METHODS: From June 2019 to December 2021, data of patients who underwent ELA combined with DCB in the popliteal artery were retrospectively reviewed. Demographics, lesion characteristics, periprocedural complications, and follow-up information were analyzed. The primary endpoint was primary patency. Secondary endpoints included major amputation-free survival rate, technical success, bailout stenting, clinically-driven target lesion reintervention, improvement of ankle-brachial index (ABI), and Rutherford class.
RESULTS: A total of 61 patients were enrolled. The mean age was 73.4 ± 11.7 years. 20 (32.8%) patients had stenotic lesions, while 41 (67.2%) patients had chronic total occlusions. The mean length of these lesions was 7.3 ± 2.8 cm. Procedure technical success rate was 95.1%. Bailout stent was performed in 3 (4.9%) patients. Intraprocedural distal embolization occurred in 3 (4.9%) patients, while flow limiting dissections occurred in 3 (4.9%) patients. The mean ABI was significantly improved from 0.45 ± 0.13 at baseline to 0.90 ± 0.12 after ELA, 0.88 ± 0.11 at 6 months and 0.85 ± 0.12 at 12 months during the follow-up period. The median follow-up time was 28.2 ± 6.1 months. Reintervention was performed in 5 (8.2%) patients. The 2-year primary patency was 83.5%.
CONCLUSIONS: ELA combined with DCB is a safe and effective strategy in the treatment of popliteal artery atherosclerotic lesions with low rates of bail-out stenting and high primary patency.
方法:回顾性分析2019年6月至2021年12月,行髂动脉联合DCB的患者资料。人口统计,病变特征,分析围手术期并发症和随访信息。主要终点是原发性通畅。次要终点包括无截肢生存率(MAFS),技术上的成功,救助支架,临床驱动的靶病变再干预(CD-TLR),踝臂指数(ABI)和卢瑟福类的改善。
结果:共纳入61例患者。平均年龄为73.4±11.7岁。20例(32.8%)患者有狭窄病变,而41例(67.2%)患者有慢性完全闭塞(CTO)。这些病变的平均长度为7.3±2.8cm。手术技术成功率为95.1%。3例(4.9%)患者进行了支架治疗。术中远端栓塞3例(4.9%),而3例(4.9%)患者发生流量限制夹层。平均ABI从基线时的0.45±0.13显著改善至ELA后的0.90±0.12,6个月时为0.88±0.11,12个月时为0.85±0.12。在随访期间。中位随访时间为28.2±6.1个月。5例(8.2%)患者进行了再干预。2年原发性通畅率为83.5%。
结论:ELA联合DCB是治疗the动脉粥样硬化病变的一种安全有效的策略,支架置入率低,原发性通畅性高。