***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    ***EXAMPLES*** 
    Input: Purpose : To determine the primary success and short-term patency of stent application as a primary treatment modality for high- grade lesions of the infrapopliteal arteries compared with treatment with percutaneous transluminal angioplasty ( PTA ) in critical limb ischemia in a r and omized prospect i ve study . Methods : Endovascular therapy was performed on 95 lesions in 51 patients ( mean age 72.0 years , range 47–80 years ) who presented clinical ly with Fontaine stages III and IV . One patient underwent treatment in both limbs . After angiographic lesion identification , patients were r and omized for treatment by PTA ( 53 lesions in 27 patients ) or stent application ( 42 lesions in 24 patients ) . Follow-up by clinical investigation and conventional angiography or spiral CT angiography was performed in 37 patients ( 57 lesions ) 6 to 12 months after the procedure , or when clinical ly indicated . Evaluation was performed by two observers , double-blinded , with thresholds for lesion restenosis of 50 % and 70 % . Statistical evaluation was performed on a lesion basis by Kaplan – Meier estimated probability rates , and log-rank and Wilcoxon tests . The primary endpoint was the angiographic patency rate of treated lesions . Results : The inter-reader agreement was high ( κ = 0.82 ) . For the stent group the cumulative primary patency at 6 months was 83.7 % at the 70 % restenosis threshold , and 79.7 % at the 50 % restenosis threshold . For PTA , the primary patency at 6 months was 61.1 % at the 70 % restenosis threshold and 45.6 % at the 50 % restenosis threshold . Both results were statistically significant ( p < 0.05 ) . Conclusion : Infrapopliteal stent application is an effective treatment modality for high- grade lesions in chronic critical limb ischemia . Compared with PTA , higher patency rates can be expected after 6 months 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 st and ard practice nowadays . An investigator-initiated , multicenter , r and omized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions . Methods and Results —Adults with critical limb ischemia ( Rutherford category ≥4 ) and infrapopliteal lesions were r and omized to receive PTA±BMS or DES with paclitaxel . Primary end point was 6-month primary binary patency of treated lesions , defined as ⩽50 % stenosis on computed tomographic angiography . Stenosis > 50 % , retreatment , major amputation , and critical limb ischemia – related death were regarded as treatment failure . Severity of failure was assessed with an ordinal score , ranging from vessel stenosis through occlusion to the clinical failures . Seventy-four limbs ( 73 patients ) were treated with DES and 66 limbs ( 64 patients ) received PTA±BMS  . Six-month patency rates were 48.0 % for DES and 35.1 % for PTA±BMS ( P=0.096 ) in the modified-intention-to-treat and 51.9 % and 35.1 % ( P=0.037 ) in the per- protocol analysis . The ordinal score showed significantly worse treatment failure  for PTA±BMS versus DES ( P=0.041 ) . The observed major amputation rate remained lower in the DES group until 2 years post-treatment , with a trend toward significance ( P=0.066 ) . Less minor amputations  occurred after DES until 6 months post-treatment ( P=0.03 ) . Conclusions —In patients with critical limb ischemia caused by infrapopliteal lesions  , DES provide better 6-month patency rates and less amputations after 6 and 12 months compared with PTA±BMS . Clinical Trial Registration —URL : http://www . clinical trials.gov . Unique identifier : NCT00471289 The study was design ed as a feasibility trial to evaluate the use of GP IIb/IIIa blockade in connection with drug eluting stents , bare stents and PTA only . Sixty patients with current ulcers were r and omly assigned to receive abciximab plus a sirolimus coated stent ( N.=14 ) , abciximab plus a bare stent ( N.=16 ) , abciximab plus PTA ( N.=14 ) and PTA alone ( N.=19 ) . Angiographic control was performed at two and six months . Recanalization was successful in all cases . Two month restenosis rate was 9 % , 45.5 % , 67 % and 46 % . At six month follow-up restenosis rate was 9 % , 67 % , 75 % and 58 % , respectively ; 14 % of all patients had major amputations within six months . Adjunctive administration of abciximab during peripheral arterial intervention below the knee was found to be safe . Sirolimus coated stent administration was followed by a higher patency rate BACKGROUND The Bypass versus Angioplasty in Severe Ischaemia of the Leg ( BASIL ) trial showed in patients with severe lower limb ischemia ( rest pain , tissue loss ) who survive for 2 years after intervention that initial r and omization to bypass surgery  , compared with balloon angioplasty , was associated with an improvement in subsequent amputation-free survival and overall survival of about 6 and 7 months , respectively . The aim of this report is to describe the angiographic severity and extent of infrainguinal arterial disease in the BASIL trial cohort so that the trial outcomes can be appropriately generalized to other patient cohorts with similar anatomic ( angiographic ) patterns of disease . METHODS Preintervention angiograms were scored using the Bollinger method and the TransAtlantic Inter-Society Consensus ( TASC ) II classification system by three consultant interventional radiologists and two consultant vascular surgeons unaware of the treatment received or patient outcomes . RESULTS As was to be expected from the r and omization process , patients in the two trial arms were well matched in terms of angiographic severity and extent of disease as documented by Bollinger and TASC II . In patients with the least overall disease , it tended to be concentrated in the superficial femoral and popliteal arteries , which were the commonest sites of disease overall . The below knee arteries became increasingly involved as the overall severity of disease increased , but the disease in the above knee arteries did not tend to worsen . The posterior tibial artery was the most diseased crural artery , whereas the peroneal appeared relatively spared . There was less interobserver disagreement with the Bollinger method than with the TASC II classification system , which also appears inherently less sensitive to clinical ly important differences in infrapopliteal disease among patients with severe leg ischemia . CONCLUSIONS Anatomic ( angiographic ) disease description in patients with severe leg ischemia requires a reproducible scoring system that is sensitive to differences in crural artery disease . The Bollinger system appears well suited for this purpose , but the TASC II classification system less so . We hope this detailed analysis will facilitate appropriate generalization of the BASIL trial data to other groups of patients affected by similar anatomic ( angiographic ) patterns of disease OBJECTIVES The study investigated the efficacy and safety of a balloon exp and able , sirolimus-eluting stent ( SES ) in patients with symptomatic infrapopliteal arterial disease . BACKGROUND Results of infrapopliteal interventions using balloon angioplasty and /or bare stents are limited by a relatively high restenosis rate , which could be potentially improved by stabilizing the lesion with a SES . METHODS Two hundred patients ( total lesion length 27 ± 21 mm ) were r and omized to infrapopliteal SES stenting or percutaneous transluminal balloon angioplasty ( PTA ) . The primary endpoint was 1-year in-segment binary restenosis by quantitative angiography . RESULTS Ninety-nine and 101 patients ( mean age 73.4 years ; 64 % diabetics ) were r and omized to SES and PTA , respectively ( 8 crossover bailout cases to SES ) . At 1 year , there were lower angiographic restenosis rates ( 22.4 % vs. 41.9 % , p = 0.019 ) , greater vessel patency ( 75.0 % vs. 57.1 % , p = 0.025 ) , and similar death , repeat revascularization , index-limb amputation rates , and proportions of patients with improved Rutherford class for SES versus PTA . CONCLUSIONS SES implantation may offer a promising therapeutic alternative to PTA for treatment of infrapopliteal peripheral arterial disease Purpose : To report the 1-year angiographic and clinical outcome from a prospect i ve single-center study investigating the infrapopliteal application of sirolimus-eluting versus bare metal stents in patients with critical limb ischemia ( CLI ) who underwent below-the-knee endovascular revascularization . Methods : Stenting was performed as a bailout procedure for suboptimal angioplasty results ( flow-limiting dissection , elastic recoil , or postangioplasty residual stenosis > 30 % ) . In the first 29 patients , infrapopliteal stenting was performed with bare metal stents ( group B ) and with sirolimus-eluting stents in the other 29 patients ( group S ) . Results : Below-the-knee angioplasty and stenting involved 65 lesions in 40 infrapopliteal arteries of 29 limbs in group B and 66 lesions in 41 infrapopliteal arteries of 29 limbs in group S. Baseline comorbidities ( hyperlipidemia and symptomatic cardiac and carotid disease ) were more pronounced in group S ( p<0.05 ) . At 6 months , sirolimus-eluting stents demonstrated significantly higher primary patency ( OR 5.625 , 95 % CI 1.711 to 18.493 , p=0.004 ) and decreased in-stent binary restenosis ( OR 0.067 , 95 % CI 0.021 to 0.017 , p<0.001 ) and in-segment binary restenosis ( OR 0.229 , 95 % CI 0.099 to 0.533 , p=0.001 ) . After 1 year , sirolimus-eluting stents were steadily associated with increased primary patency ( OR 10.401 , 95 % CI 3.425 to 31.589 , p<0.001 ) and significantly less in-stent ( OR 0.156 , 95 % CI 0.060 to 0.407 , p<0.001 ) and in-segment ( OR 0.089 , 95 % CI 0.023 to 0.349 , p=0.001 ) binary restenosis . In addition , sirolimus-eluting stents were associated with significantly fewer cumulative target lesion re interventions at 6 months ( OR 0.057 , 95 % CI 0.008 to 0.426 , p=0.005 ) and 1 year ( OR 0.238 , 95 % CI 0.067 to 0.841 , p=0.026 ) . No significant differences between groups B and S were noted at 1 year with respect to mortality ( 10.3 % versus 13.8 % , respectively ) , minor amputation ( 17.2 % versus 10.3 % ) , or limb salvage ( 100 % versus 96 % ) . Conclusion : The application of sirolimus-eluting stents reduces the restenosis rate in the infrapopliteal arteries and the rate of repeat endovascular procedures the first year after treatment Excellent results with small stents in coronary arteries have led endovascular therapists to their use in infrapopliteal vessels . However , to date no level I evidence exists to recommend primary stenting over infrapopliteal angioplasty alone . The aim of this r and omized single-center trial was to compare their 1-year outcome . A total of 38 limbs in 35 patients with critical limb ischemia were r and omized to angioplasty ( 22 pts ) or primary stenting ( 16 pts ) . Target lesions were infrapopliteal occluded ( 36 ) or stenotic ( 20 ) lesions ranging from < 2 to > 15 cm in length . The mean age was 72 years . At 12 months , there was no statistical difference in survival ( angioplasty , 69.3 % ; primary stenting , 74.7 % ) , in limb salvage ( angioplasty , 90 % ; primary stenting , 91.7 % ) , or in primary and secondary patency ( angioplasty , 66 and 79.5 % ; primary stenting , 56 and 64 % ) between the groups Renal insufficiency was the only significant negative predicting factor for limb salvage in both groups . In conclusion , the 1-year results for both groups were broadly similar . Stenting has its place in infrapopliteal angioplasty if the procedure is jeopardized by a 
    Output:
    
Trials show that the immediate technical success rate of restoring luminal patency is higher in the stent group but reveal no clear differences in short-term patency at six months between infrapopliteal arterial lesions treated with PTA with stenting versus those treated with PTA without stenting .
We ascertained no clear differences between groups in periprocedural complications , major amputation , and mortality .
However , use of different regimens for pretreatment and post-treatment antiplatelet/anticoagulant medication and the duration of its use within and between trials may have influenced the outcomes .