Document Detail


A prospective randomized multicenter comparison of balloon angioplasty and infrapopliteal stenting with the sirolimus-eluting stent in patients with ischemic peripheral arterial disease: 1-year results from the ACHILLES trial.
MedLine Citation:
PMID:  23194941     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The study investigated the efficacy and safety of a balloon expandable, sirolimus-eluting stent (SES) in patients with symptomatic infrapopliteal arterial disease.
BACKGROUND: Results of infrapopliteal interventions using balloon angioplasty and/or bare stents are limited by a relatively high restenosis rate, which could be potentially improved by stabilizing the lesion with a SES.
METHODS: Two hundred patients (total lesion length 27 ± 21 mm) were randomized to infrapopliteal SES stenting or percutaneous transluminal balloon angioplasty (PTA). The primary endpoint was 1-year in-segment binary restenosis by quantitative angiography.
RESULTS: Ninety-nine and 101 patients (mean age 73.4 years; 64% diabetics) were randomized to SES and PTA, respectively (8 crossover bailout cases to SES). At 1 year, there were lower angiographic restenosis rates (22.4% vs. 41.9%, p = 0.019), greater vessel patency (75.0% vs. 57.1%, p =0.025), and similar death, repeat revascularization, index-limb amputation rates, and proportions of patients with improved Rutherford class for SES versus PTA.
CONCLUSIONS: SES implantation may offer a promising therapeutic alternative to PTA for treatment of infrapopliteal peripheral arterial disease.
Authors:
Dierk Scheinert; Konstantinos Katsanos; Thomas Zeller; Renate Koppensteiner; Philip Commeau; Marc Bosiers; Hans Krankenberg; Iris Baumgartner; Dimitris Siablis; Johannes Lammer; Mariella Van Ransbeeck; Ayesha C Qureshi; Hans-Peter Stoll;
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  60     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  2013-01-30     Revised Date:  2013-02-05    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2290-5     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department for Angiology, Park-Krankenhaus Leipzig-Südost GmbH, Leipzig, Germany. dierk.scheinert@gmx.de
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon, Coronary / instrumentation,  methods*
Drug-Eluting Stents*
Europe / epidemiology
Female
Follow-Up Studies
Humans
Ischemia / epidemiology,  radiography,  therapy*
Male
Peripheral Arterial Disease / epidemiology,  radiography,  therapy*
Popliteal Artery* / radiography
Prospective Studies
Sirolimus / administration & dosage*
Treatment Outcome
Chemical
Reg. No./Substance:
53123-88-9/Sirolimus
Investigator
Investigator/Affiliation:
Dierk Scheinert / ; Dimitris Siablis / ; Konstantinos Katsanos / ; Dimitris Karnabatidis / ; Thomas Zeller / ; Johannes Lammer / ; Renate Koppensteiner / ; Marc Bosiers / ; Phillippe Commeau / ; Hans Krankenberg / ; Iris Baumgartner / ; Paolo Rubino / ; Klaus Brechtel / ; Volker Geist / ; Peter Huppert / ; Wouter Lansink / ; Jan Peregrin / ; Paul Sidhu / ; Pierre-Edouard Magnan /
Comments/Corrections
Comment In:
Nat Rev Cardiol. 2013 Feb;10(2):61   [PMID:  23247313 ]

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