Long-term outcomes with Jetstream atherectomy with or without drug coated balloons in treating femoropopliteal arteries: A single center experience (JET-SCE)

Shammas, Nicolas W.; Shammas, Gail A.; Jones-Miller, Sue; Shammas, W John; Bou-Dargham, Bassel; Shammas, Andrew N.; Banerjee, Subhash; Rachwan, Rayan Jo; Daher, Ghassan

doi:10.1016/j.carrev.2018.02.003

Cited by 29 publications

(27 citation statements)

References 25 publications

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“…However, our bail‐out stenting rates were still higher compared to rates reported by RCTs of DCBs for FP ISR . This can be explained by their shorter average lesion length and lower rate of Tosaka III lesions . Most of the studies that examined DCBs with or without LA for the treatment of FP‐ISR are also limited to 1‐year outcomes.…”

Section: Discussioncontrasting

confidence: 55%

“…Apart from LA, the other atherectomy option for FP‐ISR includes rotational atherectomy (RA), which has been also recently tested for peripheral ISR lesions. In a recent report, Milnerowicz et al studied the combination of RA + DCB for the treatment of iliac and infrainguinal in‐stent occlusions and achieved a 12‐month freedom from restenosis rate of 79.5% and 12‐month freedom from TLR 94.5% . LA helps debulk the neointimal tissue from the restenosed stent and therefore decreases recoil before balloon inflation .…”

Section: Discussionmentioning

confidence: 99%

“…33 This can be explained by their shorter average lesion length and lower rate of Tosaka III lesions. 13,[34][35][36] Most of the studies that examined DCBs with or without LA for the treatment of FP-ISR are also limited to There is a relative paucity of data in term of the use of LA for the treatment of FP-ISR. 32 Apart from our group, LA in combination with DCB has been studied also in a single-center RCT by Gandini et al 36 LA helps debulk the neointimal tissue from the restenosed stent and therefore decreases recoil before balloon inflation.…”

Section: Discussionmentioning

confidence: 99%

“…13,[34][35][36] Most of the studies that examined DCBs with or without LA for the treatment of FP-ISR are also limited to There is a relative paucity of data in term of the use of LA for the treatment of FP-ISR. 32 Apart from our group, LA in combination with DCB has been studied also in a single-center RCT by Gandini et al 36 LA helps debulk the neointimal tissue from the restenosed stent and therefore decreases recoil before balloon inflation. 37 At the same time, by offering plaque modification and creating micropores, it may facilitate paclitaxel uptake and retention in the lesion.…”

Section: Discussionmentioning

confidence: 99%

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Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Kokkinidis

Behan

Jawaid

et al. 2019

Cathet Cardio Intervent

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Background Femoropopliteal (FP) artery is one of the most anatomically challenging areas for sustained stent patency. The incidence of FP in‐stent restenosis (ISR) is estimated at 50% at 24 months. Prior studies have shown that lesion debulking with laser atherectomy (LA) combined with drug coated balloon (DCB) have superior outcomes compared to LA + balloon angioplasty (BA) ISR, but there have not been studies evaluating 2‐year outcomes. Methods This was a dual‐center retrospective cohort study that compared patients with FP‐ISR treated with LA + DCB versus LA + BA. Cox regression analysis was used to examine 2‐year outcomes of target lesion revascularization (TLR) and the composite outcome of TLR or restenosis. Multivariable analysis was performed for clinical and statistically significant (in the univariate analysis) variables. Results One hundred and seventeen consecutive patients with Tosaka II (n = 32) and III (n = 85) ISR were analyzed. Sixty‐six patients were treated with LA + DCB and 51 with LA + BA. The LA + DCB group had more lesions with moderate to severe calcification (58% vs. 13%; p < .0001). The LA + DCB group was more likely to be treated with the use of embolic protection devices (64% vs. 23%, p < .001) and cutting balloons (61% vs. 6%, p < .001). Bail‐out stenting rates were lower in the LA + DCB group (32% vs. 57%, p = .008). LA + DCB was superior (HR: 0.57; 95% CI: 0.34–0.9, p = .027) for the composite outcome of 2‐year TLR or restenosis. The 12‐month KM estimates for freedom from TLR or restenosis were 66% in the LA + DCB group versus 46% in the LA + BA group. The 24‐month KM estimates were 45% in the LA + DCB group versus 24% in the LA + BA group. Conclusions The combination of DCB + LA was associated with decreased rates of bail‐out stenting and improved 2‐year TLR or restenosis rates. Randomized clinical trials examining the DCB + LA combination for FP‐ISR are needed.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Kokkinidis

Behan

Jawaid

et al. 2019

Cathet Cardio Intervent

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“…That these outcomes are similar despite the difference in calcification and selection bias in OA use only further supports the potential of these findings. Thus far, DCBs have been combined with multiple different atherectomy devices for calcified FP arteries, including directional, [24][25][26][27][28][29] rotational, 30,31 and orbital atherectomy. 20,21,23 Rotational atherectomy (RA) was shown to be efficient when used by experienced operators for 234 procedures in patients with calcified (80% had moderate or severe calcification) FP disease (de novo and ISR) as an adjuvant to either DCB or balloon angioplasty (BA).…”

Section: Discussionmentioning

confidence: 99%

Two-Year Outcomes of Orbital Atherectomy Combined With Drug-Coated Balloon Angioplasty for Treatment of Heavily Calcified Femoropopliteal Lesions

et al. 2020

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Purpose: To examine whether the combination of orbital atherectomy (OA) and drug-coated balloons (DCB) can lead to superior procedural and 2-year outcomes compared with DCB only in heavily calcified femoropopliteal (FP) lesions. Materials and Methods: A retrospective chart review was conducted to identify patients treated with DCB only or OA+DCB for de novo FP lesions at a single center over a 4-year period (2014–2017). In the observation period, 113 patients met the inclusion criteria: 63 treated with DCB only (mean age 69.0±8.6 years; 62 men) vs 50 treated with OA+DCB (mean age 70.3±7.1 years; 48 men). The OA+DCB group had higher calcification rates (78% with severe calcification vs 37% in the DCB only group). Propensity score matching (PSM) was used to adjust for baseline differences between the 2 groups. Cox regression analysis was used to compare the follow-up outcomes between lesions treated with OA+DCB vs DCB only. Results: No difference in procedural complications or success was found. After PSM adjustment, the OA+DCB group was associated with lower bailout stenting rates (39.4% vs 66.7% in the DCB only group; p=0.026). The 2 groups had similar long-term outcomes, although the OA+DCB arm had a trend toward reduced TLR rates that did not reach statistical significance. The Kaplan-Meier estimates for 2-year freedom from TLR were 76.1% for the OA+DCB group vs 55.5% for the DCB only group (p=0.109). Conclusion: OA+DCB is a safe and effective combination for the treatment of calcified FP lesions. The combined therapy decreased the bailout stenting rates in the adjusted analysis. Larger cohorts and randomized trials are needed to examine OA efficacy in FP lesions.

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Femoropopliteal Arterial Interventions in the Claudicant

Parikh

Ingrassia

Finn

2023

Endovascular Interventions

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Long-term outcomes with Jetstream atherectomy with or without drug coated balloons in treating femoropopliteal arteries: A single center experience (JET-SCE)

Cited by 29 publications

References 25 publications

Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Two-Year Outcomes of Orbital Atherectomy Combined With Drug-Coated Balloon Angioplasty for Treatment of Heavily Calcified Femoropopliteal Lesions

Femoropopliteal Arterial Interventions in the Claudicant

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