Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study-
Abstract Background The role of catheter-based imaging in peripheral interventions for lower extremity artery disease (LEAD) has increased with percutaneous interventions. To clarify the relation between intravascular ultrasound (IVUS) information and procedure selection strategy for endovascular tr...
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| Format: | Article |
| Language: | English |
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SpringerOpen
2022-10-01
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| Series: | CVIR Endovascular |
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| Online Access: | https://doi.org/10.1186/s42155-022-00328-9 |
| _version_ | 1811194979321643008 |
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| author | Yuko Yazu Masahiko Fujihara Mitsuyoshi Takahara Naoya Kurata Aya Nakata Hitoshi Yoshimura Tomoaki Ito Masashi Fukunaga Amane Kozuki Yusuke Tomoi |
| author_facet | Yuko Yazu Masahiko Fujihara Mitsuyoshi Takahara Naoya Kurata Aya Nakata Hitoshi Yoshimura Tomoaki Ito Masashi Fukunaga Amane Kozuki Yusuke Tomoi |
| author_sort | Yuko Yazu |
| collection | DOAJ |
| description | Abstract Background The role of catheter-based imaging in peripheral interventions for lower extremity artery disease (LEAD) has increased with percutaneous interventions. To clarify the relation between intravascular ultrasound (IVUS) information and procedure selection strategy for endovascular treatment therapy (EVT) of the femoropopliteal artery in the real-world clinical settings wherein new endovascular technologies (NETs), including drug-coated balloon (DCB), drug-eluting stent (DES), and covered stent-graft (CS). Our retrospective multicenter analysis examined symptomatic 970 patients treated by EVT for de novo femoropopliteal lesions with IVUS guidance. The decision tree analysis was performed retrospectively to determine the association of IVUS and angiography parameters with the strategy selection of endovascular procedures. We divided the study population according to the developed tree, and identified the most popular strategy selection in each subgroup. We finally examined whether the restenosis risk would be different among respective subgroups of the tree. Results During the study periods, plain old balloon angioplasty, DCB, and bare nitinol stent were most frequently selected (25.3%, 23.9%, and 23.8%, respectively). The drug-eluting stent (DES), covered stent (CS), and spot stent strategies were used in 7.3%, 11.5%, and 8.1%. NETs had the lowest restenosis risk in the overall population. The decision tree had a depth of six branches and divided the patients into 11 subgroups by IVUS and angiography parameters. The restenosis rate was similarly low among these 11 subgroups when the most popular NET in each subgroup was selected (P = 0.94). Conclusions The use of IVUS data along with angiography data would standardize the selection of endovascular procedures and can improve patency outcomes if NETs are used properly. |
| first_indexed | 2024-04-12T00:36:13Z |
| format | Article |
| id | doaj.art-6ab931d9c1aa436cb69a9fd7b7e59549 |
| institution | Directory Open Access Journal |
| issn | 2520-8934 |
| language | English |
| last_indexed | 2024-04-12T00:36:13Z |
| publishDate | 2022-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | CVIR Endovascular |
| spelling | doaj.art-6ab931d9c1aa436cb69a9fd7b7e595492022-12-22T03:55:09ZengSpringerOpenCVIR Endovascular2520-89342022-10-01511910.1186/s42155-022-00328-9Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study-Yuko Yazu0Masahiko Fujihara1Mitsuyoshi Takahara2Naoya Kurata3Aya Nakata4Hitoshi Yoshimura5Tomoaki Ito6Masashi Fukunaga7Amane Kozuki8Yusuke Tomoi9Department of Medical Engineering, Kishiwada Tokushukai HospitalDepartment of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada-City OsakaDepartment of Diabetes Care Medicine, Osaka University Graduate School of MedicineDepartment of Medical Engineering, Kansai Rosai HospitalDepartment of Medical Engineering, Morinomiya HospitalDepartment of Medical Engineering, Saiseikai Nakatsu HospitalDepartment of Medical Engineering, Kokura Memorial HospitalCardiovascular Division, Morinomiya HospitalDepartment of Cardiology, Saiseikai Nakatsu HospitalDepartment of Cardiology, Kokura Memorial HospitalAbstract Background The role of catheter-based imaging in peripheral interventions for lower extremity artery disease (LEAD) has increased with percutaneous interventions. To clarify the relation between intravascular ultrasound (IVUS) information and procedure selection strategy for endovascular treatment therapy (EVT) of the femoropopliteal artery in the real-world clinical settings wherein new endovascular technologies (NETs), including drug-coated balloon (DCB), drug-eluting stent (DES), and covered stent-graft (CS). Our retrospective multicenter analysis examined symptomatic 970 patients treated by EVT for de novo femoropopliteal lesions with IVUS guidance. The decision tree analysis was performed retrospectively to determine the association of IVUS and angiography parameters with the strategy selection of endovascular procedures. We divided the study population according to the developed tree, and identified the most popular strategy selection in each subgroup. We finally examined whether the restenosis risk would be different among respective subgroups of the tree. Results During the study periods, plain old balloon angioplasty, DCB, and bare nitinol stent were most frequently selected (25.3%, 23.9%, and 23.8%, respectively). The drug-eluting stent (DES), covered stent (CS), and spot stent strategies were used in 7.3%, 11.5%, and 8.1%. NETs had the lowest restenosis risk in the overall population. The decision tree had a depth of six branches and divided the patients into 11 subgroups by IVUS and angiography parameters. The restenosis rate was similarly low among these 11 subgroups when the most popular NET in each subgroup was selected (P = 0.94). Conclusions The use of IVUS data along with angiography data would standardize the selection of endovascular procedures and can improve patency outcomes if NETs are used properly.https://doi.org/10.1186/s42155-022-00328-9Femoropopliteal segmentEndovascular TherapyPeripheral artery diseaseIntravascular Ultrasound、Drug-Coated stentDrug-Eluting stentCovered stent-graft |
| spellingShingle | Yuko Yazu Masahiko Fujihara Mitsuyoshi Takahara Naoya Kurata Aya Nakata Hitoshi Yoshimura Tomoaki Ito Masashi Fukunaga Amane Kozuki Yusuke Tomoi Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- CVIR Endovascular Femoropopliteal segment Endovascular Therapy Peripheral artery disease Intravascular Ultrasound、Drug-Coated stent Drug-Eluting stent Covered stent-graft |
| title | Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- |
| title_full | Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- |
| title_fullStr | Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- |
| title_full_unstemmed | Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- |
| title_short | Intravascular ultrasound-based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease—results from the ONION Study- |
| title_sort | intravascular ultrasound based decision tree model for the optimal endovascular treatment strategy selection of femoropopliteal artery disease results from the onion study |
| topic | Femoropopliteal segment Endovascular Therapy Peripheral artery disease Intravascular Ultrasound、Drug-Coated stent Drug-Eluting stent Covered stent-graft |
| url | https://doi.org/10.1186/s42155-022-00328-9 |
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