This big analysis shows rapid absorption of paclitaxel coated devices for PCI in femoropopliteal territory, which reassures us about its alleged association to increased mortality. In fact, survival, amputation-free survival and cardiovascular events rate resulted better with paclitaxel coated devices in the treatment of chronic limb ischemia.
This study emphasizes the difference that might exist between a population in the “real world” (such as the population in this study) and that of randomized studies.
Patients were divided into chronic limb ischemia vs. intermittent claudication and in paclitaxel coated balloons vs. paclitaxel coated stents. In each group, paclitaxel coated devices were compared against conventional devices. Propensity score was used to match population baseline characteristics.
37914 patients of mean 73 years old were included between the years 2010 and 2018. The annual proportion of paclitaxel coated devices increased from 3% to 39% during said period in patients with chronic limb ischemia and from 4% to 48% in patients with intermittent claudication (p<0.001 for both).
Read also: Safety of Paclitaxel-Coated Balloons in Peripheral Vascular Disease.
Both paclitaxel coated balloons and stents were associated with better survival (HR=0.83, CI 95% 0.77 to 0.90), better amputation-free survival (HR=0.85, CI 95% 0.78 to 0.91) and fewer major cardiovascular events (HR 0.82, CI 95% 0.77 to 0.89) vs conventional devices in patients with chronic limb ischemia.
In the group of patients with intermittent claudication, mortality also resulted lower, both in patients receiving paclitaxel coated balloons, stents, or a combination of both, compared against conventional devices.
Conclusion
In contrast to that previously observed in some randomized studies, in this cohort there was no increase in mortality.
Título original: Long Term Survival after Femoropopliteal Artery Revascularisation with Paclitaxel Coated Devices: A Propensity Score Matched Cohort Analysis.
Referencia: Christian-Alexander Behrendt et al. Eur J Vasc Endovasc Surg, article in press.
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