Literature DB >> 20123205

Prospective, randomized single-center trial to compare cryoplasty versus conventional angioplasty in the popliteal artery: midterm results of the COLD study.

Thomas Jahnke1, Stefan Mueller-Huelsbeck, Nicholas Charalambous, Jens Trentmann, Azadeh Jamili, Tim Hendrik Huemme, Hendrik Bolte, Martin Heller, Philipp Jost Schaefer.   

Abstract

PURPOSE: To evaluate safety and efficacy of cryoplasty versus conventional angioplasty for focal popliteal arterial occlusive disease.
MATERIALS AND METHODS: Patients with focal atherosclerotic stenoses and occlusions of the popliteal artery were randomized to cryoplasty or conventional angioplasty as the initial treatment strategy. The primary objective was target lesion patency. The secondary endpoint was treatment success without the need for stents. Duplex ultrasonography was performed at 3, 6, 9, and 15 months.
RESULTS: Eighty-six patients (mean age, 72 years; age range, 50-94 years) were enrolled in this study. Forty patients were randomized to cryoplasty and 46 to conventional angioplasty. Demographics, risk factors, clinical stage of disease, and lesion details were comparable. On intention-to-treat basis, initial success was 35% for cryoplasty versus 54% for conventional angioplasty (P = .02). The rate of grade C dissection was 35% after cryoplasty and 26% after conventional angioplasty (P = .4). Optional long-term percutaneous transluminal angioplasty (PTA) was performed in 58% of cryoplasty patients. The rate of stent placement for dissection and/or residual stenosis was 30% after cryoplasty (including long-term dilation) and 39% after conventional angioplasty (P = .34). The mean (+/-standard deviation) target lesion patency at 9 months was 79.3% +/- 7.5 for cryoplasty and 66.7% +/-8.1 for conventional angioplasty; however, the results are not significant (P = .14).
CONCLUSIONS: Cryoplasty of the popliteal artery alone showed a lower anatomic success when compared with conventional angioplasty. Combined with optional long-term PTA, however, stent placement was not needed more often. There was a trend toward higher patency after cryoplasty, but differences were not statistically significant and results of long-term follow-up have to be awaited. Copyright (c) 2010 SIR. Published by Elsevier Inc. All rights reserved.

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Year:  2010        PMID: 20123205     DOI: 10.1016/j.jvir.2009.10.021

Source DB:  PubMed          Journal:  J Vasc Interv Radiol        ISSN: 1051-0443            Impact factor:   3.464


  6 in total

1.  Comparison of cryoplasty and conventional angioplasty for treating stenotic-occlusive lesions of the femoropopliteal arteries in diabetic patients: immediate, mid-term and long-term results.

Authors:  R Fossaceca; G Guzzardi; M Di Terlizzi; I Divenuto; E Malatesta; P Cerini; C Cusaro; A Carriero
Journal:  Radiol Med       Date:  2012-02-10       Impact factor: 3.469

Review 2.  Endovascular techniques in limb salvage: cutting, cryo, brachy, and drug-eluting balloons.

Authors:  Mark G Davies; Javier E Anaya-Ayala
Journal:  Methodist Debakey Cardiovasc J       Date:  2013-04

Review 3.  An overview of optimal endovascular strategy in treating the femoropopliteal artery: mechanical, biological, and procedural factors.

Authors:  Nicolas W Shammas
Journal:  Int J Angiol       Date:  2013-03

4.  Efficacy of endoluminal interventional therapy in diabetic peripheral arterial occlusive disease: a retrospective trial.

Authors:  Liang Xiao; De-sheng Huang; Jia-jie Tong; Jing Shen
Journal:  Cardiovasc Diabetol       Date:  2012-02-28       Impact factor: 9.951

Review 5.  When Are Endovascular and Open Bypass Treatments Preferred for Femoropopliteal Occlusive Disease?

Authors:  Ali F AbuRahma
Journal:  Ann Vasc Dis       Date:  2018-03-25

6.  One-Year Outcomes Following Directional Atherectomy of Popliteal Artery Lesions: Subgroup Analysis of the Prospective, Multicenter DEFINITIVE LE Trial.

Authors:  Aljoscha Rastan; James F McKinsey; Lawrence A Garcia; Krishna J Rocha-Singh; Michael R Jaff; Stuart Harlin; Suraj Kamat; Sean Janzer; Thomas Zeller
Journal:  J Endovasc Ther       Date:  2017-11-09       Impact factor: 3.487

  6 in total

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