Linehan V, Doyle M, Barrett B, Gullipalli R. A Single-Center Study on the Outcomes of Target Limb Revascularization in Femoropopliteal Lesions Treated With Drug Coated Balloons and Bare Metal Stents.
J Endovasc Ther 2022;
29:948-955. [PMID:
34986705 PMCID:
PMC9638703 DOI:
10.1177/15266028211068772]
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Abstract
Purpose:
Multiple randomized controlled trials have shown that both drug coated
balloons (DCBs) and bare metal stents (BMSs) significantly reduce restenosis
in femoropopliteal lesions compared with plain balloon angioplasty. However,
few studies have directly compared DCB and BMS treatments. Therefore, the
goal of our study was to determine if the rate of target lesion
revascularization (TLR) differs between DCB and BMS treatment at our
center.
Materials and methods:
We performed a retrospective chart review of femoropopliteal interventions at
a single center from 2009 to 2017. The intervention, patient and lesion
characteristics, and TLR events were recorded. Exclusion criteria were loss
of follow-up, death, bail-out stenting, and amputation within 60 days of
treatment. Freedom from TLR was analyzed over a 3 year period with
Kaplan-Meier survival curves. Cox hazard ratios were calculated to account
for patient and lesion characteristics.
Results:
A total of 322 lesions (234 patients) treated with DCBs and 225 lesions (194
patients) treated with BMSs were included in this study. There were
significant differences in baseline patient and lesion characteristics
between groups—a greater proportion of women, patients with dyslipidemia,
and lesions with popliteal involvement were treated with DCBs. There was no
difference in the freedom from TLR between DCBs and BMSs. Accounting for
patient and lesion characteristics, there was still no difference between
DCBs and BMSs on the hazard of TLR. While our analysis did not detect a
difference in the rate of TLR, there was a significant difference in the
type of TLR. Compared with DCBs, a greater proportion of lesions initially
treated with BMSs were retreated via surgical bypass rather than
endovascular intervention, suggesting that lesions treated with DCBs may be
more amenable to future endovascular intervention.
Conclusion:
Our retrospective analysis showed no difference in the rate of TLR between
lesions treated with DCBs and BMSs. However, DCBs were more often used in
complicated lesions involving popliteal arteries and may also allow for
easier endovascular reintervention.
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