Impact of lipid-rich plaques in the femoropopliteal artery on limb outcomes in patients undergoing endovascular therapy

BACKGROUND: The impact of lipid-rich plaques (LRPs) in the femoropopliteal artery on limb outcomes remains underexplored. We investigated the influence of LRPs on limb outcomes in patients undergoing endovascular therapy (EVT) for femoropopliteal disease. METHODS: This single-center, prospective noninterventional observational study included patients undergoing drug-coated balloon angioplasty for femoropopliteal disease between July 2022 and November 2024. Near-infrared spectroscopy-intravascular ultrasound (NIRS-IVUS) assessment was conducted on the entire femoropopliteal arterial segment. LRP was defined as plaque with a maximum lipid-core burden index in any 4-mm region > 400. The primary outcome was major adverse limb events (MALEs) at 12 months. Secondary outcomes included primary patency and target-vessel revascularization (TVR) at 12 months. TVR was defined as any repeat EVT or surgical bypass of any segment of the target vessel. RESULTS: = 0.049) at 12 months. CONCLUSION: .