Lin Yuhao, Quan Jianjun, Dong Jian, Cong Longlong, Yang Lin
Department of Vascular Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, 710061 Xi'an, Shaanxi, China.
Department of Interventional Vascular Surgery, Hanzhong Central Hospital, 723000 Hanzhong, Shaanxi, China.
Rev Cardiovasc Med. 2024 Sep 18;25(9):331. doi: 10.31083/j.rcm2509331. eCollection 2024 Sep.
This study investigated the midterm primary patency of drug-coated balloons (DCBs), directional atherectomy plus balloon angioplasty (DA), and bare metal stent (BMS) angioplasty for the treatment of femoropopliteal lesions.
This two-center retrospective cohort study included 105 patients (110 limbs) undergoing DCB, DA, and BMS angioplasty-32 patients (34 limbs), 31 patients (32 limbs), and 42 patients (44 limbs), respectively. The demographic, baseline, and procedure data were collected, and the complications and midterm outcomes (patency, amputation-free survival, and clinically driven target lesion revascularization rates) were analyzed.
All three procedures achieved a 100% success rate. Significant improvements were noted in ankle brachial index, walking distance, and Rutherford classification at 30 days post-procedure ( < 0.001), with no differences or severe complications among the groups. The all-cause mortality rate during the follow-up period, was 5.5%, and amputation-free survival rates at 24 months were 97.0%, 90.6% and 90.9% in the DCB, DA, and BMS angioplasty groups, respectively. The primary patency rate for the DCB group (79.4%) exceeded those of the DA (56.2%) and BMS (52.2%) groups ( < 0.05), with no significant difference between the DA and BMS groups at 24 months. The secondary patency and clinically driven target lesion revascularization rates were similar among the three groups. A runoff number ≤1, Trans-Atlantic Intersociety Consensus (TASC) D, and severe calcification were found to be independent risk factors for primary patency.
The DCB procedure demonstrated superior primary patency, compared to both BMS and DA procedures, in the treatment of femoropopliteal lesions.
本研究调查了药物涂层球囊（DCB）、定向斑块旋切术联合球囊血管成形术（DA）和裸金属支架（BMS）血管成形术治疗股腘动脉病变的中期原发性通畅率。
这项双中心回顾性队列研究纳入了105例患者（110条肢体），分别接受DCB、DA和BMS血管成形术，其中DCB组32例患者（34条肢体），DA组31例患者（32条肢体），BMS组42例患者（44条肢体）。收集了人口统计学、基线和手术数据，并分析了并发症和中期结果（通畅率、无截肢生存率和临床驱动的靶病变血管重建率）。
所有三种手术成功率均达到100%。术后30天时，踝肱指数、行走距离和卢瑟福分级均有显著改善（<0.001），各组间无差异或严重并发症。随访期间全因死亡率为5.5%，DCB、DA和BMS血管成形术组24个月时的无截肢生存率分别为97.0%、90.6%和90.9%。DCB组的原发性通畅率（79.4%）超过DA组（56.2%）和BMS组（52.2%）（<0.05），24个月时DA组和BMS组之间无显著差异。三组间的继发性通畅率和临床驱动的靶病变血管重建率相似。发现流出道数目≤1、跨大西洋跨学会共识（TASC）D级和严重钙化是原发性通畅的独立危险因素。
在治疗股腘动脉病变方面，与BMS和DA手术相比，DCB手术显示出更好的原发性通畅率。
