{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T23:15:43Z","timestamp":1777936543145,"version":"3.51.4"},"reference-count":27,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Vasc Med"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Although bleeding is a common procedure-related adverse event following endovascular therapy (EVT), limited data exist regarding the procedural and anatomical factors associated with its complications in patients with lower-extremity artery disease (LEAD) undergoing EVT.\n                    <jats:bold>Methods:<\/jats:bold>\n                    Data were extracted from a nationwide Japanese EVT registry of 73,990 patients who underwent EVT for symptomatic LEAD between January 2021 and December 2022. The primary outcome measure was in-hospital bleeding complications, including access site bleeding, nonaccess site bleeding, and hemorrhagic stroke.\n                    <jats:bold>Results:<\/jats:bold>\n                    The mean age of the patients was 75 \u00b1 9 years, and 69% were men. In-hospital bleeding complications were observed in 613 (0.8%) patients. Logistic regression analysis demonstrated significant associations between bleeding complications and the following procedural, anatomical, and pharmacological variables: emergent revascularization (odds ratio [OR]: 1.90, 95% CI: 1.29\u20132.79), multiple approach sites (OR: 2.46, 95% CI: 2.00\u20133.01), bilateral arterial calcification (OR: 1.46, 95% CI: 1.19\u20131.79), chronic occlusion (OR: 1.53, 95% CI: 1.28\u20131.83), dual antiplatelet therapy (OR: 1.70, 95% CI: 1.27\u20132.28), and oral anticoagulant (OR: 1.63, 95% CI: 1.31\u20132.03). The adjusted incidence of in-hospital bleeding was 0.59% (95% CI: 0.51\u20130.68%) in patients with one of the identified procedural and anatomical risk factors, 0.96% (95% CI: 0.82\u20131.13%) in patients with two factors, and 2.40% (95% CI: 1.88\u20133.05%) in patients with three or four factors.\n                    <jats:bold>Conclusions:<\/jats:bold>\n                    Procedural and anatomical factors as well as antithrombotic strategies were significantly associated with an increased risk of in-hospital bleeding in patients with LEAD who underwent EVT.\n                  <\/jats:p>","DOI":"10.1177\/1358863x251320113","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T09:07:32Z","timestamp":1740388052000},"page":"155-161","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Cumulative impact of procedural and anatomical factors on in-hospital bleeding complications in endovascular therapy for lower-extremity artery disease: A nationwide registry study in Japan"],"prefix":"10.1177","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2317-7725","authenticated-orcid":false,"given":"Takuya","family":"Nakahashi","sequence":"first","affiliation":[{"name":"Department of Cardiology, Takaoka City Hospital, Takaoka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-041X","authenticated-orcid":false,"given":"Mitsuyoshi","family":"Takahara","sequence":"additional","affiliation":[{"name":"Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6829-7304","authenticated-orcid":false,"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Cardiovascular Division, Osaka Police Hospital, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Kohsaka","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1931-5769","authenticated-orcid":false,"given":"Yoshimitsu","family":"Soga","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Horie","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Sendai Kousei Hospital, Sendai, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Sakata","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masayuki","family":"Takamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuya","family":"Amano","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Aichi Medical University, Nagakute, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken","family":"Kozuma","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Teikyo University Hospital, Tokyo, 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