Drug‐Eluting Balloon Angioplasty for Below the Knee Lesions in End Stage Renal Disease Patients with Critical Limb Ischemia: Midterm Results

Teymen, Burak; Aktürk, Süleyman

doi:10.1111/joic.12355

Cited by 4 publications

(13 citation statements)

References 29 publications

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“…Twenty-six studies, 12 retrospective and 14 prospective, fulfilled the inclusion criteria (Table 1). 9,10,35–58 A total of 2108 CLTI patients (mean age 71.3±4.4 years; 67% men) who were treated with DCB for peripheral atherosclerotic lesions were analyzed. Major risk factors were hypertension (91%, 1339/1478), diabetes (69%, 1138/1642), dyslipidemia (63%, 1101/1756), smoking (46%, 799/1754), coronary artery disease (41%, 602/1,468), and end-stage renal disease (26%, 389/1490).…”

Section: Resultsmentioning

confidence: 99%

“…For 16 studies 9,10,[35][36][37][40][41][42]44,49,50,52,53,55,56,58 the primary target lesion was in the femoropopliteal segment (n=1315), while the other 10 studies 38,39,43,[45][46][47][48]51,54,57 involved the infrapopliteal arteries (n=793). In 11 studies with data about inflow/outflow disease, these nontarget lesions were treated at the discretion of the operator using standard techniques.…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

“…39,[43][44][45]47,48,51,57 Major amputation was necessary in 2% (9 studies; 95% CI 1% to 4%; I 2 =42.1%) and the incidence of all-cause mortality over 1 year was 10% (8 studies; 95% CI 5% to 1%; I 2 =76.9%). Five studies 38,39,43,45,51 demonstrated wound healing in 82% (95% CI 76% to 87%; I 2 =32.5%) of the patients during follow-up. Only the In.PACT DEEP RCT by Zeller et al 64 reported long-term follow-up, with 40% mortality at 5 years.…”

Section: Outcomes By Lesion Location In Clti Patientsmentioning

confidence: 99%

“…Twenty-six studies, 12 retrospective and 14 prospective, fulfilled the inclusion criteria (Table 1). Twenty-one studies 9,35,[38][39][40][41][42][43]45,46,[48][49][50][51][52][53][54][55][56][57][58] provided information regarding the antiplatelet regimen prior to and after the endovascular therapy. In most studies, dual antiplatelet therapy (DAPT) was prescribed after the endovascular repair for at least 1 to 3 months and after that point aspirin was primarily prescribed as single, lifelong antiplatelet therapy.…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

“…In most studies, dual antiplatelet therapy (DAPT) was prescribed after the endovascular repair for at least 1 to 3 months and after that point aspirin was primarily prescribed as single, lifelong antiplatelet therapy. Only 5 studies 36,37,44,45,53 reported on statin use. The percentage of patients taking a statin at baseline was highly heterogeneous among those 5 studies, ranging from 41% to 90%.…”

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

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Safety and Efficacy of Drug-Coated Balloon Angioplasty for the Treatment of Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis

et al. 2020

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Purpose: To investigate the safety and efficacy of drug-coated balloons (DCB) for the treatment of femoropopliteal or infrapopliteal lesions in patients with chronic limb-threatening ischemia (CLTI). Materials and Methods: A systematic literature search was conducted in PubMed, Scopus, and Cochrane Central up to January 2020 to identify randomized trials and observational studies presenting data on the effectiveness and safety of DCBs in the treatment of femoropopliteal or infrapopliteal lesions. A meta-analysis utilizing random effects modeling was conducted to investigate primary patency and all-cause mortality at 12 months; the results are reported as the odds ratios (ORs) and 95% confidence intervals (CIs). Secondary outcomes were procedural success, bailout stenting, target lesion revascularization (TLR), reocclusion, major amputation, wound healing, and major adverse limb events. Results: Twenty-six studies, 12 retrospective and 14 prospective, comprising 2108 CLTI patients treated with DCBs for femoropopliteal (n=1315) or infrapopliteal (n=793) lesions were analyzed. The average lesion lengths were 121±44 and 135±53 mm, respectively. The overall 12-month all-cause mortality and major amputation rates were 9% (95% CI 6% to 13%) and 5% (95% CI 2% to 8%), respectively. Primary patency rates were 82% (95% CI 76% to 87%) and 64% (95% CI 58% to 70%), respectively. A sensitivity analysis of the infrapopliteal lesions demonstrated no difference between DCB and balloon angioplasty in terms of primary patency, TLR, major amputation, or mortality over 12 months. However, patients with infrapopliteal lesions undergoing DCB angioplasty did have a significantly lower risk for reocclusion (10% vs 25%; OR 0.38, 95% CI 0.21 to 0.70, p=0.002). Conclusion: DCB angioplasty of femoropopliteal and infrapopliteal lesions in patients with CLTI results in acceptable 12-month patency rates, although comparative data have not shown a patency benefit for infrapopliteal lesions. The 12-month mortality rate of DCB vs balloon angioplasty was not significantly different, but studies with longer-term outcomes are necessary to determine any association between DCB use and mortality in patients with CLTI.

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Section: Resultsmentioning

confidence: 99%

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

Section: Outcomes By Lesion Location In Clti Patientsmentioning

confidence: 99%

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

Section: Characteristics Of the Eligible Studiesmentioning

confidence: 99%

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Safety and Efficacy of Drug-Coated Balloon Angioplasty for the Treatment of Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis

et al. 2020

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Comparative 12-Month Outcomes of Drug-Coated Balloon Versus Non-Drug-Coated Balloon Revascularization Strategy in Chronic Limb-Threatening Ischemia: Results From the XLPAD Registry

Giannopoulos¹,

Jeon–Slaughter

Kahlon³

et al. 2020

Cardiovascular Revascularization Medicine

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Editor's Choice – Drug Coated Balloon Angioplasty vs. Standard Percutaneous Transluminal Angioplasty in Below the Knee Peripheral Arterial Disease: A Systematic Review and Meta-Analysis

Ipema

Huizing

Schreve

et al. 2020

European Journal of Vascular and Endovascular Surgery

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WHAT THIS PAPER ADDS This systematic review and meta-analysis is an update on the role of drug coated balloons in the endovascular treatment of infrapopliteal arterial disease. Based on the results of this paper no statistically significant differences were found between drug coated balloon angioplasty and standard percutaneous transluminal angioplasty. Objective: The aim was to review and analyse the literature on clinical outcomes of drug coated balloon (DCB) vs. standard percutaneous transluminal angioplasty (PTA) for the treatment of infrapopliteal arterial disease. Methods: This is a systematic review and meta-analysis. The MEDLINE, EMBASE and Cochrane Database of Systematic Reviews were searched for studies published between January 2008 and November 2018. Two authors independently performed the search, study selection, assessment of methodological quality and data extraction. Studies were eligible when reporting PTA and DCB outcomes in infrapopliteal arteries, published in English, human studies, and full text was available. Methodological quality was determined by MINORS and Cochrane risk of bias tool. GRADE methodology was used to rate the evidence for observed outcomes. The primary outcome was the 12 month limb salvage rate. Secondary outcomes were 12 month survival, amputation free survival (AFS), restenosis, and target lesion revascularisation (TLR) rates. Inclusion criteria for pooling data were randomised controlled trials and comparative studies with 12 month outcomes. Results: Ten studies representing 1593 patients met the inclusion criteria. The quality was assessed as moderate or low. Data from five studies were pooled, and 12 month outcomes for DCB vs. PTA were limb salvage rate, 94.0% vs. 95.7% (odds ratio (OR), 0.92; 95% confidence interval (CI), 0.39e2.21); and survival rate, 89.8% vs. 92.9% (OR 0.69; 95% CI 0.39e1.21). Data from four studies were pooled, and 12 month outcomes for PTA vs. DCB were restenosis rate, 62.0% vs. 32.9% (OR 2.87; 95% CI 0.83e9.92); and TLR rate, 27.8% vs. 14.0% (OR 2.76; 95% CI 0.90e8.48). Pooled data from two studies showed 12 month AFS rate for DCB vs. PTA; 82.5% vs. 88.7% (OR 0.79; 95% CI 0.23e2.75). No statistically significant differences were found. Conclusion: Based on this systematic review and meta-analysis no significant differences in limb salvage, survival, restenosis, TLR, and AFS rates were found when DCB angioplasty was compared with standard PTA.

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Drug‐Eluting Balloon Angioplasty for Below the Knee Lesions in End Stage Renal Disease Patients with Critical Limb Ischemia: Midterm Results

Abstract: DEB is effective in the treatment of below the knee critical stenosis and occlusions in ESRD patients with critical limb ischemia.

Cited by 4 publications

References 29 publications

Safety and Efficacy of Drug-Coated Balloon Angioplasty for the Treatment of Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis

Safety and Efficacy of Drug-Coated Balloon Angioplasty for the Treatment of Chronic Limb-Threatening Ischemia: A Systematic Review and Meta-Analysis

Comparative 12-Month Outcomes of Drug-Coated Balloon Versus Non-Drug-Coated Balloon Revascularization Strategy in Chronic Limb-Threatening Ischemia: Results From the XLPAD Registry

Editor's Choice – Drug Coated Balloon Angioplasty vs. Standard Percutaneous Transluminal Angioplasty in Below the Knee Peripheral Arterial Disease: A Systematic Review and Meta-Analysis

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