Lipid-rich plaques in the femoropopliteal artery were associated with a significantly worse 12-month major adverse limb event-free survival rate (HR 10.9; 95% CI 1.2-100.1; p=0.03).
Observational (n=37)
No
Does the presence of lipid-rich plaque in the femoropopliteal artery worsen limb outcomes in patients undergoing endovascular therapy?
The presence of lipid-rich plaques in the femoropopliteal artery strongly predicts poor 12-month limb outcomes and restenosis after drug-coated balloon angioplasty.
Effect estimate: HR 10.9 (95% CI 1.2-100.1)
p-value: p=0.03
Abstract Introduction A lipid-rich plaque (LRP) detected using near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) is related to increased major adverse cardiovascular events in patients with coronary artery disease. However, the impacts of LRP in the femoropopliteal artery (FPA) on limb outcomes remain underexplored. Purpose We sought the influence of LCPs in FPA on limb outcomes in patients who underwent endovascular therapy for femoropopliteal disease. Methods This single-center prospective observational study included 37 patients (median age, 75. 6 years; male, 75. 6%; diabetes mellitus, 61. 1%; dialysis, 22. 2%) who underwent drug-coated balloon angioplasty for femoropopliteal disease between July 2022 and October 2024. NIRS-IVUS assessment was performed on the entire femoropopliteal arterial segment. For comparison, the participants were divided into LRP (n=13) and non-LRP (n=24) groups. LRP was defined as a maximum lipid-core burden index in any 4-mm region (max-LCBI4mm) 400. The primary outcome was major adverse limb event (MALE) at 12 months, which consisted of target-vessel revascularization, acute limb ischemia, and major amputation. The secondary outcome was primary patency at 12 months (freedom from restenosis). Restenosis was defined as a peak systolic velocity ratio of 2. 4 measured with duplex ultrasound or 50% diameter stenosis or occlusion identified using ultrasound and computed tomography. Results The patients in the LRP group had a significantly lower 12-month MALE-free survival rate and 12-month primary patency rate than those in the non-LRP group (log-rank p=0. 009 and log-rank p=0. 009, respectively). LRP was also related to a worse 12-month MALE-free survival rate (hazard ratio, 10. 9; 95% CI, 1. 2-100. 1; p=0. 03) and 12-month primary patency rate (hazard ratio, 11. 3; 95% CI, 1. 2-105. 1; p=0. 03). Conclusion The LRP in FPA was associated with poor 12-month MALE-free survival and primary patency in patients undergoing endovascular therapy for femoropopliteal disease. Figureₒutcomes
Sato et al. (Sat,) conducted a observational in femoropopliteal disease (n=37). Lipid-rich plaque (LRP) presence vs. Non-LRP was evaluated on Major adverse limb event (MALE) at 12 months (HR 10.9, 95% CI 1.2-100.1, p=0.03). Lipid-rich plaques in the femoropopliteal artery were associated with a significantly worse 12-month major adverse limb event-free survival rate (HR 10.9; 95% CI 1.2-100.1; p=0.03).