Clinical Efficacy of Different Endovascular Approaches in Femoropopliteal Artery Disease with Moderate-to-Severe Calcification: A Meta-Analysis.
Bing Wang, Haoliang Wu, Weibin Wu et al.
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In 30 seconds
This systematic review and meta-analysis assessed endovascular treatment outcomes in patients with peripheral artery disease and moderate-to-severe femoropopliteal artery calcification. Across 13 included studies, pooled 12-month primary patency was 83.8%, and freedom from clinically driven target lesion revascularization was 90.7%. Descriptive subgroup estimates varied across stent-, atherectomy-, and intravascular lithotripsy-based strategies, but the review cautions that these are not comparative rankings and do not establish superiority. The authors characterize short-term outcomes as acceptable and call for higher-quality head-to-head comparisons.
Key findings
- Across 13 studies, pooled 12-month primary patency after endovascular treatment was 83.8%.
- Pooled freedom from clinically driven target lesion revascularization was 90.7%.
- Descriptive subgroup estimates for primary patency were 83.0% for stent-based, 86.66% for atherectomy-based, and 82.75% for intravascular lithotripsy-based strategies.
- Subgroup estimates were descriptive; limited head-to-head evidence prevents conclusions about comparative superiority.
Why it matters
Moderate-to-severe calcification can complicate femoropopliteal endovascular treatment. These pooled estimates provide a summary of reported 12-month patency and reintervention-related outcomes in this population, while the variation across strategies highlights the need to distinguish descriptive results from evidence of comparative effectiveness.
What to keep in mind
The review reports limited availability of head-to-head comparisons. Publication-bias assessments may be unreliable in subgroups with few studies.