LAUSR

models with log-rank tests to determine survival in Kaplan-Meier curves. P < .05 was the threshold for significance. Results: There were 342 infrapopliteal interventions performed on 290 patients at a mean age of 67.36 12.6 years; 61% were male. There were 183 angioplasties (53.5%) and 159 atherectomies (46.5%) performed. Angioplasty and atherectomy groups had similar demographics, comorbidities, numbers of patients with tissue loss (145 [79.2%] vs 134 [84.2%]; P 1⁄4 .2641) and ischemic rest pain (38 [20.7%] vs 25 [15.7%]; P 1⁄4 .5119), mean followup (19.0 6 9.9 months vs 20.3 6 9.2 months; P 1⁄4 .3231), mean number of vessels treated during the index procedure (1.7 6 0.8 vs 1.9 6 0.8; P 1⁄4 .0318), and the mean lesion length treated (10.44 6 8.41 cm vs 9.05 6 6.73 cm; P 1⁄4 .09), respectively. Primary patency rates at 3 months were 91.8% (168) for angioplasty versus 92.5% (147) for atherectomy (P 1⁄4 .8). Similar 6-month (158 [86%] vs 135 [85%]; P 1⁄4 .7), 12-month (156 [85%] vs 122 [77%]; P 1⁄4 .04), and 18-month (152 [83.1%] vs 121 [76.1%]; P 1⁄4 .08) interval patency rates were seen in 2 groups. There were 45 atherectomy patients (28.3%) who had reinterventions versus 29 angioplasty patients (15.8%; P 1⁄4 .0058) with a median of 74 days before the need for reintervention. Diabetes was the only clinical factor associated with increased risk of reintervention (B 1⁄4 0.76; P 1⁄4 .018) in both groups. Primary assisted patency rates were 86.3% (n 1⁄4 158) in angioplasty versus 76.1% (n 1⁄4 121) in atherectomy group (P 1⁄4 .0174). Primary patency rates did not differ between the 2 groups (Fig 1). The risk of reintervention was, however, greater in the atherectomy group (Fig 2). The 30-day amputation rates (5 [2.7%] vs 6 [3.8%]; P 1⁄4 .7606) and mortality rates (4 [2.2%] vs 2 [1.3%]; P 1⁄4 .6894) were similar in the angioplasty and atherectomy groups, respectively. The atherectomy group had higher local complication rates (7 [4.4%] vs 1 [0.5%]; P 1⁄4 .0273). Conclusions: Atherectomy provides similar patency rates to angioplasty alone for infrapopliteal peripheral arterial disease, but is associated with higher reintervention and local complication rates. Further appropriately designed studies are required to determine the exact role of atherectomy in this subset of patients.