NEJM Original Article

The New England Journal of Medicine, January 4, 2024

Data from a multicenter, randomized, controlled trial (RCT) of 261 patients with chronic limb-threating ischemia and Infrapopliteal artery disease. Patients were randomly assigned to receive treatment with an everolimus-eluting resorbable scaffold or angioplasty.

What’s Interesting about this article?

  • Peripheral artery disease is a global health problem affecting more than 230 million people, including 7-12 million people in the U.S.
  • Treatment with angioplasty for chronic limb-threating ischemia is frequently associated with frequent reintervention and adverse limb outcomes from restenosis.
  • The treatment of patients with Infrapopliteal artery disease with the everolimus-eluting resorbable scaffold was superior to angioplasty in this study.

JournalDoc Comments:

  • Untreated limb-threatening ischemia of the legs is a serious health problem with resting pain in the limb and a high rate of ulceration gangrene and amputation.
  • As noted in an accompanying editorial by Joshua A. Beckman, MD, device therapy in peripheral artery disease may be “coming of age” with the use of resorbable scaffolds that provide support to the vessel wall and prevent acute and subacute vessel closure.
  • This study focused both on device success and clinical outcomes, which are the hall marks of  evidence-based medicine. Future studies should always include clinical outcomes.

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