Outcomes of Adjunctive Drug-Coated Versus Uncoated Balloon after Atherectomy in Femoropopliteal Artery Disease

Yun Jeong Lee, Young Guk Ko, Chul Min Ahn, Sung Jin Hong, Jung Sun Kim, Byeong Keuk Kim, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The purpose of this study is to evaluate outcomes using drug-coated balloon (DCB) in comparison with uncoated balloon as adjunctive treatment after atherectomy for femoropopliteal artery lesions. Methods: This single-center retrospective and prospective study included 115 patients with 126 femoropopliteal artery lesions treated with endovascular treatment using atherectomy. Of these, 58 patients received adjunctive DCB after atherectomy (group A) and 57 patients were managed with uncoated balloon after atherectomy (group B). Immediate and late clinical outcomes were compared. Results: Baseline clinical and lesion data were comparable between the 2 groups. However, group A included more uses of rotational atherectomy (43.9% vs. 1.7%, P < 0.001) or embolization protection filter (53.0% vs. 6.7%, P = 0.001), and fewer cases requiring provisional stenting (4.5% vs. 18.3%, P = 0.014). Clinical primary patency at 1 year was significantly higher in group A than in group B (76.3% vs. 61.1%, P = 0.039). There was a trend toward higher 1-year target lesion revascularization (TLR)-free survival in group A (89.8% vs. 77.9% at 1 year, P = 0.275) without statistical significance. Proportional hazards regression analysis indicated that age (hazard ratio [HR] 0.94, 95% confidence interval [CI] 0.90–0.99, P = 0.016) and provisional stenting (HR 9.78, 95% CI 2.20–43.46, P = 0.003) were independent factors associated with restenosis after combined treatment with atherectomy and DCB. Conclusions: In femoropopliteal artery disease, the combination of atherectomy with adjunctive DCB achieved better clinical outcomes in terms of clinical primary patency compared to atherectomy plus uncoated balloon while TLR-free survival may also be improved.

Original languageEnglish
Pages (from-to)391-399
Number of pages9
JournalAnnals of Vascular Surgery
Volume68
DOIs
Publication statusPublished - 2020 Oct

Bibliographical note

Funding Information:
This research was supported by grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, South Korea, funded by the Ministry of Health & Welfare, Republic of Korea (grants HI15C1277, HI17C0882, and HI16C2211) and the Cardiovascular Research Center, Seoul, Korea.

Funding Information:
This research was supported by grants of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute , South Korea, funded by the Ministry of Health & Welfare , Republic of Korea (grants HI15C1277 , HI17C0882 , and HI16C2211 ) and the Cardiovascular Research Center , Seoul, Korea.

Publisher Copyright:
© 2020 Elsevier Inc.

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

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