Pitoulias Apostolos G, Taneva Gergana T, Avranas Konstantinos, Abu Bakr Nizar, Pitoulias Georgios A, Donas Konstantinos P
Rhein Main Vascular Center, Department of Vascular and Endovascular Surgery, Asklepios Clinics Langen, Paulinen Wiesbaden, Seligenstadt, 63225 Langen, Germany.
Research Collaborator at Rhein Main Vascular Center, Department of Vascular and Endovascular Surgery, Asklepios Clinics Langen, Paulinen Wiesbaden, Seligenstadt, 63225 Langen, Germany.
J Clin Med. 2024 Feb 27;13(5):1346. doi: 10.3390/jcm13051346.
The aim of the study is to evaluate the safety and effectiveness of rotational atherectomy-assisted balloon angioplasty (BTK-RA) for the treatment of isolated below the knee (BTK) atherosclerotic lesions and to compare the outcomes to plain old balloon angioplasty (POBA). Between January 2020 and September 2023, 96 consecutive patients with chronic limb threatening ischemia (CTLI) and isolated BTK-lesions underwent POBA (group A) or BTK-RA (group B). The primary outcome measures were: periprocedural technical success, primary patency, postoperative increase of the ankle branchial index (ABI), target lesion revascularization (TLR), limb salvage, minor amputation and death. Both techniques had similar technical success, operative time, intraprocedural complications and bailout stent implantations, independently of the operator's experience. Group B had significantly higher primary patency rates (93.5% vs. 72.0%, respectively, = 0.006), TLR (2.1% vs. 24%, = 0.057), lower in-hospital stay (2.0-3.0 vs. 4.0-6.0 days, respectively, < 0.001) and higher postoperative ABI (0.8-0.2 vs. 0.7-0.1, respectively, = 0.008), compared to group A. Significant differences (POBA : 20, 40%, BTK-RA = 3, 6.5%) were found in minor amputation rates between the two groups ( < 0.001), while the respective limb salvage rates were similar in both groups (94.0% vs. 97.8%, = 0.35). The use of BTK-RA for the treatment of BTK-lesions in patients with CTLI showed significant clinical advantages in comparison to POBA.
本研究的目的是评估旋磨术辅助球囊血管成形术（BTK-RA）治疗孤立性膝下（BTK）动脉粥样硬化病变的安全性和有效性，并将结果与单纯球囊血管成形术（POBA）进行比较。在2020年1月至2023年9月期间，96例连续的慢性肢体威胁性缺血（CTLI）和孤立性BTK病变患者接受了POBA（A组）或BTK-RA（B组）治疗。主要结局指标为：围手术期技术成功率、原发通畅率、术后踝肱指数（ABI）增加、靶病变血管重建（TLR）、肢体挽救、小截肢和死亡。两种技术在技术成功率、手术时间、术中并发症和补救性支架植入方面相似，与术者经验无关。与A组相比，B组的原发通畅率显著更高（分别为93.5%和72.0%，P = 0.006），TLR更低（2.1%和24%，P = 0.057），住院时间更短（分别为2.0 - 3.0天和4.0 - 6.0天，P < 0.001），术后ABI更高（分别为0.8 - 0.2和0.7 - 0.1，P = 0.008）。两组间小截肢率存在显著差异（POBA：20例，40%；BTK-RA：3例，6.5%，P < 0.001），而两组的肢体挽救率相似（94.0%和97.8%，P = 0.35）。与POBA相比，在CTLI患者中使用BTK-RA治疗BTK病变显示出显著的临床优势。
