Comparable clinical characteristics and outcomes of patients undergoing endovascular treatment for aorto-iliac or femoropopliteal lesions

Lower extremity peripheral arterial disease is usually a consequence of advanced atherosclerosis, leading to high mortality and morbidity. Although clinical characteristics and outcomes may differ among patients having peripheral disease in different arterial territories, contemporary data are scarce. From January 2019 to December 2022, this multicenter registry study included 712 patients undergoing endovascular treatment (EVT) for either aorto-iliac (AI) or femoropopliteal (FP) lesions. Patient characteristics and outcomes were compared between AI-EVT and FP-EVT groups. Clinical endpoints included major adverse cardiovascular events, major adverse limb events (MALE), and all-cause mortality, stratified by chronic limb-threatening ischemia (CLTI). Of the 712 patients, 217 (30.5%) and 495 (69.5%) underwent AI-EVT or FP-EVT. Patients undergoing AI-EVT were more likely to be men and current smokers, while diabetes was more frequent in the FP-EVT group. The prevalence of CLTI was significantly higher in the FP-EVT group. In the entire study population, the FP-EVT rather than the AI-EVT group had a significantly higher rate of MALE and mortality, but the incidence of major adverse cardiovascular events was similar between the two groups. When focusing only on patients without CLTI, the mortality risk was similar, while the MALE risk was still higher in the FP-EVT group. In conclusion, patients undergoing EVT for AI and FP lesions in contemporary settings were differently characterized by baseline factors. Although the worse clinical outcomes in the FP-EVT group were mainly driven by the higher prevalence of CLTI, the MALE risk was still increased in patients without CLTI.