{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T02:39:14Z","timestamp":1792636754867,"version":"4.5.0"},"reference-count":29,"publisher":"Becaris Publishing Limited","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Comp. Eff. Res."],"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:p>\n            <jats:bold>Aim:<\/jats:bold>\n            Use long-term follow-up data from the IMPERIAL study to determine whether drug-eluting polymer-based nitinol stent treatment can delay the time to repeat intervention for femoropopliteal artery disease and how such a delay may result in cost savings in a value-based episode of care.\n            <jats:bold>Patients &amp; methods:<\/jats:bold>\n            The IMPERIAL randomized controlled trial was an international study of a paclitaxel-eluting polymer-coated stent (Eluvia, Boston Scientific, MA, USA) versus a polymer-free paclitaxel-coated stent (Zilver PTX, Cook Corporation, IN, USA) for treating lesions of the femoropopliteal arterial segment. Study patients (n\u00a0=\u00a0465) had symptomatic lower limb ischemia. Safety and efficacy assessments were performed through 5\u00a0years. Mean time to first reintervention was calculated in post-hoc analysis for patients who underwent a clinically driven target lesion revascularization (CD-TLR) through 3 or 5\u00a0years following the index procedure. To simulate potential cost savings associated with differential CD-TLR burden over time, a cost-avoidance analysis using input parameters from IMPERIAL and US 100% Medicare standard analytical files was developed.\n            <jats:bold>Results:<\/jats:bold>\n            Among patients with a first CD-TLR through 3\u00a0years of follow-up, mean time to reintervention was 5.5\u00a0months longer (difference 166\u00a0days, 95% CI: 51, 282\u00a0days; p\u00a0=\u00a00.0058) for patients treated with Eluvia (n\u00a0=\u00a056) than for those treated with Zilver PTX (n\u00a0=\u00a030). Through the 5-year study follow-up period, CD-TLR rates were 29.3% (68\/232) for Eluvia and 34.2% (39\/114) for Zilver PTX (p\u00a0=\u00a00.3540) and mean time to first reintervention exceeded 2\u00a0years for patients treated with Eluvia at 737\u00a0days versus 645\u00a0days for the Zilver PTX group (difference 92\u00a0days, 95% CI: -85, 269\u00a0days; p\u00a0=\u00a00.3099). Simulated savings considering reinterventions occurring over 1 and 5\u00a0years following initial use of Eluvia over Zilver PTX were US $1,395,635 and US $1,531,795, respectively, when IMPERIAL CD-TLR rates were extrapolated to 1000 patients.\n            <jats:bold>Conclusion:<\/jats:bold>\n            IMPERIAL data suggest initial treatment with Eluvia extends the time patients spend without undergoing reintervention. This extension may be associated with cost savings in relevant time frames.\n          <\/jats:p>","DOI":"10.57264\/cer-2024-0025","type":"journal-article","created":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T08:59:31Z","timestamp":1712912371000},"source":"Crossref","is-referenced-by-count":7,"title":["Polymer-based drug-eluting stent treatment extends the time to reintervention for patients with symptomatic femoropopliteal artery disease: clinical evidence and potential economic value"],"prefix":"10.57264","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4676-2839","authenticated-orcid":false,"given":"William A","family":"Gray","sequence":"first","affiliation":[{"name":"Department of Medicine, Sidney Kimmel School of Medicine, Thomas Jefferson University, Philadelphia, PA\u00a019107, USA"},{"name":"Division of Cardiology, Main Line Health, Wynnewood, PA, USA &amp; Lankenau Heart Institute, Wynnewood, PA\u00a019096, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"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":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiko","family":"Fujihara","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6829-7304","authenticated-orcid":false,"given":"Osamu","family":"Iida","sequence":"additional","affiliation":[{"name":"Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anvar","family":"Babaev","sequence":"additional","affiliation":[{"name":"New York University Medical Center, New York, NY\u00a010016, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daizo","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Morinomiya Hospital, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2704-3871","authenticated-orcid":false,"given":"Thomas","family":"Zeller","sequence":"additional","affiliation":[{"name":"Department of Angiology, Universit\u00e4ts-Herzzentrum Freiburg-Bad Krozingen, Bad Krozingen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"O'Connor","sequence":"additional","affiliation":[{"name":"Hackensack University Medical Center, Hackensack, NJ\u00a007061, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3772-5887","authenticated-orcid":false,"given":"Michael R","family":"Jaff","sequence":"additional","affiliation":[{"name":"Peripheral Interventions, Boston Scientific, Marlborough, MA\u00a001752, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M","family":"Chavez","sequence":"additional","affiliation":[{"name":"Peripheral Interventions, Boston Scientific, Marlborough, MA\u00a001752, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"M\u00fcller-H\u00fclsbeck","sequence":"additional","affiliation":[{"name":"Institut F\u00fcr Diagnostische und Interventionelle Radiologie und Neuroradiologie, Diako Hospital gGmbH, Flensburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"36897","reference":[{"issue":"8","key":"e_1_3_10_3_2","first-page":"e93","article-title":"Heart disease and stroke statistics \u2013 2023 update: a report from the American Heart Association","volume":"147","author":"Tsao CW","year":"2023","unstructured":"Tsao CW, Aday AW, Almarzooq ZI Heart disease and stroke statistics \u2013 2023 update: a report from the American Heart Association. 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