A Retrospective Comparative Study of Twelve-Month Clinical Outcomes for Drug-Coating Balloon Angioplasty and Stent Impla
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CLINICAL INVESTIGATION
ARTERIAL INTERVENTIONS
A Retrospective Comparative Study of Twelve-Month Clinical Outcomes for Drug-Coating Balloon Angioplasty and Stent Implantation in Treating Patients with Popliteal Obstructive Lesions Jianming Guo1 • Lianrui Guo1 • Shijun Cui1 • Alan Dardik2 • Yiren Liu1 Zhu Tong1 • Yongquan Gu1
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Received: 7 January 2020 / Accepted: 5 June 2020 Springer Science+Business Media, LLC, part of Springer Nature and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) 2020
Abstract Purpose Despite increased interest in treating superficial femoral and popliteal arteries with endovascular technology, there is little data regarding comparative results of different treatment modalities in the popliteal artery. It was hypothesized that to improve clinical outcomes in this segment, drug-coating balloon (DCB) angioplasty would not be inferior to stent implantation. Methods The records of consecutive Chinese patients with popliteal lesions who were treated with DCB or stenting between June 2016 and February 2017 were retrospectively reviewed. The preoperative demographic, lesion characteristics and postoperative outcomes were compared and statistically analyzed. All patients were divided into different subgroups according to the degree of calcium or degree of ischemia. Results One hundred two consecutive patients with popliteal lesions were treated with DCB or stenting and 95 (93.1%) completed a follow-up. Critical limb ischemia was present in 70.5% and occlusions were present in 61.1% of patients. DCB angioplasty was performed on 43 patients and angioplasty with primary stenting was performed on 52 patients. There was no difference in twelve-month primary & Lianrui Guo [email protected] & Yongquan Gu [email protected] 1
Department of Vascular Surgery, Institute of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China
2
Section of Vascular Surgery, Vascular Biology and Therapeutics, Yale University School of Medicine, Yale University, New Haven, CT, USA
patency (79.1% vs 82.7%; P = 0.687), secondary patency (95.3% vs 94.2%; P = 0.808) and amputation-free survival (93.0% vs 94.2%; P = 0.825) between the DCB group and stent groups. In patients with severe calcium, the twelvemonth primary patency (61.1% vs. 79.2%; P = 0.239) and amputation-free survival (83.3% vs 87.5%; P = 0.739) did not differ between the DCB and stent groups. Conclusions This study demonstrates that DCB treatment in Chinese patients with popliteal atherosclerotic occlusive lesions can be associated with similar twelve-month patency and amputation-free survival compared to stenting, even in patients with severe calcification. Level of Evidence Level 3a, Non-randomized follow-up study. Keywords Popliteal artery Drug-coating balloon Stent Endovascular
Introduction In recent years, endovascular interventions of popliteal lesions have become more common and some studies suggested that primary patency of stenting group is higher than angioplasty group for popliteal
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