{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T02:00:57Z","timestamp":1792807257066,"version":"4.5.0"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"12","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,6,20]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Endovascular intervention of femoropopliteal chronic total occlusions (CTOs) is technically more complex. However, there is lack of comparative analysis between CTO and non\u2010CTO femoropopliteal interventions.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We report procedural details and outcomes of patients treated for femoropopliteal CTO and non\u2010CTO lesions in the XLPAD (Excellence in Peripheral Artery Disease) registry (NCT01904851) between 2006 and 2019. Primary outcomes were procedural success and 1\u2010year major adverse limb events, a composite of all\u2010cause death, target limb revascularization, or major amputation. Analysis included 2895 patients (CTO: n=1516 patients; non\u2010CTO: n=1379 patients) with 3658 lesions (CTO: n=1998 lesions; non\u2010CTO: n=1660 lesions). Conventional balloon angioplasty (20.86% versus 33.48%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or drug\u2010coated balloon angioplasty (1.26% versus 2.93%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were more frequent in the non\u2010CTO group, whereas bare\u2010metal stents (28.09% versus 20.22%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) or covered stents (4.08% versus 1.83%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) were more frequent in the CTO group. Debulking procedures were more commonly performed in the non\u2010CTO group (41.44% versus 53.13%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001), despite a similar degree of calcification between the 2 groups. Procedural success was higher in the non\u2010CTO group (90.12% versus 96.79%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Procedural complications were higher in the CTO group (7.21% versus 4.66%,\n              <jats:italic>P<\/jats:italic>\n              =0.002), mainly due to excess distal embolization (1.5% versus 0.6%,\n              <jats:italic>P<\/jats:italic>\n              =0.015). Adjusted 1\u2010year major adverse limb events were higher in the CTO group (22.47% versus 18.77%,\n              <jats:italic>P<\/jats:italic>\n              =0.019), driven mainly by target limb revascularization (19.00% versus 15.34%,\n              <jats:italic>P<\/jats:italic>\n              =0.013).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Procedural success is lower for endovascular treatment of femoropopliteal CTO compared with non\u2010CTO lesions. CTO lesions are associated with higher rates of periprocedural complications and reinterventions after 1 year.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028425","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T10:28:05Z","timestamp":1686824885000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Comparative Outcomes of Interventions for Femoropopliteal Chronic Total Occlusion Versus Non\u2013Chronic Total Occlusion Lesions From the Multicenter XLPAD Registry"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0269-2605","authenticated-orcid":false,"given":"Shirling","family":"Tsai","sequence":"first","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3541-1814","authenticated-orcid":false,"given":"Yulun","family":"Liu","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence","family":"Hoang","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"Methodist Health System Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Vu","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"Methodist Health System Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0882-7344","authenticated-orcid":false,"given":"Hua","family":"Lu","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1319-5903","authenticated-orcid":false,"given":"Bala","family":"Ramanan","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"University of Texas Southwestern Medical Center Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-1447","authenticated-orcid":false,"given":"David","family":"Fernandez Vazquez","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Rosol","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Hospital Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sameh","family":"Sayfo","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Hospital Plano TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad Amer","family":"Alaiti","sequence":"additional","affiliation":[{"name":"Medical City Plano Plano TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8352-5667","authenticated-orcid":false,"given":"Panagiotis","family":"Koutakis","sequence":"additional","affiliation":[{"name":"Baylor University Waco TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-9701","authenticated-orcid":false,"given":"Emmanouil S.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Minnesota Heart Institute Minneapolis MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4888-2431","authenticated-orcid":false,"given":"Mehdi H.","family":"Shishehbor","sequence":"additional","affiliation":[{"name":"University Hospital Harrington Heart and Vascular Institute Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0863-7914","authenticated-orcid":false,"given":"Subhash","family":"Banerjee","sequence":"additional","affiliation":[{"name":"North Texas Veterans Affairs Health Care Systems Dallas TX USA"},{"name":"Baylor Scott and White Hospital Dallas TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"111","article-title":"A percutaneous crossing algorithm for femoropopliteal and tibial artery chronic total occlusions (PCTO algorithm)","volume":"31","author":"Banerjee S","year":"2019","unstructured":"Banerjee S, Shishehbor MH, Mustapha JA, Armstrong EJ, Ansari M, Rundback JH, Fisher B, Pena CS, Brilakis ES, Lee AC, et al. 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