Comparison of Drug-Coated Balloon Angioplasty Alone and Directional Atherectomy Combined with Drug-Coated Balloon Angioplasty in Patients with Lower Extremity Peripheral Arterial Disease with Claudication

Kavala, Ali Aycan; Kuserli, Yusuf; Türkyilmaz, Gülsüm; Yeşiltaş, Mehmet Ali; Türkyilmaz, Saygın

doi:10.1016/j.avsg.2022.10.007

Cited by 1 publication

(3 citation statements)

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“…The AT device can reduce the plaque/thrombus load of occlusive lesions, thereby obtaining larger lumens, which is more conducive to the delivery and utilization of DCB drugs. Previous studies confirmed that the primary patency of AT combined with DCB is significantly higher than that of DCB alone and BMS 11 , 21 . More importantly, this procedure can preserve potential opportunities for future therapy.…”

Section: Discussionmentioning

confidence: 69%

“…However, the AT procedure could improve the effect of vessel preparation and is more conducive to the use of DCBs. Further studies have shown that AT devices combined with DCBs show higher patency 21 , 31 , 32 . Our study demonstrated that the AT procedure followed by DCB angioplasty has a higher primary patency and lower restenosis rate for FP occlusion.…”

Section: Discussionmentioning

confidence: 95%

“…Further studies have confirmed that the effect of AT followed by DCB angioplasty is better than that of AT followed by ordinary balloon angioplasty. The advantages of AT combined with DCB have been confirmed not only in FP lesions but also in lesions below the knee and severe calcified lesions 15 – 18 , which could reduce the incidence of flow-limiting dissection and bailout stenting and improve the long-term outcome of DCB angioplasty 19 – 21 .…”

Section: Introductionmentioning

confidence: 95%

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Comparison of mid-outcome among bare metal stent, atherectomy with or without drug-coated balloon angioplasty for femoropopliteal arterial occlusion

Yang,

Quan,

Dong

et al. 2024

Sci Rep

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This study evaluated the outcomes of a bare metal stent (BMS), DCB alone, atherectomy plus a drug-coated balloon (AT + DCB) and AT alone for the treatment of femoropopliteal artery occlusion. Four groups were included in this retrospective cohort study: 119 patients underwent the BMS procedure, 89 patients underwent DCB alone, 52 patients underwent AT + DCB, and 61 patients underwent AT alone. Patients were followed-up at 1, 6, 12 and 24 months after the procedure, the clinical outcomes and complications were assessed, and the primary outcomes were primary patency and restenosis. AT + DCB showed a lower bailout stent, and BMS displayed a higher retrograde puncture, flow-limiting dissection and postdilation (p < 0.05). For all procedures, the walking distance, ABI and pain score post-procedure were significantly improved compared with the pre-procedure values (p < 0.001). The restenosis rate was higher in BMS (21.0%) and AT alone (24.6%) than in DCB (10.1%) alone and AT + DCB (11.5%) (p = 0.04); there was no difference in amputation or clinically driven target lesion revascularization among procedures. The primary patency rates were 77.7%, 89.4%, 88.0% and 73.7% in the BMS, DCB alone, AT + DCB and AT alone groups at 24 months, respectively (p = 0.03), while the secondary patency and main adverse events (stroke, MI and death) were similar. Proximal concavity, proximal target vessel diameter ≥ 5 mm, runoff number ≥ 2 and DCB use were protective factors for primary patency. Our results suggested that AT + DCB and DCB alone were associated with higher primary patency, and DCB devices (combined with/without AT) should be the preferred choice for FP lesions.

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Section: Discussionmentioning

confidence: 69%