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Abstract：
This study evaluated the outcomes of a bare metal stent (BMS), DCB alone, atherectomy plus a drug-coated balloon (AT + DCB) and AT alone for the treatment of femoropopliteal artery occlusion. Four groups were included in this retrospective cohort study: 119 patients underwent the BMS procedure, 89 patients underwent DCB alone, 52 patients underwent AT + DCB, and 61 patients underwent AT alone. Patients were followed-up at 1, 6, 12 and 24 months after the procedure, the clinical outcomes and complications were assessed, and the primary outcomes were primary patency and restenosis. AT + DCB showed a lower bailout stent, and BMS displayed a higher retrograde puncture, flow-limiting dissection and postdilation (p < 0.05). For all procedures, the walking distance, ABI and pain score post-procedure were significantly improved compared with the pre-procedure values (p < 0.001). The restenosis rate was higher in BMS (21.0%) and AT alone (24.6%) than in DCB (10.1%) alone and AT + DCB (11.5%) (p = 0.04); there was no difference in amputation or clinically driven target lesion revascularization among procedures. The primary patency rates were 77.7%, 89.4%, 88.0% and 73.7% in the BMS, DCB alone, AT + DCB and AT alone groups at 24 months, respectively (p = 0.03), while the secondary patency and main adverse events (stroke, MI and death) were similar. Proximal concavity, proximal target vessel diameter ≥ 5 mm, runoff number ≥ 2 and DCB use were protective factors for primary patency. Our results suggested that AT + DCB and DCB alone were associated with higher primary patency, and DCB devices (combined with/without AT) should be the preferred choice for FP lesions.
摘要：
这项研究评估了裸金属支架（BMS）的结果，单独的DCB，动脉粥样硬化切除术加药物涂层球囊（AT+DCB）和AT单独用于治疗股pop动脉闭塞。这项回顾性队列研究包括四组：119例患者接受了BMS手术，89例患者仅接受DCB，52例患者接受AT+DCB,61例患者仅接受AT治疗。术后1、6、12和24个月对患者进行随访。评估临床结果和并发症，主要结局是原发通畅和再狭窄.AT+DCB显示较低的脱困支架,和BMS显示更高的逆行穿刺，流量限制夹层和扩张后（p<0.05）。对于所有程序，步行距离,术后ABI和疼痛评分较术前显著改善(p<0.001)。单独BMS（21.0%）和AT（24.6%）的再狭窄率高于单独DCB（10.1%）和AT+DCB（11.5%）（p=0.04）；手术间截肢或临床驱动的靶病变血运重建没有差异。原发性通畅率为77.7%,89.4%,BMS中的88.0%和73.7%，单独的DCB，AT+DCB和单独AT组在24个月时，分别(p=0.03)，而继发性通畅和主要不良事件(中风，MI和死亡）相似。近侧凹面,近端靶血管直径≥5mm,径流数≥2和DCB的使用是原发性通畅的保护因素.我们的结果表明，AT+DCB和单独的DCB与较高的原发通畅性相关，和DCB装置(结合/不结合AT)应是FP病变的首选。
