Medizinische Universität Graz - Research portal
Selected Publication:
SHR Neuro Cancer Cardio Lipid Metab Microb
Schulte, KL; Pilger, E; Schellong, S; Tan, KT; Baumann, F; Langhoff, R; Torsello, G; Zeller, T; Amendt, K; Brodmann, M; EXPAND Investigators.
Primary Self-EXPANDing Nitinol Stenting vs Balloon Angioplasty With Optional Bailout Stenting for the Treatment of Infrapopliteal Artery Disease in Patients With Severe Intermittent Claudication or Critical Limb Ischemia (EXPAND Study).
J Endovasc Ther. 2015; 22(5):690-697
Doi: 10.1177/1526602815598955
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Brodmann Marianne
- Pilger Ernst
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- Abstract:
- To compare primary placement of a self-expanding nitinol stent to percutaneous transluminal angioplasty (PTA) with bailout stenting in infrapopliteal arteries of patients with severe intermittent claudication or critical limb ischemia (CLI). In the EXPAND trial (ClinicalTrials.gov; identifier NCT00906022), 92 patients (mean age 72.9±9.5 years; 62 men) undergoing treatment for infrapopliteal stenosis in 11 European centers were randomized 1:1 to either self-expanding nitinol stenting with the Astron Pulsar/Pulsar-18 nitinol stent or PTA with bailout stenting. The primary endpoint was sustainable clinical improvement after 12 months, defined as a ≥1-category increase for Rutherford category 3 patients or a ≥2-category increase for CLI patients (Rutherford categories 4/5) compared with baseline. Furthermore, target lesion revascularization (TLR), mortality, and amputation were assessed after 12 months. Sustained clinical improvement at 1 year was observed in 74.3% of the patients treated with primary stenting and in 68.6% of the patients treated with PTA and bailout stenting (p>0.05). Kaplan-Meier estimates of freedom from TLR (76.6% and 77.6%), mortality (7.4% vs 2.1%), and amputation [8.9% (major 6.7%) vs 13.2% (major 8.7%)] at 1 year were not significantly different. Primary self-expanding nitinol stenting did not show statistically different clinical outcomes compared to angioplasty with bailout stenting for infrapopliteal lesions. © The Author(s) 2015.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Aged, 80 and over -
- Alloys -
- Amputation -
- Angioplasty, Balloon - adverse effects
- Angioplasty, Balloon - instrumentation
- Angioplasty, Balloon - mortality
- Critical Illness -
- Disease Progression -
- Disease-Free Survival -
- Endovascular Procedures - adverse effects
- Endovascular Procedures - instrumentation
- Endovascular Procedures - mortality
- Europe -
- Female -
- Humans -
- Intermittent Claudication - diagnosis
- Intermittent Claudication - mortality
- Intermittent Claudication - physiopathology
- Intermittent Claudication - therapy
- Ischemia - diagnosis
- Ischemia - mortality
- Ischemia - physiopathology
- Ischemia - therapy
- Kaplan-Meier Estimate -
- Limb Salvage -
- Male -
- Middle Aged -
- Peripheral Arterial Disease - diagnosis
- Peripheral Arterial Disease - mortality
- Peripheral Arterial Disease - physiopathology
- Peripheral Arterial Disease - therapy
- Popliteal Artery - physiopathology
- Prospective Studies -
- Prosthesis Design -
- Recurrence -
- Risk Assessment -
- Risk Factors -
- Stents -
- Time Factors -
- Treatment Outcome -
- Vascular Patency -
- Find related publications in this database (Keywords)
- peripheral artery disease
- bailout stenting
- primary stenting
- infrapopliteal lesions
- nitinol stent
- self-expanding stent
- critical limb ischemia
- below-the-knee interventions
- mortality
- amputation
- target lesion revascularization