Table 3.
Effect of Atherectomy Versus PTA Treatment on Major Amputation, Any Amputation, and MALE Risk
| Outcome | Overall (n=8609) | 1 Artery Treated (n=2235) | Femoropopliteal Treated (n=4542) | Diabetic (n=5154) | ||||
|---|---|---|---|---|---|---|---|---|
| HR (95% CI) | P Value | HR (95% CI) | P Value | HR (95% CI) | P Value | HR (95% CI) | P Value | |
| Major amputation | ||||||||
| Unadjusted | 0.99 (0.82–1.19) | 0.906 | 1.07 (0.74–1.56) | 0.718 | 0.87 (0.66–1.14) | 0.300 | 0.94 (0.76–1.16) | 0.549 |
| Multivariable+REa | 1.14 (0.93–1.39) | 0.200 | 1.18 (0.78–1.79) | 0.420 | 1.13 (0.85–1.52) | 0.400 | 1.08 (0.86–1.35) | 0.510 |
| IVb | 1.38 (0.86–2.22) | 0.180 | 1.91 (0.69–5.30) | 0.210 | 1.10 (0.59–2.05) | 0.770 | 1.19 (0.71–1.99) | 0.511 |
| Any amputation | ||||||||
| Unadjusted | 0.98 (0.85–1.12) | 0.744 | 0.93 (0.70–1.24) | 0.634 | 0.96 (0.79–1.18) | 0.709 | 0.95 (0.82–1.11) | 0.553 |
| Multivariable+REa | 1.10 (0.93–1.27) | 0.230 | 1.07 (0.79–1.45) | 0.670 | 1.21 (0.98–1.49) | 0.082 | 1.09 (0.91–1.28) | 0.390 |
| IVb | 1.51 (1.08–2.13) | 0.019 | 2.42 (1.15–5.10) | 0.019 | 1.32 (0.84–2.06) | 0.230 | 1.39 (0.96–2.01) | 0.077 |
| MALE | ||||||||
| Unadjusted | 1.07 (0.94–1.20) | 0.304 | 0.98 (0.78–1.24) | 0.882 | 1.00 (0.86–1.17) | 0.968 | 1.09 (0.94–1.27) | 0.246 |
| Multivariable+REa | 1.14 (1.06–1.30) | 0.041 | 1.09 (0.85–1.39) | 0.510 | 1.10 (0.93–1.30) | 0.250 | 1.15 (0.98–1.35) | 0.093 |
| IVb | 1.28 (0.95–1.75) | 0.097 | 1.12 (0.61–2.09) | 0.700 | 1.17 (0.81–1.67) | 0.410 | 1.41 (0.97–2.04) | 0.070 |
HR indicates hazard ratio; IV, instrumental variable; MALE, major adverse limb event; PTA, percutaneous transluminal angioplasty; RE, random effect.
*All HR estimates from Cox regression models. Unless specified (eg, unadjusted) models are adjusted for age, sex, race, ethnicity, transfer from rehabilitation, nursing home living, smoking, body mass index, hypertension, diabetes mellitus, insulin‐dependent diabetes mellitus, coronary disease, chronic obstructive pulmonary disease, congestive heart failure, dialysis, prior stent or PTA, prior bypass, aspirin, P2Y antagonist use, statin, ambulatory status, procedure urgency, limb indication, number of arteries treated, arterial location, and Trans‐Atlantic Inter‐Society Consensus Document on Management of Peripheral Arterial Disease (TASC) score.
Adjusted model includes random‐effects component for center.
Adjusted model incorporates instrument (proportion of atherectomy of all atherectomy and PTA procedures performed at center in the 12 months before patient's procedure).