Prognosis of Directional Atherectomy Combined with Drug-Coated Balloon Angioplasty versus Bare Nitinol Stent Angioplasty for Femoropopliteal Arteriosclerosis Obliterans: A Retrospective Cohort Study

Lichun Wei1,2, Jianming Guo1, Lianrui Guo1, Lixing Qi1, Shijun Cui1, Zhu Tong1, Peiyong Hou2 and Yongquan Gu1*

1Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, China
2Department of Vascular Surgery, The Fourth Affiliated Hospital, Guangxi Medical University, China

^*Correspondance to: Yongquan Gu 

 PDF  Full Text DOI: 10.25107/2474-1647.3461

Abstract

Objectives: The present study aimed to evaluate the prognosis value of Directional Atherectomy (DA) +Drug-Coated Balloon (DCB) angioplasty for Femoropopliteal Arteriosclerosis Obliterans (FPAO). Methods: This retrospective cohort study included FPAO patients who underwent percutaneous endovascular surgery at Xuanwu Hospital of Capital Medical University and the Fourth Affiliated Hospital of Guangxi Medical University between January 2016 and June 2019. The primary outcome was the primary patency rate. The secondary outcomes were technical success and all-cause death. Results: During the study period, 110 (44%) and 140 (56%) patients underwent DA+DCB and Bare Nitinol Stent (BNS). There were no differences between groups in the 10- and 20-month patency rates (98.2% vs. 93.6% and 68.2% vs. 60.0%, both P>0.05). The 30-month primary patency rate in the DA+DCB group was significantly higher than the BNS group (27.3% vs. 15.7%, P=0.003). Technical success rate and all-cause death were similar between groups. Flow-limiting dissections occurred more frequently in the BNS group than in the DA+DCB group (27.9% vs. 10.9%, P=0.033). After adjustment for potential cofounders, such as gender, smoking, hypertension, hyperlipidemia, ABI after surgery, TASC II B, lesion length ≥ 15 cm, vessel runoff 2, and vessel runoff 3, the HR for primary patency rate comparing BNS to DA+DCB was 2.61 (95% CI: 1.61-4.25). Conclusion: In this retrospective cohort study, DA+DCB was associated with higher 30-month primary patency rate, with a lower incidence of flow-limiting dissection.

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Wei L, Guo J, Guo L, Qi L, Cui S, Tong Z, et al. Prognosis of Directional Atherectomy Combined with Drug- Coated Balloon Angioplasty versus Bare Nitinol Stent Angioplasty for Femoropopliteal Arteriosclerosis Obliterans: A Retrospective Cohort Study. Clin Surg. 2022; 7: 3461..