Clinical Outcomes of Atherectomy Plus Drug-coated Balloon Versus Drugcoated Balloon Alone in the Treatment of Femoropopliteal Artery Disease
- Author:
Jung-Joon CHA
1
;
Jae-Hwan LEE
;
Young-Guk KO
;
Jae-Hyung ROH
;
Yong-Hoon YOON
;
Yong-Joon LEE
;
Seung-Jun LEE
;
Sung-Jin HONG
;
Chul-Min AHN
;
Jung-Sun KIM
;
Byeong-Keuk KIM
;
Donghoon CHOI
;
Myeong-Ki HONG
;
Yangsoo JANG
Author Information
- Publication Type:Original Research
- From:Korean Circulation Journal 2022;52(2):123-133
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background and Objectives:Atherectomy as a pretreatment has the potential to improve the outcomes of drug-coated balloon (DCB) treatment by reducing and modifying atherosclerotic plaques. The present study investigated the outcomes of atherectomy plus DCB (A+DCB) compared with DCB alone for the treatment of femoropopliteal artery disease.
Methods:A total of 311 patients (348 limbs) underwent endovascular therapy using DCB for native femoropopliteal artery lesions at two endovascular centers. Of these, 82 limbs were treated with A+DCB and 266 limbs with DCB alone. After propensity score matching based on clinical and lesion characteristics, a total of 82 pairs was compared for immediate and mid-term outcomes.
Results:For the matched study groups, the lesion length was 172.7±111.2 mm, and severe calcification was observed in 43.3%. The technical success rate was higher in the A+DCB group than in the DCB group (80.5% vs. 62.2%, p=0.015). However, the A+DCB group showed more procedure-related minor complications (37.0% vs. 13.4%, p=0.047). At 2-year follow-up, primary clinical patency (73.8% vs. 82.6%, p=0.158) and the target lesion revascularization (TLR)-free survival (84.3% vs. 88.2%, p=0.261) did not differ between the two groups. In Cox proportional hazard analysis, atherectomy showed no significant impact on the outcome of DCB treatments.
Conclusions:The pretreatment with atherectomy improved technical success of DCB treatment; however, it was associated with increased minor complications. In this study, A+DCB showed no clinical benefit in terms of TLR-free survival or clinical patency compared with DCB treatment alone.
