Abstract：
BACKGROUND: The treatment of atherosclerotic lesions in the popliteal artery is challenging. This study aims to investigate the efficacy and safety of excimer laser ablation (ELA) combined with drug-coated balloon (DCB) for these lesions.
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.
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.
摘要：
背景：在动脉动脉粥样硬化病变的治疗是具有挑战性的。本研究旨在探讨准分子激光消融（ELA）联合药物涂层球囊（DCB）治疗这些病变的疗效和安全性。
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。
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。
