{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T08:45:40Z","timestamp":1793090740919,"version":"4.5.0"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2017,4,5]]},"abstract":"\n Background<\/jats:title>\n \n Clinical outcomes reported after treatment of infrapopliteal lesions with drug\u2010eluting stents (DESs) have been more favorable compared with percutaneous transluminal angioplasty with a bailout bare metal stent (\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n ) through midterm follow\u2010up in patients with critical limb ischemia. In the present study, long\u2010term results of treatment of infrapopliteal lesions with\n DESs<\/jats:styled-content>\n are presented.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n Adults with critical limb ischemia (Rutherford category \u22654) and infrapopliteal lesions were randomized to receive\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n or\n DESs<\/jats:styled-content>\n with paclitaxel. Long\u2010term follow\u2010up consisted of annual assessments up to 5\u00a0years after treatment or until a clinical end point was reached. Clinical end points were major amputation (above ankle level), infrapopliteal surgical or endovascular reintervention, and death. Preserved primary patency (\u226450% restenosis) of treated lesions was an additional morphological end point, assessed by duplex sonography. In total, 74 limbs (73 patients) were treated with\n DESs<\/jats:styled-content>\n and 66 limbs (64 patients) were treated with\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n . The estimated 5\u2010year major amputation rate was lower in the\n DES<\/jats:styled-content>\n arm (19.3% versus 34.0% for\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n ;\n P<\/jats:italic>\n =0.091). The 5\u2010year rates of amputation\u2010 and event\u2010free survival (survival free from major amputation or reintervention) were significantly higher in the\n DES<\/jats:styled-content>\n arm compared with\n PTA<\/jats:styled-content>\n \u2010BMS (31.8% versus 20.4%,\n P<\/jats:italic>\n =0.043; and 26.2% versus 15.3%,\n P<\/jats:italic>\n =0.041, respectively). Survival rates were comparable. The limited available morphological results showed higher preserved patency rates after\n DESs<\/jats:styled-content>\n than after\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n at 1, 3, and 4\u00a0years of follow\u2010up.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n Both clinical and morphological long\u2010term results after treatment of infrapopliteal lesions in patients with critical limb ischemia are improved with\n DES<\/jats:styled-content>\n compared with\n PTA<\/jats:styled-content>\n \u2010\n BMS<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Clinical Trial Registration<\/jats:title>\n \n URL<\/jats:styled-content>\n :\n http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n . Unique identifier:\n NCT<\/jats:styled-content>\n 00471289.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.116.004877","type":"journal-article","created":{"date-parts":[[2017,4,14]],"date-time":"2017-04-14T20:20:10Z","timestamp":1492201210000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":78,"title":["Long\u2010Term Follow\u2010up of the PADI Trial: Percutaneous Transluminal Angioplasty Versus Drug\u2010Eluting Stents for Infrapopliteal Lesions in Critical Limb Ischemia"],"prefix":"10.1161","volume":"6","author":[{"given":"Marlon I.","family":"Spreen","sequence":"first","affiliation":[{"name":"Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jasper M.","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Knippenberg","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukas C.","family":"van Dijk","sequence":"additional","affiliation":[{"name":"Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Paul P. M.","family":"de Vries","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Sint Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan Albert","family":"Vos","sequence":"additional","affiliation":[{"name":"Department of Radiology, Sint Antonius Hospital, Nieuwegein, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gert Jan","family":"de Borst","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evert\u2010Jan P. A.","family":"Vonken","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Okker D.","family":"Bijlstra","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Leiden University, Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan J.","family":"Wever","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Randolph G.","family":"Statius van Eps","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Willem P. Th. M.","family":"Mali","sequence":"additional","affiliation":[{"name":"Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"van Overhagen","sequence":"additional","affiliation":[{"name":"Department of Radiology, Haga Teaching Hospital, The Hague, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2006.12.037"},{"key":"e_1_3_5_3_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.RVI.0000240426.53079.46"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(05)67704-5"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(03)00092-2"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-013-0550-1"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-010-9881-3"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.07.099"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00330-008-1225-1"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2014.04.015"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr144"},{"key":"e_1_3_5_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.989"},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.114.002376"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.04.035"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.04.073"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0741-5214(97)70045-4"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1053\/ejvs.2002.1801"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2014.02.012"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1583\/1545-1550-20.2.131"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-013-0578-2"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2014.12.013"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.08.007"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvir.2009.05.031"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5876-9-165"},{"key":"e_1_3_5_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1078-5884(11)60009-9"},{"key":"e_1_3_5_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.08.073"},{"key":"e_1_3_5_27_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. The fate of patients with critical leg ischemia. Semin Vasc Surg. 1999;12:142\u2013147.","journal-title":"Semin Vasc Surg"},{"key":"e_1_3_5_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.002938"},{"key":"e_1_3_5_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.02.041"},{"key":"e_1_3_5_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2011.10.089"},{"key":"e_1_3_5_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60394-2"},{"key":"e_1_3_5_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejvs.2006.11.022"},{"key":"e_1_3_5_33_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2007.11.055"},{"key":"e_1_3_5_34_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001811"},{"key":"e_1_3_5_35_2","doi-asserted-by":"publisher","DOI":"10.1583\/JEVT-12-3926MR.1"},{"key":"e_1_3_5_36_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2014.06.1198"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.116.004877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T06:21:39Z","timestamp":1715581299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.116.004877"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,4,5]]},"references-count":35,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2017,4,5]]}},"alternative-id":["10.1161\/JAHA.116.004877"],"URL":"https:\/\/doi.org\/10.1161\/jaha.116.004877","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,4,5]]},"assertion":[{"value":"2016-10-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-02-08","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2017-04-14","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e004877"}}