Effect of drug-coated balloons versus bare-metal stents on endothelial function in patients with severe lower limb peripheral artery disease

Abstract

Background Research shows impaired endothelial function in patients with vascular diseases and improved endothelial function following revascularization and medical treatment. There is, however, a dearth of data on the effects of different endovascular therapeutic strategies on endothelial function. We sought to compare the effects of two endovascular strategies of drug-coated balloons versus stenting on endothelial function. Methods The reactive hyperemia index, the ankle-brachial index, and the toe-brachial index were measured in patients undergoing endovascular revascularization preprocedurally and on the 90th postprocedural day. After adjusting for baseline line characteristics, reactive hyperemia index were compared between the two groups at baseline and at 90 days. Results Between January 2018 and March 2019, 86 patients were prospectively included in a non-randomized manner. Drug-coated ballooning alone was carried out on 46 patients, and bailout stenting after plain balloon angioplasty was performed on the remaining 40 patients The post-revascularization reactive hyperemia index exhibited a significant rise in both groups (1.58 ± 0.21 vs. 1.43 ± 0.20; P = 0.0001). There was no difference in the postprocedural reactive hyperemia index between the two treatment groups. Additionally, the follow-up reactive hyperemia index showed no significant change compared with the postprocedural reactive hyperemia index (1.58 ± 0.23 vs. 1.57 ± 0.22). The results of subgroup analysis between a group of clinically high-risk patients and a group of patients with complex lesions were similar to the aforementioned results. Conclusions The reactive hyperemia index was significantly improved by endovascular therapy in our study population. However, no difference was observed between drug-coated ballooning and bare-metal stenting, which highlights the effects of vessel patency on endothelial function.

The evaluation of efficacy of atmospheric pressure plasma in diabetic ulcers healing: A randomized clinical trial

“…Management strategies for DFU include prevention and control of infection, offloading pressure, removing necrotic tissue, applying appropriate dressings and medications, ensuring adequate blood flow, controlling blood sugar. [5][6][7] The high cost of DFU to both patients and healthcare systems necessitates instituting preventive and control measures at the earliest opportunity.…”

Efficacy and Safety Differences between Domestic Paclitaxel Drug‐Coated Balloons and Metal Bare Stents in the Treatment of ASO of Femoral‐Popliteal Arteries Type IIA–C

“…With the improvement of living standards and the aggravation of the aging population, the incidence of ASO is increasing year by year and has become one of the major diseases threatening the life safety of patients. As a classic intramural treatment, BMS materials have the advantages of flexibility, high biocompatibility, and good support and have good clinical efficacy in improving the short-term patency rate after PTA and improving the patient's postoperative motor function [ 9 ]. With the development of endovascular treatment technology, the advantages of DCB in the clinical treatment of ASO are highlighted.…”

Influence of endovascular treatment on the vascular endothelium in patients with peripheral arterial disease: a systematic review

“…Endovascular procedures in all studies included the use of balloon catheters and stents when indicated. One study [12] compared the DCB (Drug-Coated Balloon) to POBA (Percutaneous Old Balloon Angioplasty). The results of PTA were analyzed based on the occurrence of restenosis (i.e.…”

“…Two studies [12,14] included in this review primarily compared RHI values before and after PTA, as summarized in Table 2. Shafe et al [12] measured RHI after endovascular revascularization in two groups of patients: DCB-treated patients and POBA with stenting-treated patients.…”

“…In contrast, the effect of angioplasty on endothelial function is less clear. In addition, very few studies have included patients with atherosclerotic lower limb ischemia [8][9][10][11][12][13][14]. The goal of this systematic review was to appraise the effects of angioplasty on endothelial functioning in patients with PAD.…”