Evidence mapPaperPMID 35403499Full record

ArticleJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists2023

Risk Factor Analysis for Crossing Failure in Primary Antegrade Wire-Catheter Approach for Femoropopliteal Chronic Total Occlusions.

Giulia Bernardini, Theodosios Bisdas, Angeliki Argyriou, Fadi Saab, Giovanni Torsello, Nikolaos Tsilimparis, Konstantinos Stavroulakis

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Article in Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.0field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 3 countries.

Giulia BernardiniDepartment of Vascular Surgery and Organ Transplant Unit, University Hospital of Catania, Catania, Italy.ORCID 0000-0002-8731-0954
Theodosios Bisdas3rd Department of Vascular Surgery, Athens Medical Center, Athens, Greece.
Angeliki ArgyriouClinic of Vascular Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany.ORCID 0000-0002-8075-9695
Fadi SaabAdvanced Cardiac and Vascular Centers for Amputation Prevention, Grand Rapids, MI, USA.
Giovanni TorselloClinic of Vascular Surgery, Marien Hospital Herne, Ruhr-University of Bochum, Herne, Germany.ORCID 0000-0001-7513-5063
Nikolaos TsilimparisDepartment of Vascular Surgery, Ludwig-Maximilians-University Hospital, Munich, Germany.
Konstantinos StavroulakisDepartment of Vascular Surgery, Ludwig-Maximilians-University Hospital, Munich, Germany.ORCID 0000-0002-9775-9210
Ludwig-Maximilians-Universität München · DEUniversitätsklinik Marien Hospital Herne · DEAthens Medical Center · GRUniversity of Catania · IT

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionAntegrade wire-catheter crossing remains the primary approach for femoropopliteal interventions. Nonetheless, data reporting on crossing failure are limited. Aim of this study is to identify risk factors for antegrade crossing failure in patients with femoropopliteal chronic total occlusions (CTOs).

methodsThis is a single-center, retrospective analysis. Patients with femoropopliteal CTOs treated between May 2018 and February 2020 were included into this study. Primary endpoint of this analysis was primary crossing success defined as successful antegrade crossing without the use of retrograde access, crossing or re-entry devices. The assisted crossing success was additionally analyzed. A logistic regression analysis identified risk factors for failed primary antegrade crossing.

resultsData from 300 patients were analyzed. The majority (n=183, 61%) presented with lifestyle limiting claudication. The mean lesion length was 180 mm [interquartile range (IQR) 100-260 mm], whereas the median CTO length was 100 mm (IQR=50-210 mm). A chronic total occlusion crossing approach based on plaque morphology (CTOP) type I configuration was observed in 9% (n=26) of the lesions, type II in 61% (n=183), type III in 8% (n=25), and type IV in 66 CTOs (n= 66, 22%). Severe calcification based on the Peripheral Arterial Calcium Scoring Scale (PACSS), Peripheral Academic Research Consortium (PARC), and 360° grading systems was identified in 17%, 24%, and 28% of the lesions, respectively. A contralateral femoral access was used in 278 cases (93%). The primary crossing success amounted to 70% (n=210). The use of a re-entry device in 28 patients (9%) or of a combined antegrade-retrograde approach in 11% (n=34) of the cases increased the assisted crossing success to 89% (n=267). The presence of calcification (odds ratio [OR]=4.2, 95% CI=1.7-10.2) or of circumferential calcium (OR=2.5, 95% CI=1.3-4.9), a CTOP class ΙΙΙ or ΙV (OR=1.9, 95% CI=1.4-2.6), a proximal superficial femoral artery (SFA) occlusion (OR=3.5, 95% CI=1.7-7.4) and a CTO at P3 (OR=4.1, 95% CI=1.5-10.8) were associated with an increased risk for antegrade crossing failure.

conclusionsIn this study, chronic total occlusions (CTO) morphology, calcification burden, and lesion's location were identified as independent risk factors for failed antegrade crossing. Nonetheless, the use of alternative crossing strategies significantly increased the overall crossing success.

Indexed as

Femoral ArteryPeripheral Arterial DiseaseCalciumCathetersChronic DiseaseHumansRetrospective StudiesRisk FactorsTreatment OutcomeCalciumchronic total occlusioncrossing techniquesfemoropopliteal segmentocclusive diseaseperipheral artery disease

Identifiers

PMID35403499
PMCPMC10209497
OpenAlexW4223480800

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.