Paclitaxel-coated Devices Improve Outcomes in Patients Presenting With Chronic Limb-Threatening Ischemia

Paclitaxel (PTX)-coated devices decrease restenosis after femoropopliteal artery intervention. Recently, they have been linked to a potential increase in late mortality and amputation based on data of patients predominantly presenting with claudication. Outcome PTX chronic limb-threatening ischemia (CLTI) are unknown. The objective this study was compare outcome CLTI treated without PTX. Patients who underwent interventions for from January 2016 October 2020 (n = 35,533; 13,546 PTX) the Society Vascular Surgery Quality Initiative were reviewed. divided exposure propensity matched control differences symptoms, comorbidities, perioperative medications. After matching there 13,528 each cohort. Primary measures overall survival (OS), limb salvage, freedom target vessel revascularization (TVR), major adverse events (MALE) assessed using Kaplan-Meier analysis. no significant baseline characteristics. At 2-year follow-up, difference OS between no-PTX (81 vs 80%; P .07). A benefit observed treatment salvage (90% 87%; < .001) (Fig 1), MALE (73% 69%; 2), TVR (81% 78%; .001). Multivariable Cox regression analysis confirms that is associated improved (hazard ratio [HR], 0.76; 95% confidence interval [CI], 0.69-0.83; .001), (HR, 0.73; CI, 0.68-0.78; 0.72; 0.66-0.79; 0.95; 1.01-0.88; .11). 2 years, PTX-coated device demonstrated TVR, OS. This suggests use may be beneficial not as suggested by recent meta-analyses.Fig 2View Large Image Figure ViewerDownload Hi-res image Download (PPT)