek, Paweł Maga, Roman Nowobilski","doi":"10.1024/0301-1526/a001168","DOIUrl":"10.1024/0301-1526/a001168","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Peripheral artery disease (PAD) and chronic obstructive pulmonary disease (COPD) are inflammatory diseases. These two entities often co-exist, but little is known about the prevalence of this phenomenon in patients with PAD. The objectives of this prospective cross-sectional study were to determine the prevalence of COPD in patients with PAD and to assess the frequency of COPD underdiagnosis in this group of patients. <i>Patients and methods:</i> Consecutive patients admitted to angiology department were evaluated. Measurements of ankle-brachial and toe-brachial index as well as peripheral arteriography were performed in all participants to confirm PAD. In tobacco smokers with PAD spirometry was performed to identified patients with COPD. Clinical information was obtained from the patients on the basis of questionnaires. <i>Results:</i> Eighty-eight out of 300 consecutive patients were included and assessed. COPD was diagnosed in 33 (37.5%) hospitalized smokers with PAD. COPD has not previously been diagnosed in 28 (84.8%) patients who met the criteria of the disease. <i>Conclusions:</i> There was high prevalence of COPD among tobacco smokers hospitalized in the angiology department. Most of them had never had spirometry performed before. The underdiagnosis rate is relatively high; therefore, all patients with PAD who smoke tobacco should have a spirometry performed, as a screening for COPD.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"91-98"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143011308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joerg Herold, Nikolaos Dagkonakis, E Sebastian Debus, Ursula Rauch-Kröhnert, Uwe Zeymer, Rupert M Bauersachs
{"title":"Dual pathway inhibition in patients with peripheral artery disease in Germany.","authors":"Joerg Herold, Nikolaos Dagkonakis, E Sebastian Debus, Ursula Rauch-Kröhnert, Uwe Zeymer, Rupert M Bauersachs","doi":"10.1024/0301-1526/a001174","DOIUrl":"10.1024/0301-1526/a001174","url":null,"abstract":"<p><p><b></b> <i>Background</i>: Dual-pathway inhibition (DPI) with aspirin and rivaroxaban exhibited a net clinical benefit for patients with cardiovascular disease in the randomized COMPASS trial. The non-observational, international XATOA registry showed that the COMPASS results can be reproduced in clinical practice in patients with coronary artery disease (CAD) and peripheral artery disease (PAD). Here we report patient characteristics and clinical outcomes for the subgroup of German PAD patients of the XATOA registry and compare them to COMPASS PAD patients. <i>Patients and methods</i>: XATOA was an international prospective registry of patients receiving DPI with a mean follow-up period of 15 months. The subgroup of German patients with PAD in XATOA comprised 1,819 patients, of which 925 patients (50.9%) had only PAD and 894 patients (49.1%) had both CAD and PAD. Patient characteristics such as prior medical history and prior medications as well as clinical outcomes such as incidences of major adverse limb events (MALE), major adverse cardiovascular events (MACE) and major bleeding events were assessed. <i>Results:</i> DPI was well-tolerated in clinical practice. Patient characteristics and clinical outcomes especially for patients with only PAD differed from characteristics and outcomes of the overall German XATOA population as well as the PAD subgroup of COMPASS. Patients with only PAD were markedly less supplied with lipid-lowering agents and betablockers. Incidences of MALE were high in German PAD patients of XATOA (9.0%) and markedly higher than in the PAD subgroup of COMPASS (1.2%). Incidences of MACE and major bleeding events were lower in German PAD patients of XATOA (MACE: 2.9%, major bleeding: 1.4%) than in PAD patients of COMPASS (MACE: 5.1%, major bleeding: 3.1%). <i>Conclusions</i>: DPI with rivaroxaban and aspirin is well-tolerated by PAD patients in German clinical practice. PAD patients in Germany exhibit different characteristics and show a different clinical outcome profile than PAD patients in COMPASS.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"142-149"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142955610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nasser Malyar, Christian-Alexander Behrendt, Christine Espinola-Klein, Gerd Grözinger, Holger Lawall, Robert Nechwatal, Christoph Ploenes, Ulrich Rother, Rezvan Ahmadi, Erika Baum, Hinrich Böhner, Gesine Dörr, Markus Dörr, Hartmut Görtz, Peter Huppert, Michael Jünger, Christoph Kalka, Hans Peter Lorenzen, Andreas Maier-Hasselmann, Oliver Müller, Monika Nothacker, Kilian Rittig, Arno Schmidt-Trucksäss, Emilia Stegemann, Markus Steinbauer, Tomislav Stojanovic, Christiane Tiefenbacher, Alexander Tzabazis, Mathias Wilhelmi
{"title":"S3-Leitlinie zur Diagnostik, Therapie und Nachsorge der peripheren arteriellen Verschlusskrankheit.","authors":"Nasser Malyar, Christian-Alexander Behrendt, Christine Espinola-Klein, Gerd Grözinger, Holger Lawall, Robert Nechwatal, Christoph Ploenes, Ulrich Rother, Rezvan Ahmadi, Erika Baum, Hinrich Böhner, Gesine Dörr, Markus Dörr, Hartmut Görtz, Peter Huppert, Michael Jünger, Christoph Kalka, Hans Peter Lorenzen, Andreas Maier-Hasselmann, Oliver Müller, Monika Nothacker, Kilian Rittig, Arno Schmidt-Trucksäss, Emilia Stegemann, Markus Steinbauer, Tomislav Stojanovic, Christiane Tiefenbacher, Alexander Tzabazis, Mathias Wilhelmi","doi":"10.1024/0301-1526/a001171","DOIUrl":"10.1024/0301-1526/a001171","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"54 S113","pages":"1-119"},"PeriodicalIF":2.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143493788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alkis Bontinis, Vangelis Bontinis, Argirios Giannopoulos, Ioannis Kontes, Vasiliki Manaki, Apostolos G Pitoulias, Angeliki Chorti, Kiriakos Ktenidis
{"title":"The routine use of Rivaroxaban as thromboprophylaxis following endovenous thermal ablation.","authors":"Alkis Bontinis, Vangelis Bontinis, Argirios Giannopoulos, Ioannis Kontes, Vasiliki Manaki, Apostolos G Pitoulias, Angeliki Chorti, Kiriakos Ktenidis","doi":"10.1024/0301-1526/a001182","DOIUrl":"https://doi.org/10.1024/0301-1526/a001182","url":null,"abstract":"<p><p><b></b> <i>Background:</i> We investigated the safety and efficacy of rivaroxaban as routine thromboprophylaxis after endovenous thermal ablation (EVTA). <i>Patients and methods:</i> Adhering to the PRISMA 2020 guidelines, we conducted a systematic review for studies published up to April 2024. Primary endpoints included endovenous heat-induced thrombosis (EHIT) class ≥ II, deep vein thrombosis (DVT), major and minor bleeding and the composite endpoint of major thromboembolic complications including any incidents of EHIT ≥ III, DVT or pulmonary embolism (PE). <i>Results:</i> Eight retrospective case series, encompassing 1666 patients, and 2049 truncal veins were included. The pooled EHIT ≥ II, DVT, and major thromboembolic complications estimates were 0.73% (95% CI: 0.37-1.42), 0.51% (95% CI: 0.22-1.17) and 0.71% (95% CI: 0.27-1.89). The crude and pooled major and minor bleeding estimates were 0% (0/885) and 2.60% (95% CI: 1.05-6.33). The pooled early truncal and great saphenous vein (GSV) occlusion outcomes were 99.03% (95% CI: 96.88-99.70) and 98.74% (95% CI: 92.07-99.81). The pooled and crude superficial thrombophlebitis and PE estimates were 2.86% (95% CI: 0.88-8.89) and 0% (0/579). While the comparative analysis between rivaroxaban and low molecular weight heparins (LMWH)/fondaparinux displayed improved outcomes favouring rivaroxaban in terms of DVT, risk ratio (RR), 0.60 (95% CI: 0.12-3.07) and truncal occlusion, odds ratio (OR), 1.43 (95% CI: 0.31-6.55) outcomes did not reach statistical significance. Meta-regression analysis including rivaroxaban treatment durations spanning from three to ten days displayed a negative association between duration of treatment and both truncal, (β = -0.4740, p<0.01) and GSV, (β = -0.4583, p<0.01) occlusion in the early pos-operative period. <i>Conclusions:</i> The results of this review underscore the potential safety of rivaroxaban as thromboprophylaxis in the context of endovenous thermal ablation. The observed inverse relationship between anticoagulation duration and occlusion outcomes should be interpreted with caution, highlighting the need for further research.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
David Pinsdorf, Daniel Messiha, Ramtin Knuschke, Olga Petrikhovich, Julia Lortz, Rolf Alexander Jánosi, Tienush Rassaf, Christos Rammos
{"title":"Comparison of ultrasound-assisted thrombolysis and mechanical thrombectomy in intermediate-high-risk pulmonary embolism.","authors":"David Pinsdorf, Daniel Messiha, Ramtin Knuschke, Olga Petrikhovich, Julia Lortz, Rolf Alexander Jánosi, Tienush Rassaf, Christos Rammos","doi":"10.1024/0301-1526/a001180","DOIUrl":"https://doi.org/10.1024/0301-1526/a001180","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Pulmonary embolism (PE) can result in high mortality. Early risk stratification and treatment are critical for individualized management. In patients with intermediate-high-risk (IHR) PE, guidelines recommend to consider a percutaneous catheter-directed treatment (CDT). While different techniques are available, comparisons between treatments regarding right ventricular (RV) function and outcome are still scarce. This study aimed to compare changes in RV function as well as outcomes in patients with IHR PE after CDT with ultrasound-assisted thrombolysis (USAT) as compared to large-bore mechanical thrombectomy (MT). <i>Patients and methods:</i> This is a retrospective, single-center study in IHR PE, diagnosed in accordance with the ESC Guidelines. All patients underwent a CDT either with USAT (EKOS, Boston Scientific) or MT (FlowTriever System, Inari). Right heart function (RV/LV ratio, TAPSE) was assessed via transthoracic echocardiography before and after CDT as well as interventional characteristics and postinterventional hospital stay were compared. <i>Results:</i> From June 2022 to April 2024, 26 patients (35% female; aged 61.2±15.2 years) were diagnosed with IHR PE and underwent CDT. 14 patients (53.8%) were treated with USAT and 12 patients (46.2%) with MT. The mean procedural time was 40.4±19.8 minutes for USAT and 104±32.2 minutes for MT. RV/LV ratio was improved in both groups (change from baseline USAT -0.48±0.25; MT -0.36±0.13). TAPSE increased by 6.95±3.7 mm in USAT and by 9.8±4.6 mm in MT. Major bleeding (defined as BARC ≥ 3a) occurred only in three patients of the USAT group. The 90-day mortality rate was 0% in both groups. <i>Conclusions:</i> In patients with IHR PE both USAT and MT lead to an improved RV function without mortality within 90 days. Further randomized data have to discriminate the differential impact of novel tools for the treatment of IHR PE.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143068167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gabor Forgo, Riccardo Fumagalli, Silvia Cardi, Stefano Barco, Nils Kucher, Tim Sebastian
{"title":"Large-bore rotational thrombectomy and balloon angioplasty for thrombus fragmentation and removal from occluded iliofemoral or inferior vena cava stents.","authors":"Gabor Forgo, Riccardo Fumagalli, Silvia Cardi, Stefano Barco, Nils Kucher, Tim Sebastian","doi":"10.1024/0301-1526/a001176","DOIUrl":"https://doi.org/10.1024/0301-1526/a001176","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Although venous stent placement is an established treatment for patients with deep vein thrombosis (DVT) and post-thrombotic syndrome (PTS), stent patency rate may be as low as 80% at 12 months. Treatment of stent occlusion requires the removal of a large amount of fresh or organized thrombus from stents with a diameter of 12-20 mm. The feasibility of large-bore rotational thrombectomy in combination with angioplasty to treat thrombosed venous iliofemoral or inferior vena cava stents has not been investigated yet. <i>Patients and methods:</i> Between May 2023 and June 2024, 12 patients (15 limbs) with symptomatic venous stent occlusions were treated at our institution with the 10-French Rotarex™ thrombectomy device and completed 3-month follow-up by Duplex ultrasound. The primary outcome was primary patency at 90 days after thrombectomy of stent occlusion. Safety outcomes included device-related complications, bleeding, and death. <i>Results:</i> Median age was 41 years, 75% were women. At the index procedure, 10 (83%) patients presented with PTS and two (17%) with acute DVT. Median time from index procedure to re-intervention was 1125 (Q1-Q3: 897-2297) days and from symptom onset to re-intervention 39 (Q1-Q3: 8-186) days. Technical success of re-intervention was achieved in all cases, and bail-out stent-in-stent placement was not required in 5 (33%) limbs. The primary patency rate at 90 days was 86.7% (95% CI: 71.0-100.0). Two (17%) patients experienced recurrent stent thrombosis and were managed conservatively. Peri-interventional minor bleeding occurred in two (17%) patients. There were no device-related complications, major bleeding, or deaths. <i>Conclusions:</i> Large-bore rotational thrombectomy appears to be a feasible strategy to treat iliofemoral and inferior vena cava stent thrombosis, achieving acceptable short-term patency without major adverse events.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143012663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hans-Ulrich Kreider-Stempfle, Thomas Remp, Sibylle Puntscher, Uwe Siebert, Norah Kreider
{"title":"Comparison of endovascular infrapopliteal revascularisation strategies based on the angiosome model in diabetics with CLTI.","authors":"Hans-Ulrich Kreider-Stempfle, Thomas Remp, Sibylle Puntscher, Uwe Siebert, Norah Kreider","doi":"10.1024/0301-1526/a001153","DOIUrl":"10.1024/0301-1526/a001153","url":null,"abstract":"<p><p><b></b> <i>Background:</i> Infrapopliteal endovascular interventions (EVT) strategies in diabetic patients are still in debate because the lesions are more likely to be diffuse with a different pattern of collateral arteries ranging from reduced to normal caliber. The aim of this all-comers study was to analyse the outcome of two different infrapopliteal EVT strategies (Group I: angiosome-based direct revascularization - DR vs. Group II: complete (direct + indirect) revascularization strategy - CR) in diabetic patients with chronic limb-threatening ischemia (CLTI) in 2 time-periods. Furthermore we analysed the outcome if DR or CR failed and only indirect revascularization (IR) or no revascularization was possible. Both groups were differentiated in patients with collaterals, defined as an intact pedal arch (immediate or after pedal PTA). <i>Patients and methods:</i> The database includes 91 consecutive EVT with two intrapopliteal interventional strategies performed in 68 diabetic patients (pts. 24 female, 44 male, mean age 73±10 years) between 2013-2016 and 2017-2022. Positive clinical outcome was defined as wound healing with or w/o minor amputation, combined with a symptom improvement to Rutherford category 0 or 1 after 6 months. The clinical outcome proportions were compared using the Fisher's exact test. <i>Results:</i> Successful DR (59%) and successful CR (47%) strategy demonstrated a similar positive clinical outcome (92.6% vs. 90.5%; <i>p</i>=0.594). Indirect revascularization (Group I: 26%; Group II: 44%) showed a significantly lower positive outcome in comparison to a successful DR as well as CR strategy (33.3% vs. 92.6%, <i>p</i>=0.0003; 40% vs 90.5%, <i>p</i>=0.001). IR outcome improved by the presence of collaterals (66.7% vs. 30.8%). <i>Conclusions:</i> In case of successful intervention, both strategies (DR and CR) yielded a similarly high proportion of positive clinical outcome. The role of collaterals and the pedal arch on the clinical outcome are important in patients in whom only IR was possible.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"27-34"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Philipp Franke, Emmanuel Katsogridakis, Theodosios Bisdas, Athanasios Saratzis, Giovanni Torsello, Nikolaos Tsilimparis, Konstantinos Stavroulakis
{"title":"Impact of polypharmacy on patients undergoing revascularisation for peripheral arterial disease.","authors":"Philipp Franke, Emmanuel Katsogridakis, Theodosios Bisdas, Athanasios Saratzis, Giovanni Torsello, Nikolaos Tsilimparis, Konstantinos Stavroulakis","doi":"10.1024/0301-1526/a001164","DOIUrl":"10.1024/0301-1526/a001164","url":null,"abstract":"<p><p><b></b> <i>Background:</i> To evaluate the impact of polypharmacy, defined as the concurrent use of five or more medications, on the clinical outcomes of patients undergoing revascularisation for symptomatic peripheral arterial disease (PAD). <i>Patients and methods:</i> This is a retrospective analysis of consecutive PAD patients treated by surgical, endovascular or hybrid therapy in a tertiary center between January 2017 and December 2017. The composite of amputation and/or death (amputation-free survival; AFS) was the primary endpoint. Mortality, major limb amputation, risk for Major Cardio-Cerobro-vascular Events (MACCE) and re-intervention during follow-up were additionally analyzed. <i>Results:</i> A total of 560 patients (369 male, 66%) were included. Mean age was 72.43 ± 38.67, while the main indication for treatment was lifestyle limiting claudication (330 patients, 59%). Most patients (434, 78%) were treated with endovascular means, and the commonest anatomical site of intervention was the femoropopliteal arterial segment (449 patients, 80%). A total of 409 (73%) met the criteria for polypharmacy. Cox regression analysis showed that polypharmacy was an independent predictor of death (exp: 4.72, p=0.008), MACCE (exp: 2.82, p=0.001), re-intervention (exp 1.51, p=0.0016) and of the composite outcome of AFS (exp: 3.46, p=0.021) but not of major amputation (exp: 1.26, p=0.686). Propensity-score matching analysis showed that even when controlling for comorbidity and procedural characteristics, polypharmacy is associated with a higher risk of cardiovascular death (p<0.001), MACCE (p<0.001), and re-intervention (p=0.001). <i>Conclusions:</i> In this study, polypharmacy was associated with unfavourable clinical outcomes for patients undergoing revascularisation for symptomatic PAD, without influencing the risk for major limb amputation.</p>","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":" ","pages":"35-42"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Fantastic Plastic?","authors":"Mirko Vogler, Max Jonathan Stumpf, Norbert Weiss","doi":"10.1024/0301-1526/a001165","DOIUrl":"https://doi.org/10.1024/0301-1526/a001165","url":null,"abstract":"","PeriodicalId":23528,"journal":{"name":"Vasa-european Journal of Vascular Medicine","volume":"54 1","pages":"73"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}