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. 2024 Jan 2;14(1):63.
doi: 10.1038/s41598-023-50511-8.

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

Lin Yang #  1 , Jianjun Quan #  2   3 , Jian Dong  2 , Ningning Ding  4 , Yang Han  2 , Longlong Cong  2 , Yuhao Lin  2 , Jianlin Liu  2
Affiliations

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

Lin Yang et al. Sci Rep. .

Abstract

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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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flowchart of the study procedure. DCB drug-coated balloon, AT atherectomy, CD-TLR clinically driven target lesion revascularization.
Figure 2
Figure 2
Kaplan‒Meier survival analysis for cumulative survival (a), primary (b) and secondary (c) patency rates of the four procedures. The number at risk represents the number of evaluable participants at the beginning of each follow-up interval. BMS bare metal stent, DCB drug-coated balloon, AT + DCB atherectomy + drug-coated balloon, AT atherectomy, mon month, No. number.
See this image and copyright information in PMC

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