{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:45:35Z","timestamp":1793090735236,"version":"4.5.0"},"reference-count":34,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2016,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background\u2014<\/jats:title>\n                    <jats:p>Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results\u2014<\/jats:title>\n                    <jats:p>\n                      Adults with critical limb ischemia (Rutherford category \u22654) and infrapopliteal lesions were randomized to receive PTA\u00b1BMS or DES with paclitaxel. Primary end point was 6-month primary binary patency of treated lesions, defined as \u226450% stenosis on computed tomographic angiography. Stenosis &gt;50%, retreatment, major amputation, and critical limb ischemia\u2013related death were regarded as treatment failure. Severity of failure was assessed with an ordinal score, ranging from vessel stenosis through occlusion to the clinical failures. Seventy-four limbs (73 patients) were treated with DES and 66 limbs (64 patients) received PTA\u00b1BMS. Six-month patency rates were 48.0% for DES and 35.1% for PTA\u00b1BMS (\n                      <jats:italic>P<\/jats:italic>\n                      =0.096) in the modified-intention-to-treat and 51.9% and 35.1% (\n                      <jats:italic>P<\/jats:italic>\n                      =0.037) in the per-protocol analysis. The ordinal score showed significantly worse treatment failure for PTA\u00b1BMS versus DES (\n                      <jats:italic>P<\/jats:italic>\n                      =0.041). The observed major amputation rate remained lower in the DES group until 2 years post-treatment, with a trend toward significance (\n                      <jats:italic>P<\/jats:italic>\n                      =0.066). Less minor amputations occurred after DES until 6 months post-treatment (\n                      <jats:italic>P<\/jats:italic>\n                      =0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions\u2014<\/jats:title>\n                    <jats:p>In patients with critical limb ischemia caused by infrapopliteal lesions, DES provide better 6-month patency rates and less amputations after 6 and 12 months compared with PTA\u00b1BMS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n                    <jats:p>\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n                      . Unique identifier: NCT00471289.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.114.002376","type":"journal-article","created":{"date-parts":[[2016,2,9]],"date-time":"2016-02-09T23:13:10Z","timestamp":1455059590000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":82,"title":["Percutaneous Transluminal Angioplasty and Drug-Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia (PADI) Trial"],"prefix":"10.1161","volume":"9","author":[{"given":"Marlon I.","family":"Spreen","sequence":"first","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper M.","family":"Martens","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina E.","family":"Hansen","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Knippenberg","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elke","family":"Verhey","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Paul P.M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan-Albert","family":"Vos","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert Jan","family":"de Borst","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert-Jan P.A.","family":"Vonken","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J.","family":"Wever","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randolph G.","family":"Statius van Eps","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem P.Th.M.","family":"Mali","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"van Overhagen","sequence":"additional","affiliation":[{"name":"From the Departments of Radiology (M.I.S., J.M.M., L.C.v.D., H.v.O.) and Vascular Surgery (B.K., J.J.W., R.G.S.v.E.), Haga Teaching Hospital, The Hague, The Netherlands; Department of Gastroenterology and Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands (B.E.H., E.V.); Departments of Vascular Surgery (J.-P.P.M.d.V.) and Radiology (J.-A.V.), Sint Antonius Hospital, Nieuwegein, The Netherlands; and Departments of Vascular Surgery (G.J.d.B.) and Radiology (E.-J.P.A.V., W.P.T.M..."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.12.037"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000240426.53079.46"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67704-5"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(03)00092-2"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-013-0550-1"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-010-9881-3"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.025"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2008.01.005"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181fc3c73"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2005.11.016"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2012.07.017"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.06.007"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr144"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.989"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1225-1"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.07.099"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(97)70045-4"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.04.073"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1259\/bjr\/97382129"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(00)80028-3"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.08.073"},{"key":"e_1_3_4_23_2","first-page":"142","article-title":"The fate of patients with critical leg ischemia.","volume":"12","author":"Dormandy J","year":"1999","unstructured":"Dormandy J, Heeck L, Vig S. 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