Midterm Outcome of Directional Atherectomy Combined with Drug-Coated Balloon Angioplasty Versus Drug-Coated Balloon Angioplasty Alone for Femoropopliteal Arteriosclerosis Obliterans

Cai, Zhiwen; Guo, Lianrui; Qi, Lixing; Cui, Shijun; Tong, Zhu; Guo, Jianming; Wang, Zhonggao; Gu, Yongquan

doi:10.1016/j.avsg.2019.06.014

Cited by 26 publications

(20 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This result also suggested that combination of DA and DCB was effective for the treatment of severely calcified femoropopliteal artery. 19 Foley 2017 16 Konstantinos 2018 20 Cai 2019 21 Kokkinidis 2020 17 1…”

Section: Discussionmentioning

confidence: 99%

“…Foley et al 16 and Kokkinidis et al 17 used the OA device. Zeller et al, 18 Stavroulakis et al, 19 Stavroulakis et al, 20 and Cai et al 21 used DA device during the operation. All six studies selected the paclitaxel-coated balloon for DCB therapy.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

“…The majority of lesions were located in superficial femoral artery and popliteal artery. The degree of lesion calcification was graded in five studies except for Cai et al 21 In the atherectomy plus DCB group, there were 86 lesions (37.7%) with severe calcification, compared with 84 lesions (28.8%) in the DCB only group.…”

Section: Summary Of Included Studiesmentioning

confidence: 99%

See 2 more Smart Citations

Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

Objectives To compare the safety and efficiency of atherectomy plus drug-coated balloon with drug-coated balloon only for the treatment of femoropopliteal artery lesions. Methods This systematic review and meta-analysis was performed and reported following the requirement of the PRISMA. EMBASE, MEDLINE, and Cochrane library were queried from January 2000 to June 2020 to identify eligible literature. The modified Downs and Black checklist was used to assess the quality of included studies. Outcome measures included bail-out stenting, distal embolization, perforation, hematoma, primary patency at 12 months, target lesion revascularization at 12 months, leg amputation at 12 months, and mortality at 12 months. We used DerSimonian and Laird random-effects model to pool the dichotomous data on risk ratio (RR) with 95% confidence intervals (CIs) from each study to obtain an overall estimate for major outcomes. Subgroup analysis and sensitivity analyses were conducted. Results Six studies (two randomized controlled trials and four retrospective cohort studies) with 470 patients were included. Atherectomy plus drug-coated balloon group was associated with lower rates of bail-out stenting (RR: 0.49, 95%CI: 0.34–0.71, P < 0.001). There was no significant difference between two groups in terms of distal embolization (RR: 2.06, 95%CI: 0.51–8.38, P = 0.31), perforation (RR: 2.04, 95%CI: 0.43–9.71, P = 0.37), hematoma (RR: 1.75, 95%CI: 0.43–7.09, P = 0.43), primary patency at 12 months (1.09, 95%CI: 0.98–1.21, P = 0.12), target lesion revascularization at 12 months (RR: 0.68, 95%CI: 0.41–1.14, P = 0.15), leg amputations at 12 months (RR: 0.54, 95%CI: 0.13–2.23, P = 0.39), mortality at 12 months (RR: 2.18, 95%CI: 0.71–6.64, P = 0.17). Sensitivity analysis had no effect on our findings. Conclusions The combination of atherectomy and drug-coated balloon was safe and effective in the treatment of femoropopliteal artery lesions, with lower incidence of bail-out stenting compared with drug-coated balloon only.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Summary Of Included Studiesmentioning

confidence: 99%

See 1 more Smart Citation

Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Interventional therapy characterized by minimal invasion, high safety, good efficacy and easy recovery, mainly including thrombolysis, balloon dilation, endoluminal atherectomy, stent placement and artery reconstruction, has been widely applied recently [5]. In this study, experimental and control groups had comparable baseline clinical data (p > 0.05).…”

Section: Discussionmentioning

confidence: 84%

Therapeutic Effects of Interventional Therapy and Conservative Therapy on Lower Extremity Arteriosclerosis Obliterans and Risk Factors for Prognosis

Chen¹,

Zhang²,

Jiang³

et al. 2021

ARTRES

View full text Add to dashboard Cite

Background: Arteriosclerosis Obliterans (ASO) is an important cause for lower limb amputation. We aimed to compare the effects of interventional and conservative therapies on lower extremity ASO, and to analyze the risk factors for prognosis.Methods: Ninety-eight eligible patients were randomly divided into experimental (n = 50) and control groups (n = 48). Conservative therapy was conducted for control group, and experimental group was given conservative and interventional therapies. Their baseline clinical data, hospital stay length, claudication distance, Rutherford stage, diseased arteries, Ankle-Brachial Index (ABI), clinical outcomes and adverse events were recorded. Then they were divided into poor (n = 31) and good prognosis groups (n = 67), and risk factors were explored by univariate and multivariate analyses. Results:The hospital stay length of experimental group was significantly shorter than that of control group (p < 0.05). After treatment, Rutherford stage decreased, and vascular patency rate and total response rate rose in experimental group (p < 0.05). Claudication distance and ABI significantly increased in both groups compared with those before treatment, especially in experimental group (p < 0.05). The incidence rates of cardiovascular and cerebrovascular events, amputation and death were significantly lower in experimental group (p < 0.05). Age, conservative therapy, smoking, hypertension, diabetes mellitus, hyperlipidemia and fibrinogen were independent risk factors for poor prognosis (p < 0.05). Age of >70 years old and fibrinogen level of >4 g/L had greater effects on prognosis. Conclusion:Interventional therapy works well for lower extremity ASO, with high safety, easy recovery and mild complications. Poor prognosis is caused by old age, conservative therapy, smoking, hypertension, diabetes mellitus, hyperlipidemia and increased fibrinogen.

show abstract

“…Despite a lack of clear therapeutic recommendations, the debulking process of the ISR may potentially improve the therapeutic effects of DCBs by reducing the thickness of thrombi and hyperplastic tissue and improving drug delivery to the intima. However, only a few studies ( 3 , 7 , 8 ) with a limited number of cases have reported the results of debulking devices with DCBs for FP-ISR, and their findings are inconclusive. The authors, therefore, aimed to ascertain the safety and midterm outcomes of Rotarex®S rotational atherectomy plus DCB for patients with FP-ISR.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Mechanical Atherectomy Plus Thrombectomy Using the Rotarex®S Device Followed by a Drug-Coated Balloon for the Treatment of Femoropopliteal Artery In-stent Restenosis: A Prospective Single-Center, Single-Arm Efficacy Trial (PERMIT-ISR Trial)

Liu

Guo

et al. 2021

Front. Surg.

View full text Add to dashboard Cite

Background: Studies investigating debulking devices with drug-coated balloons (DCBs) in the treatment of femoropopliteal (FP) artery in-stent restenosis (ISR) are limited. We aimed to evaluate the safety and midterm outcome of percutaneous mechanical atherectomy plus thrombectomy (MATH) using the Rotarex®S (Straub Medical, Wangs, Switzerland) catheter followed by a DCB in the treatment of FP-ISR.Methods: This study was a single-center single-arm trial. Patients with symptomatic (Rutherford category 2–5) de novo restenosis lesions of FP-ISR were treated with MATH and subsequent DCB. From June 2016 to May 2018, 59 patients with FP-ISR were enrolled. The primary endpoint was target lesion revascularization (TLR) and changes in the Rutherford category of the target limb at 12 months. Secondary endpoints included primary and secondary patency at 12 months, technical success rate, major adverse events, and ankle-brachial index (ABI). Risk factors for TLR were analyzed using Cox proportional hazard model.Results: The average follow-up time was 33 ± 8 months. The rate of technical success was 88.1% (52/59). Nine patients received bailout stenting. The rate of freedom from TLR was 84.7% (50/59) at 1 year, the Rutherford category changed at 12 months were significantly improved from baseline (p < 0.01). The primary patency rates and the secondary patency at the 12-month follow-ups were 82.5 and 92.5%, respectively. The ABI changed at 12 months were significantly improved from baseline (p < 0.01). Global limb anatomic staging system (GLASS) classification III [hazard ratio (HR) 18.44, 95% CI (1.57–215.99), p = 0.020] and postoperative Rutherford classification ≥4 [HR 8.28, 95% CI (1.85–37.06), p = 0.006] were identified as independent predictors of TLR.Conclusion: Our preliminary data suggested that MATH using a Rotarex®S catheter combined with DCB angioplasty is a safe, minimally invasive, and effective treatment for FP-ISR with favorable, immediate, and midterm outcomes.Clinical Trial Registration:http://www.chictr.org.cn, identifier [ChiCTR2000041380].

show abstract

Midterm Outcome of Directional Atherectomy Combined with Drug-Coated Balloon Angioplasty Versus Drug-Coated Balloon Angioplasty Alone for Femoropopliteal Arteriosclerosis Obliterans

Cited by 26 publications

References 23 publications

Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis

Atherectomy plus drug-coated balloon versus drug-coated balloon only for treatment of femoropopliteal artery lesions: A systematic review and meta-analysis

Therapeutic Effects of Interventional Therapy and Conservative Therapy on Lower Extremity Arteriosclerosis Obliterans and Risk Factors for Prognosis

Percutaneous Mechanical Atherectomy Plus Thrombectomy Using the Rotarex®S Device Followed by a Drug-Coated Balloon for the Treatment of Femoropopliteal Artery In-stent Restenosis: A Prospective Single-Center, Single-Arm Efficacy Trial (PERMIT-ISR Trial)

Contact Info

Product

Resources

About