Research Day

Questioning The Validity Of Published Data On Percutaneous Transluminal Angioplasty As A Benchmark For Infrainguinal Endovascular Procedures

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INTRODUCTION: Percutaneous transluminal angioplasty (PTA) of the infrainguinal arteries was the first endovascular technique for improving lower extremity circulation. It involves the inflation of a balloon-tipped catheter placed within stenotic or occluded vessels to improve perfusion and increase downstream blood flow. Subsequently, various other techniques, including subintimal angioplasty, stenting, or atherectomy alone or in combination, have been introduced to improve PTA results.

OBJECTIVE: New techniques are frequently compared to PTA as a benchmark, making valid PTA data essential for treatment development and outcome prediction. Our objective was to identify papers that have relevant data related to PTA and perform a thorough systematic review.

METHODS: We analyzed 976 papers published in peer reviewed journals within the Embase and PubMed databases to determine outcomes and effectiveness of PTA alone. The studies were chosen using a delineated search with inclusion and exclusion criteria. Inclusion parameters were defined as publication date after 2000, infrainguinal PTA procedures, one year of follow-up, and more than 50 patients evaluated. Exclusion criteria were defined as >10% of procedures using stent, atherectomy, or subintimal angioplasty. Additionally, reference lists of selected papers and key systematic reviews were perused.

RESULTS: In our review, we found only seven papers that contained pure PTA data, with an additional six studies that presented data from procedures utilizing only PTA ≥90% of the time.

CONCLUSION: There is a dearth of data related to the effectiveness of PTA without other interventions. Due to this, the comparison of other devices to PTA alone may not be valid.

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