OR9-3 | Endovascular Outcomes of Patients with Heart Failure Undergoing Non-Stent Infrainguinal Interventions from the XLPAD Registry

There are limited data comparing endovascular intervention outcomes in heart failure (HF) patients presenting with symptomatic peripheral artery disease (PAD). Herein we report comparative outcomes (peri-procedural and 1-year major adverse cardiovascular events or MACE) in 1,060 patients (213 HF and 847 non-HF) between 2019-2022 from the multicenter XLPAD Registry (NCT01904851) undergoing non-stent femoropopliteal (FP) and below-the knee (BTK) artery interventions. Mean age 69.36±10.9 years, 27.9% women. Significantly greater proportion in the HF group had hypertension (95.3% vs 89%) and chronic kidney disease (47.9% vs 24.4%), prior myocardial infarction (28.6% vs 16.2%), and critical limb ischemia (CLI) presentation (62.9% vs 54.7%) compared with non-HF (p<0.05 for all comparisons). Equal proportion of interventions were performed in BTK (55% vs 53%) and FP+BTK (45% vs 47%) lesions, respectively in HF and non-HF groups. Mean ABI in both groups was ∼0.8±0.3 due to severe calcification (20.5%), CKD and diabetes mellitus (73%). Chronic total occlusion intervention was the most common lesion (HF 53% vs non-HF 43%; p=0.009). Mean lesion length was 126±106 mm. Conventional balloon angioplasty (81%) and atherectomy (19.4%) were used equally in both groups, except for laser atherectomy use (HF 9.4% vs non-HF 15.2%; p=0.02). Technical success, peri-procedural outcomes, death and MACE at 1-year are shown in Figure 1. HF patients undergoing non-stent intervention for symptomatic PAD have comparable technical success, but significantly worse 1-year mortality and MACE.