Laser Atherectomy Combined With Drug-Coated Balloon Angioplasty Is Associated With Improved 1-Year Outcomes for Treatment of Femoropopliteal In-Stent Restenosis

Kokkinidis, Damianos G.; Hossain, Prio; Jawaid, Omar; Alvandi, Bejan; Foley, T. Raymond; Singh, Gagan D.; Waldo, Stephen W.; Laird, John R.

doi:10.1177/1526602817745668

Cited by 46 publications

(37 citation statements)

References 34 publications

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“…Laser atherectomy can reduce plaque burden inside the stent, leading to reduced repeat TLR for ISR FP lesions. 27,28 Further research is necessary to investigate this issue in real-world practice.…”

Section: Kobayashi N Et Almentioning

confidence: 99%

Comparison of Balloon Angioplasty and Stent Implantation for Femoropopliteal Disease According to Patient and Lesion Subgroup

et al. 2019

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Background: Little is known about the superiority of balloon angioplasty vs. stent implantation for femoropopliteal (FP) lesions according to subgroup. Methods and Results: This study involved 1,018 de novo (balloon angioplasty, n=462; stent implantation, n=556) and 114 in-stent restenosis (ISR) FP lesions (balloon angioplasty, n=69; stent implantation, n=45) treated with endovascular therapy. For de novo FP lesions, the 3-year primary patency rate was significantly better with stent implantation than with balloon angioplasty (61% vs. 69%, log-rank P=0.001), but it was similar for ISR FP lesions (40% vs. 43%, log-rank P=0.83). For de novo FP lesions, stent implantation was favorable in all subgroups except for female sex (hazard ratio [HR]

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Section: Kobayashi N Et Almentioning

confidence: 99%

Comparison of Balloon Angioplasty and Stent Implantation for Femoropopliteal Disease According to Patient and Lesion Subgroup

et al. 2019

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“…1,2 Previous studies have linked the combination of DCB and LA superior results compared to LA + BA for 1-year outcomes. 7,[24][25][26][27][28] Herein, we examine the 2-year outcomes of this combination treatment.…”

Section: Introductionmentioning

confidence: 99%

Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Kokkinidis

Behan

Jawaid

et al. 2019

Cathet Cardio Intervent

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Background Femoropopliteal (FP) artery is one of the most anatomically challenging areas for sustained stent patency. The incidence of FP in‐stent restenosis (ISR) is estimated at 50% at 24 months. Prior studies have shown that lesion debulking with laser atherectomy (LA) combined with drug coated balloon (DCB) have superior outcomes compared to LA + balloon angioplasty (BA) ISR, but there have not been studies evaluating 2‐year outcomes. Methods This was a dual‐center retrospective cohort study that compared patients with FP‐ISR treated with LA + DCB versus LA + BA. Cox regression analysis was used to examine 2‐year outcomes of target lesion revascularization (TLR) and the composite outcome of TLR or restenosis. Multivariable analysis was performed for clinical and statistically significant (in the univariate analysis) variables. Results One hundred and seventeen consecutive patients with Tosaka II (n = 32) and III (n = 85) ISR were analyzed. Sixty‐six patients were treated with LA + DCB and 51 with LA + BA. The LA + DCB group had more lesions with moderate to severe calcification (58% vs. 13%; p < .0001). The LA + DCB group was more likely to be treated with the use of embolic protection devices (64% vs. 23%, p < .001) and cutting balloons (61% vs. 6%, p < .001). Bail‐out stenting rates were lower in the LA + DCB group (32% vs. 57%, p = .008). LA + DCB was superior (HR: 0.57; 95% CI: 0.34–0.9, p = .027) for the composite outcome of 2‐year TLR or restenosis. The 12‐month KM estimates for freedom from TLR or restenosis were 66% in the LA + DCB group versus 46% in the LA + BA group. The 24‐month KM estimates were 45% in the LA + DCB group versus 24% in the LA + BA group. Conclusions The combination of DCB + LA was associated with decreased rates of bail‐out stenting and improved 2‐year TLR or restenosis rates. Randomized clinical trials examining the DCB + LA combination for FP‐ISR are needed.

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“…Brodmann et al [4] analysierten 21 Patienten mit kalzifizierten Stenosen der A. femoralis communis, die sich einer peripheren IVL unterzogen. Der technische Erfolg betrug in dieser Studie 100 % (21/21), wobei alle Zielläsionen zugänglich waren und lithoplastisch angegangen werden konnten.…”

Section: Verfahrenunclassified

Möglichkeiten der Atherektomie zur Behandlung der pAVK

Augustin¹,

Kickuth²

2020

Gefäßmedizin Scan - Zeitschrift für Angiologie, Gefäßchirurgie,

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Laser Atherectomy Combined With Drug-Coated Balloon Angioplasty Is Associated With Improved 1-Year Outcomes for Treatment of Femoropopliteal In-Stent Restenosis

Abstract: When used for treatment of complex FP-ISR lesions, DCB angioplasty combined with laser atherectomy is associated with significantly reduced 1-year TLR and reocclusion rates.

Cited by 46 publications

References 34 publications

Comparison of Balloon Angioplasty and Stent Implantation for Femoropopliteal Disease According to Patient and Lesion Subgroup

Comparison of Balloon Angioplasty and Stent Implantation for Femoropopliteal Disease According to Patient and Lesion Subgroup

Laser atherectomy and drug‐coated balloons for the treatment of femoropopliteal in‐stent restenosis: 2‐Year outcomes

Möglichkeiten der Atherektomie zur Behandlung der pAVK

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