{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T01:15:02Z","timestamp":1777943702271,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,10,14]],"date-time":"2020-10-14T00:00:00Z","timestamp":1602633600000},"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":["Vascular"],"published-print":{"date-parts":[[2021,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Paclitaxel-eluting stents have demonstrated improved patency over balloon angioplasty and bare metal stenting for endovascular interventions in the femoral-popliteal segment. Recently, concerns have arisen regarding the safety of paclitaxel use and its association with mortality. This study aims to examine real-world, long-term mortality, and patency of patients treated with the Zilver PTX drug-eluting stent.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients treated with the PTX stent after FDA approval between 2013 and 2015 were identified from an institutional database. Demographic, procedural, and device information was collected and initial- and lifetime-exposure dose of paclitaxel was calculated. The primary outcome was all-cause mortality and its association with paclitaxel exposure. Long-term patency was also evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Seventy-nine procedures involving PTX placement were performed on 64 individual patients during the study period, with 15 (23.4%) having bilateral procedures. Average age was 70 years, and 71.9% were male. Forty-five patients (70.3%) were claudicants, and 19 (29.7%) had chronic, limb-threatening ischemia. An average of 2.3 PTX stents, totaling 203 mm in length, were placed per procedure. Paclitaxel exposure was 1.87\u2009mg\/procedure initially (range 0.38\u20134.03\u2009mg), and average lifetime exposure was 4.65\u2009mg\/patient (range 0.38\u201327.91\u2009mg). Average follow-up was 59.6 months. Kaplan\u2013Meier estimated survival was 96.9%, 81.2% and 71.7% at one , three, and five years. On multivariate analysis, no specific factors were associated with overall morality including initial paclitaxel dose (HR 0.99, 95% CI 0.99\u20131.00) and lifetime paclitaxel exposure (HR 0.98, 95% CI 0.89\u20131.08). Kaplan\u2013Meier primary patency was 76.2%, 60.1%, and 29.3% at one, two, and five years, respectively. Secondary patency was 92.2%, 85.4%, and 75.2% at the same intervals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>At a mean follow-up of five years, exposure to higher doses of paclitaxel from Zilver PTX does not appear to be associated with increased mortality compared to lower doses in real-world patients. Long-term patency rates confirm the efficacy of Zilver PTX, and further investigation may be warranted before abandoning paclitaxel use altogether.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1708538120964371","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T00:58:38Z","timestamp":1602723518000},"page":"567-573","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Paclitaxel exposure and long-term mortality of patients treated with the Zilver PTX drug-eluting stent"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2764-6552","authenticated-orcid":false,"given":"Jordan R","family":"Stern","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of Vascular and Endovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5121-1735","authenticated-orcid":false,"given":"Kenneth","family":"Tran","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular and Endovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Venita","family":"Chandra","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular and Endovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E John","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular and Endovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason T","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Vascular and Endovascular Surgery, Stanford University School of Medicine, Stanford, CA, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,10,14]]},"reference":[{"key":"bibr1-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2013.05.022"},{"key":"bibr2-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.028893"},{"key":"bibr3-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.118.007702"},{"key":"bibr4-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)32262-1"},{"key":"bibr5-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.115.016900"},{"key":"bibr6-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2016.08.006"},{"key":"bibr7-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.118.011245"},{"key":"bibr8-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.119.044697"},{"key":"bibr9-1708538120964371","doi-asserted-by":"crossref","unstructured":"Ouriel K, Adelman MA, Rosenfield K, et\u00a0al. Safety of paclitaxel-coated balloon angioplasty for femoropopliteal peripheral artery disease.\n                      JACC Cardiovasc Interv\n                      2019; 12: 2515\u20132524.","DOI":"10.1016\/j.jcin.2019.08.025"},{"key":"bibr10-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.01.013"},{"key":"bibr11-1708538120964371","doi-asserted-by":"crossref","unstructured":"Dake MD, Ansel GM, Bosiers M, et\u00a0al. Paclitaxel-coated Zilver PTX drug-eluting stent treatment does not result in increased long-term all-cause mortality compared to uncoated devices.\n                      Cardiovasc Intervent Radiol\n                      2020; 43: 8\u201319.","DOI":"10.1007\/s00270-019-02324-4"},{"key":"bibr12-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvs.2009.08.073"},{"key":"bibr13-1708538120964371","doi-asserted-by":"publisher","DOI":"10.1007\/s00270-018-2110-1"},{"key":"bibr14-1708538120964371","doi-asserted-by":"crossref","unstructured":"Dake MD, Ansel GM, Lottes AE. Zilver PTX RCT mortality analysis: no difference in long-term mortality rate for Zilver PTX drug-eluting stent compared to PTA\/BMS.\n                      CVIR Endovasc\n                      2019; 2: 25.","DOI":"10.1186\/s42155-019-0069-x"}],"container-title":["Vascular"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1708538120964371","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1708538120964371","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1708538120964371","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T07:33:57Z","timestamp":1777707237000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1708538120964371"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,14]]},"references-count":14,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2021,8]]}},"alternative-id":["10.1177\/1708538120964371"],"URL":"https:\/\/doi.org\/10.1177\/1708538120964371","relation":{},"ISSN":["1708-5381","1708-539X"],"issn-type":[{"value":"1708-5381","type":"print"},{"value":"1708-539X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,14]]}}}