{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T14:36:20Z","timestamp":1783953380925,"version":"3.55.0"},"reference-count":23,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Endovascular revascularization (EVR) is a pillar of therapeutic management in patients with symptomatic lower extremity artery disease (LEAD). Due to lack of scientific evidence, the approach of EVR type and the devices used at the different anatomic vascular segments of the lower limbs vary substantially between operators and centers. We analyzed data from the RECcording COurses of vasculaR Diseases (RECCORD) registry to assess the current real-world EVR treatment patterns in relation to anatomic vascular segments in symptomatic LEAD patients in Germany. Patients and Methods: RECCORD is an ongoing, prospective, multicenter, all-comers and entirely web-based registry platform. Baseline demographic and periprocedural data of patients undergoing EVR for symptomatic LEAD were assessed and performed EVRs were grouped according to the intervened anatomic vascular segment. We analyzed four EVR groups comprising either the aorto-iliac, femoropopliteal, or infrapopliteal segments (all these EVRs with or without a further intervention in another anatomic segment) or the infrapopliteal segment alone. Results: A total of 2210 EVR segments (in 1639 patients) were analyzed. Of those 616 (27.9%) were aorto-iliacal, 1346 (60.9%) femoropopliteal, 248 (11.2%) infrapopliteal and 104 (4.7%) only infrapopliteal segments. Aorto-iliac EVR was associated with younger age, smoking, claudication and simple lesions, while the distal infrapopliteal EVRs were related to advanced age, diabetes, multiple comorbidities, limb threatening ischemia and complex lesions. The use of different EVR devices at the aorto-iliac, femoropopliteal, infrapopliteal and only infrapopliteal segments were: only ballon-angioplasty: 8.3%, 12.9%, 58.1% and 63.5%; stenting: 82.3%, 45.3%, 16.9% and 12.5%; drug-coated balloon: 11.2%, 55.0%, 19.4% and 19.2%. Conclusion: The RECCORD registry data demonstrate that in LEAD clinical and lesion characteristics are related to anatomic vascular segments. Despite the clear relationship between vascular segments and the current use of device types, prospective, segment-specific clinical studies are warranted to establish a consistent, evidence-based path for EVR in LEAD.<\/jats:p>","DOI":"10.3390\/jcm11206074","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T02:29:46Z","timestamp":1665973786000},"page":"6074","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Clinical Characteristics and Current Practice of Endovascular Revascularization in Aorto-Iliac, Femoropopliteal and Infra-Popliteal Lower Extremity Artery Disease\u2014Insights from the RECCORD Registry"],"prefix":"10.3390","volume":"11","author":[{"given":"Jacqueline","family":"Stella","sequence":"first","affiliation":[{"name":"Department of Cardiology I\u2014Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00fcrgen","family":"Stausberg","sequence":"additional","affiliation":[{"name":"Independent Researcher, 45276 Essen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Lichtenberg","sequence":"additional","affiliation":[{"name":"Vascular Center, Arnsberg Clinic, 59759 Arnsberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Division of Vascular Medicine, Medical Clinic and Policlinic IV, Hospital of the Ludwig-Maximilians-University, 80336 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser M.","family":"Malyar","sequence":"additional","affiliation":[{"name":"Department of Cardiology I\u2014Coronary and Peripheral Vascular Disease, Heart Failure, University Hospital Muenster, Cardiol, 48149 Muenster, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,10,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1024\/0301-1526\/a000440","article-title":"Restenosis after endovascular revascularization in peripheral artery disease","volume":"44","author":"Malyar","year":"2015","journal-title":"Vasa"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1024\/0301-1526\/a000631","article-title":"Rationale and design of the RECording COurses of vasculaR Diseases registry (RECCORD registry)","volume":"46","author":"Malyar","year":"2017","journal-title":"Vasa"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1024\/0301-1526\/a000882","article-title":"Demographic and procedural characteristics in the RECording COurses of vasculaR Diseases (RECCORD) registry\u2014The first 1000 patients","volume":"49","author":"Malyar","year":"2020","journal-title":"Vasa"},{"key":"ref_4","first-page":"200","article-title":"Impact of atherosclerotic risk factors on the anatomical distribution of peripheral arterial disease","volume":"20","author":"Haltmayer","year":"2001","journal-title":"Int. Angiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e3276","DOI":"10.1002\/dmrr.3276","article-title":"Guidelines on diagnosis, prognosis, and management of peripheral artery disease in patients with foot ulcers and diabetes (IWGDF 2019 update)","volume":"36","author":"Hinchliffe","year":"2020","journal-title":"Diabetes Metab. Res. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.pcad.2011.04.003","article-title":"Claudication: Treatment options for femoropopliteal disease","volume":"54","author":"Schillinger","year":"2011","journal-title":"Prog. Cardiovasc. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e011245","DOI":"10.1161\/JAHA.118.011245","article-title":"Risk of Death Following Application of Paclitaxel-Coated Balloons and Stents in the Femoropopliteal Artery of the Leg: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"7","author":"Katsanos","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1024\/0301-1526\/a000877","article-title":"Distal embolization during percutaneous revascularization of the lower extremity arteries","volume":"49","author":"Boc","year":"2020","journal-title":"Vasa"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1161\/CIRCINTERVENTIONS.114.001306","article-title":"Access site complications after peripheral vascular interventions: Incidence, predictors, and outcomes","volume":"7","author":"Ortiz","year":"2014","journal-title":"Circ. Cardiovasc. Interv."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1016\/j.jcin.2019.03.012","article-title":"Bleeding Complications in Lower-Extremity Peripheral Vascular Interventions: Insights from the NCDR PVI Registry","volume":"12","author":"Bhardwaj","year":"2019","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1093\/eurheartj\/ehx095","article-title":"2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: The European Stroke Organization (ESO)The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS)","volume":"39","author":"Aboyans","year":"2018","journal-title":"Eur. Heart J."},{"key":"ref_12","first-page":"e726","article-title":"2016 AHA\/ACC Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease: A Report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"135","author":"Gornik","year":"2017","journal-title":"Circulation"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Writing Committee Members, Gerhard-Herman, M.D., Gornik, H.L., Barrett, C., Barshes, N.R., Corriere, M.A., Drachman, D.E., Fleisher, L.A., Fowkes, F.G.R., and Hamburg, N.M. (2017). 2016 AHA\/ACC Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease: Executive Summary. Vasc. Med., 22, NP1\u2013NP43.","DOI":"10.1177\/1358863X17701592"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1007\/s00059-020-04998-w","article-title":"Medication-based secondary prevention in patients with peripheral arterial occlusive disease: An analysis based on secondary data","volume":"46","author":"Gebauer","year":"2021","journal-title":"Herz"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1016\/j.jacc.2013.09.073","article-title":"Association between statin medications and mortality, major adverse cardiovascular event, and amputation-free survival in patients with critical limb ischemia","volume":"63","author":"Westin","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1016\/j.jacc.2020.05.048","article-title":"Atherosclerotic Risk and Statin Use Among Patients with Peripheral Artery Disease","volume":"76","author":"Colantonio","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"704","DOI":"10.1016\/j.jacc.2019.11.053","article-title":"In-Hospital Outcomes and Discharge Medication Use Among Patients with Critical Limb Ischemia Versus Claudication","volume":"75","author":"Rymer","year":"2020","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e000697","DOI":"10.1161\/JAHA.113.000697","article-title":"Adherence to guideline-recommended therapy is associated with decreased major adverse cardiovascular events and major adverse limb events among patients with peripheral arterial disease","volume":"3","author":"Armstrong","year":"2014","journal-title":"J. Am. Heart Assoc."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1177\/1358863X9700200314","article-title":"The role of tobacco cessation, antiplatelet and lipid-lowering therapies in the treatment of peripheral arterial disease","volume":"2","author":"Hirsch","year":"1997","journal-title":"Vasc. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1973","DOI":"10.1016\/j.jvs.2019.02.066","article-title":"Cigarette smoking intensity informs outcomes after open revascularization for peripheral artery disease","volume":"70","author":"Young","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1158","DOI":"10.1016\/j.jvs.2004.08.049","article-title":"Influence of smoking on incidence and prevalence of peripheral arterial disease","volume":"40","author":"Willigendael","year":"2004","journal-title":"J. Vasc. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2306","DOI":"10.1016\/j.jacc.2018.03.008","article-title":"Major Adverse Limb Events and Mortality in Patients with Peripheral Artery Disease: The COMPASS Trial","volume":"71","author":"Anand","year":"2018","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1994","DOI":"10.1056\/NEJMoa2000052","article-title":"Rivaroxaban in Peripheral Artery Disease after Revascularization","volume":"382","author":"Bonaca","year":"2020","journal-title":"N. Engl. J. Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6074\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T00:54:12Z","timestamp":1760144052000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/20\/6074"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,14]]},"references-count":23,"journal-issue":{"issue":"20","published-online":{"date-parts":[[2022,10]]}},"alternative-id":["jcm11206074"],"URL":"https:\/\/doi.org\/10.3390\/jcm11206074","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,14]]}}}