Evidence map›Paper›PMID 38008929›Full record

SynthesisJournal of endovascular therapy : an official journal of the International Society of Endovascular Specialists2025

Percutaneous Transluminal Angioplasty for Infrapopliteal Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-analysis of Primary Patency and Binary Restenosis Rates.

Daniel J Snyder, Robert S Zilinyi, Sonal Pruthi, Sareena George, Daniela Tirziu, Alexandra Lansky, Ari J Mintz, Sanjum S Sethi, Sahil A Parikh

Open access · greenAbstract readSystematic ReviewMeta-Analysis
In one paragraph

Synthesis in Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

  1. Retrievable scaffold therapy before paclitaxel drug-coated balloon angioplasty in infrapopliteal arteries: one-year outcomes of the DEEPER OUS Study.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2025
    Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 2 institutions in 1 country.

Daniel J SnyderDepartment of Medicine, Columbia University Irving Medical Center, New York-Presbyterian, New York, NY, USA.ORCID 0000-0002-6018-1443
Robert S ZilinyiDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Sonal PruthiDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Sareena GeorgeDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Daniela TirziuYale Cardiovascular Research Group, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.
Alexandra LanskyYale Cardiovascular Research Group, Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA.ORCID 0000-0001-8002-7497
Ari J MintzDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Sanjum S SethiDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Sahil A ParikhDivision of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
Columbia University Irving Medical Center · USYale University · US

Funding

Clinical and Translational Science AwardUL1TR001873 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI REILLY, MUREDACH P · 2016 to 2025
$99.0M
POSTDOCTORAL TRAINING IN ARTERIOSCLEROSIS RESEARCHT32HL007343 · NHLBI · COLUMBIA UNIV NEW YORK MORNINGSIDE · PI HENRY N GINSBERG, Muredach P Reilly · 1985 to 2026
$12.7M
NCATS NIH HHS UL1 TR001873NHLBI NIH HHS T32 HL007343
6 · The paper itself

Abstract

purposePercutaneous transluminal angioplasty (PTA) remains the mainstay of endovascular therapy for infrapopliteal chronic limb-threatening ischemia (CLTI), but outcomes have not been well characterized using high-quality data. The aim of this meta-analysis was to provide an updated benchmark for rates of primary patency and binary restenosis after PTA using prospectively collected, predominantly core-lab adjudicated randomized controlled trial (RCT) data. MATERIALS AND

methodsMEDLINE, EMBASE, Cochrane Central, and ClinicalTrials.gov were queried for RCTs published through November 2022 using PTA as a control arm and including patients with infrapopliteal CLTI. Studies were excluded if >25% of patients had intermittent claudication, other vessels were included, or primary patency or binary restenosis were not outcomes. Outcomes were analyzed using random effects models. This analysis was publicly registered (PROSPERO ID#394543). No funding was utilized.

resultsSeventeen RCTs were included (1048 patients, 1279 lesions). Pooled primary patency rates using data from 6 RCTs were 68% at 6 months (95% confidence interval [CI]=45%-84%) and 66% at 12 months (95% CI=51%-79%). Pooled binary restenosis rates using data from 11 RCTs were 54% at 6 months (95% CI=33%-73%) and 60% at 9 to 12 months (95% CI=39%-78%). Significant heterogeneity was present in all outcomes (

conclusionsThis meta-analysis provides estimates for binary restenosis and primary patency following PTA utilizing prospectively collected, predominantly core-lab adjudicated data. Results demonstrate 1-year primary patency rates that are 10% to 20% higher than what has been historically used in power calculations. These new estimates will help facilitate more accurate power analysis for future RCTs.Clinical ImpactRates of primary patency and binary restenosis after percutaneous transluminal angioplasty (PTA) have not been well-described using high-quality data, and investigators have been utilizing estimates of 40% to 50% and 45% to 65%, respectively, when performing power calculations for trials. This meta-analysis demonstrates using high-quality, prospectively collected, and predominantly core-lab adjudicated randomized controlled trial data that actual rates of primary patency are closer to 60% up to 1 year following PTA and provides the first meta-analysis estimate of binary restenosis rates up to 1 year after PTA. These estimates will help facilitate more accurate power calculations for future RCTs in this space.

Indexed as

AngioplastyChronic Limb-Threatening IschemiaIschemiaPeripheral Arterial DiseasePopliteal ArteryVascular PatencyAgedChronic DiseaseFemaleHumansMaleMiddle AgedRandomized Controlled Trials as TopicRecurrenceRisk AssessmentRisk Factorsangioplastybelow-the-kneechronic limb-threatening ischemiainfrapopliteal

Identifiers

PMID38008929
PMCPMC12605916
OpenAlexW4389054104

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.