Marlon I. Spreen's research while affiliated with HagaZiekenhuis van Den Haag and other places
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Publications (8)
PurposeRecently, two meta-analyses concluded that there appears to be an increased risk of long-term mortality of paclitaxel-coated balloons and stents in the superficial femoral and popliteal artery, and paclitaxel-coated balloons below the knee. In this post hoc study of the PADI Trial, we investigated the long-term safety of first-generation pac...
Purpose
Drug-eluting stents (DES) improve clinical and morphological long-term results compared to percutaneous transluminal angioplasty (PTA) with bailout bare metal stenting (BMS) in patients with critical limb ischemia (CLI) and infrapopliteal lesions (PADI trial). We performed a cost-effectiveness analysis of DES compared to PTA ± BMS in cooper...
Background:
Chronic limb-threatening ischemia (CLTI) represents the most severe form of peripheral artery disease and has a large impact on quality of life, morbidity, and mortality. Interventions are aimed at improving tissue perfusion and averting amputation and secondary cardiovascular complications with an optimal risk-benefit ratio. Several p...
Objective:
The objective of this study was to assess the prognostic value of a high or immeasurable ankle-brachial index (ABI) at baseline for major amputation and amputation-free survival (AFS) in patients with critical limb ischemia (CLI).
Methods:
Data from two recent trials in patients with CLI and proven infrapopliteal arterial obstructive...
Table S1. Outcome at 1‐Year Follow‐up, per Patient
Table S2. Outcome at 2‐Year Follow‐up, per Patient
Table S3. Outcome at 3‐Year Follow‐up, per Patient
Table S4. Outcome at 4‐Year Follow‐up, per Patient
Table S5. Outcome at 5‐Yeas Follow‐up, per Patient
Background
Clinical outcomes reported after treatment of infrapopliteal lesions with drug‐eluting stents (DESs) have been more favorable compared with percutaneous transluminal angioplasty with a bailout bare metal stent (PTA‐BMS) through midterm follow‐up in patients with critical limb ischemia. In the present study, long‐term results of treatment...
Objective:
Although never assessed prospectively, diabetes mellitus (DM) is assumed to negatively affect the outcomes of critical limb ischemia (CLI). DM was highly prevalent in two recently conducted randomized controlled trials in CLI patients, the PADI (Percutaneous Transluminal Balloon Angioplasty [PTA] and Drug Eluting Stents for Infrapoplite...
Background—
Endovascular infrapopliteal treatment of patients with critical limb ischemia using percutaneous transluminal angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-init...
Citations
... Coronary drug-eluting stents deliver targeted antiproliferative drug therapy directly to the blood vessel wall to reduce neointimal hyperplasia, negative remodelling, and instent re-stenosis. They have been used in the treatment of infrapopliteal artery disease for over a decade, with multiple randomised controlled trials demonstrating superior primary patency compared with PTA and/or BMSs [5,6,20]. Currently, they are often used as a bail-out strategy for post-angioplasty dissection, elastic recoil, or in the treatment of focal de novo disease. ...
... Two primary cost analyses (23,24) compared prostatic artery embolization with transurethral resection of the prostate for the treatment of benign prostatic hyperplasia and found prostatic artery embolization to be less expensive and more cost-effective despite a slightly higher QALY for transurethral resection of the prostate. One study (25) compared spermatic vein embolization with laparoscopic ligation for varicocele ( Table 3). ...
... Several domains came to the fore: pain, mobility, wounds, patient and family support systems, psychological and mental health, and a patientlevel experience measure related to overall social impact and QoL (Fig 2). [29][30][31] The group's consensus was that each of these domains contributed in a distinct way toward QoL for patients with CLTI, and a PROM focused on this effort would need to adequately capture these elements. 21,[32][33][34][35][36][37][38][39][40] Finally, making certain a tool that could be completed accurately by a family member would also be a key contribution. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/365933349621762-1464256717407_Q64/Martin-Teraa.jpg)
... Calcification is increasingly recognized as an independent severity factor in CLTI, which may also negatively affect stent patency. 25,26 The significantly greater prevalence of moderate or severe calcification in the DES arm as assessed by the angiographic core lab could have influenced the SAVAL trial outcomes. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/272319113330705-1441937344367_Q64/Hendrik-Gremmels.jpg)
... 47 Post-interventional antithrombotic medications and post-procedural complications were poorly reported, as shown in Supplementary Tables S5 and S6. Where reported, trials were either funded by investigator obtained grants (n ¼ 3) 36,39,44 or by industry support (n ¼ 11). 22e25, 32,35,37,41e43,45 Most trials were funded by industry, however, there was no observable difference in the quality of studies between different funding sources. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/424304019021832-1478173369432_Q64/Bob-Knippenberg.jpg)
... Multiple randomised controlled trials (RCTs) have demonstrated the efficacy of coronary drug-eluting stents (DESs) in improving primary patency, lowering immediate procedural residual stenosis and improving amputation rates compared with baremetal stents (BMSs) and/or PTA alone [5][6][7][8][9]. More recent devices, including drug-eluting resorbable scaffolds (DRSs), specialty, lithotripsy, and drug-coated balloons, as well as the Tack endovascular dissection repair system, designed specifically to treat post-PTA dissection, have sought to overcome the issue of residual foreign bodies that can add complexity to future endovascular procedures [10][11][12]. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/527290372825088-1502727229009_Q64/Bettina-Hansen-2.jpg)
... Primary sustained clinical improvement through 36 months was achieved in over 50% of patients with DM or CLTI, although it was lower compared to non-DM and IC participants. Overall longterm survival was lower in patients with DM and CLTI, compared to non-DM and IC, highlighting the frailty of these patients [19][20][21]. DM is a risk factor for PAD and accelerated PAD progression leading to more ischemic events [22,23]. Similarly, the present study observed a higher percentage of CLTI among DM compared to non-DM at baseline. ...
