{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:36:50Z","timestamp":1787960210032,"version":"build-2784847793"},"reference-count":47,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"7","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,4,4]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with severe\u2010stage chronic kidney disease (CKD) were excluded from femoropopliteal disease trials evaluating drug\u2010coated balloons (DCBs) and drug\u2010eluting stents (DESs) versus plain balloon angioplasty (POBA) and bare metal stents (BMSs). We examined the interaction between CKD status and device type for the association with 24\u2010month all\u2010cause mortality and major amputation risk.<\/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 studied patients undergoing femoropopliteal interventions (September 2016\u2013December 2018) from Medicare\u2010linked VQI (Vascular Quality Initiative) registry data. We compared outcomes for: (1) early\u2010stage CKD (stages 1\u20133) receiving DCB\/DES, (2) early\u2010stage CKD receiving POBA\/BMS, (3) severe\u2010stage (4 and 5) CKD receiving DCB\/DES, and (4) severe\u2010stage CKD receiving POBA\/BMS. We studied 8799 patients (early\u2010stage CKD: 94%; severe\u2010stage: 6%). DCB\/DES use was 57% versus 51% in patients with early\u2010stage versus severe\u2010stage CKD. Twenty\u2010four\u2010month mortality risk for patients with early\u2010stage CKD receiving DCB\/DES (reference) was 21% versus 28% (hazard ratio [HR], 1.47 [95% CI, 1.31\u20131.65]) for those receiving POBA\/BMS; patients with severe\u2010stage CKD: those receiving DCB\/DES had a 49% (HR, 2.61 [95% CI, 2.06\u20133.31]) mortality risk versus 52% (HR, 3.64 [95% CI, 2.91\u20134.55]) for those receiving POBA\/BMS (interaction\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Adjusted analyses attenuated these results. For severe\u2010stage CKD, DCB\/DES versus POBA\/BMS mortality risk was not significant at 24\u2009months (post hoc comparison\n                      <jats:italic>P<\/jats:italic>\n                      =0.06) but was higher for the POBA\/BMS group at 18\u2009months (post hoc\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.05). Patients with early\u2010stage CKD receiving DCB\/DES had the lowest 24\u2010month amputation risk (6%), followed by 11% for early\u2010stage CKD\u2010POBA\/BMS, 15% for severe\u2010stage CKD\u2010DCB\/DES, and 16% for severe\u2010stage CKD\u2010POBA\/BMS (interaction\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). DCB\/DES versus POBA\/BMS amputation rates in patients with severe\u2010stage CKD did not differ (post hoc\n                      <jats:italic>P<\/jats:italic>\n                      =0.820).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">DCB\/DES versus POBA\/BMS use in patients with severe\u2010stage CKD was associated with lower mortality and no difference in amputation outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.122.028622","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T05:25:47Z","timestamp":1679981147000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Drug\u2010Coated Balloon and Drug\u2010Eluting Stent Safety in Patients With Femoropopliteal and Severe Chronic Kidney Disease"],"prefix":"10.1161","volume":"12","author":[{"given":"Jonathan","family":"Hanna","sequence":"first","affiliation":[{"name":"Department of Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6104-6254","authenticated-orcid":false,"given":"Kim G.","family":"Smolderen","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA"},{"name":"Department of Psychiatry Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulanka","family":"Castro\u2010Dominguez","sequence":"additional","affiliation":[{"name":"Harrington Heart &amp; Vascular Institute University Hospitals, Case Western Reserve University Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4294-5507","authenticated-orcid":false,"given":"Ga\u00eblle","family":"Romain","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Lee","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5733-949X","authenticated-orcid":false,"given":"Jeffrey","family":"Turner","sequence":"additional","affiliation":[{"name":"Section of Nephrology, Department of Internal Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4954-5672","authenticated-orcid":false,"given":"Carlos","family":"Mena\u2010Hurtado","sequence":"additional","affiliation":[{"name":"Vascular Medicine Outcomes Program (VAMOS), Section of Cardiovascular Medicine, Department of Medicine Yale School of Medicine New Haven CT USA"},{"name":"Section of Cardiovascular Medicine, Department of Internal Medicine Yale School of Medicine New Haven CT USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.121.318535"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ackd.2014.07.005"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2012.02.340"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2002.29865"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523-1755.2000.00173.x"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.024"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg414"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005183422003"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2011.02.017"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.25387"},{"key":"e_1_3_1_12_2","first-page":"205","article-title":"Determinants of coronary vascular calcification in patients with chronic kidney disease and end\u2010stage renal disease: a systematic review","volume":"17","author":"McCullough PA","year":"2004","unstructured":"McCullough PA, Sandberg KR, Dumler F, Yanez JE. 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