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Percutaneous vascular stenting reduces amputations, complications

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SAN DIEGO — In an analysis of more than 88,000 lower-extremity peripheral vascular interventions performed within a 6-year period, percutaneous vascular stenting was associated with decreased rates of amputation and postprocedural complications compared with angioplasty alone.

Shilpkumar Arora, MD, from St. Luke’s Medical Center, New York, and colleagues evaluated the efficacy of lower-extremity vascular stenting using the Nationwide Inpatient Sample database, which is designed to reflect a 20% sample of community hospitals in the United States. The researchers used procedure codes for bare-metal and drug-eluting stents and angioplasty to analyze 88,324 lower-extremity vascular interventions performed from 2006 to 2011 among adult patients (54.8% male; 59% white).

The primary outcome was in-hospital mortality. The secondary outcome was a composite of mortality and postprocedural complications. Amputation was also assessed as a separate outcome. The data were reported at the Society for Cardiovascular Angiography and Interventions Scientific Sessions.

Fifty-two percent of patients received BMS and less than 2% received DES. Utilization of BMS and DES was associated with a significant reduction in amputations compared with angioplasty alone (7.3% for BMS and 8.1% for DES vs. 13.6% for angioplasty; P < .001). Stenting was also associated with a lower rate of mortality/postprocedural complications (OR = 0.89; 95% CI, 0.83-0.96 for DES and OR = 0.88; 95% CI, 0.86-0.89 for BMS). The researchers did not observe a link between stenting and in-hospital mortality.

“This analysis is important because it provides data regarding the clinical efficacy of vascular stenting in lower-extremity vascular interventions from a large, unrestricted and real-world population sample,” Arora said in a press release. – by Katie Kalvaitis

Reference:

Arora S, et al. Best of the Best Abstracts. Presented at: Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 6-9, 2015; San Diego.

Disclosure: Arora reports no relevant financial disclosures.