{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:33:27Z","timestamp":1773200007581,"version":"3.50.1"},"reference-count":28,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T00:00:00Z","timestamp":1521504000000},"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":["J Endovasc Ther"],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:p> Purpose: To report midterm results of the \u201cpave-and-crack\u201d technique to facilitate safe and effective scaffolding of heavily calcified femoropopliteal lesions in preparation for delivery of a Supera interwoven stent. Methods: Data were collected retrospectively on 67 consecutive patients (mean age 71\u00b18 years; 54 men) treated with this technique between November 2011 and February 2017 at a single center. A third (22\/64, 34%) of the patients had critical limb ischemia (CLI). Most lesions were TASC D (52\/67, 78%), and the majority were occlusions (61\/66, 92%). The mean lesion length was 26.9\u00b111.2 cm. Nearly two-thirds (40\/64, 62%) had grade 4 calcification (Peripheral Arterial Calcium Scoring System). To prepare for Supera stenting, the most heavily calcified segments of the lesion were predilated aggressively to obliterate recoil. A Viabahn stent-graft was then implanted to \u201cpave\u201d the lesion and protect from vessel rupture as aggressive predilation continued until the calcified plaque was \u201ccracked\u201d before lining the entire lesion with a Supera stent. Patency and target lesion revascularization (TLR) rates were estimated using the Kaplan-Meier method. Results: Procedural success was achieved in 100% and technical success (residual stenosis &lt;30%) in 98% (66\/67). The mean cumulative stent lengths were 16\u00b19 cm for the Viabahn and 23\u00b112 cm for the Supera. Only 2 complications occurred (distal embolization and access-site pseudoaneurysm). Two CLI patients died within 30 days, and 3 patients (all claudicants) underwent a TLR. Patients were followed for a mean 19\u00b118 months, during which another 2 CLI patients died and 1 patient had a major amputation. One-year primary and secondary patency estimates were 79% and 91%, respectively; freedom from TLR was 85%. Conclusion: Despite severe lesion calcification, patients experienced high technical success and a safe and durable therapy at midterm follow-up with the femoropopliteal \u201cpave-and-crack\u201d technique. <\/jats:p>","DOI":"10.1177\/1526602818763352","type":"journal-article","created":{"date-parts":[[2018,3,20]],"date-time":"2018-03-20T10:14:52Z","timestamp":1521540892000},"page":"334-342","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":44,"title":["Endovascular Treatment of Severely Calcified Femoropopliteal Lesions Using the \u201cPave-and-Crack\u201d Technique: Technical Description and 12-Month Results"],"prefix":"10.1177","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7934-2016","authenticated-orcid":false,"given":"Marina","family":"Dias-Neto","sequence":"first","affiliation":[{"name":"Department of Angiology and Vascular Surgery, S\u00e3o Jo\u00e3o Hospital Center, Porto, Portugal"},{"name":"Cardiovascular Research Center, Faculty of Medicine, University of Porto, Portugal"}]},{"given":"Manuela","family":"Matschuck","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, Germany"}]},{"given":"Yvonne","family":"Bausback","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, Germany"}]},{"given":"Ursula","family":"Banning-Eichenseher","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, Germany"}]},{"given":"Sabine","family":"Steiner","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, Germany"}]},{"given":"Daniela","family":"Branzan","sequence":"additional","affiliation":[{"name":"Vascular Surgery, University Hospital Leipzig, Germany"}]},{"given":"Holger","family":"Staab","sequence":"additional","affiliation":[{"name":"Vascular Surgery, University Hospital Leipzig, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5611-6991","authenticated-orcid":false,"given":"Ramon L.","family":"Varcoe","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia"},{"name":"Department of Surgery, Prince of Wales Hospital, Randwick, New South Wales, Australia"}]},{"given":"Dierk","family":"Scheinert","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, Germany"}]},{"given":"Andrej","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Division of Interventional Angiology, University Hospital Leipzig, 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