Percutaneous transluminal stenting versus directional atherectomy for lower limb artery TASC Ⅱ Class A and B superficial femoral artery lesions / 中华普通外科杂志

Objective To compare the effect and safety of stenting versus directional atherectomy (DA) in the treatment of TASCⅡ A and B superficial femoral artery lesions.Methods 100 patients with TASC Ⅱ A and B lesions were divided into percutaneous transluminal stenting(PTS) group (n =50) and DA group (n =50).Patients were compared in terms of technical success rate,treatment success rate,first operation cost,postoperative ankle brachial index (ABI),limb salvage rate,survival,and patency.Results The technical success rate in both PTS and DA group was 100％.The treatment success rate was 98％ vs.86％,P＞0.05.Postoperative ABI:0.82 ±0.19 vs.0.80 ±0.27,P＞0.05.First operation cost:(34 820 ± 1 051) yuan vs.(45 635 ± 1 358) yuan,P ＜0.001;All patients were followed-up for up to 2-year,the cumulative patency rate was 81.6％ vs.72.9％ (P＞0.05).Limb salvage rate was 97.9％ vs.93.8 ％,P ＞ 0.05.Conclusion There were no significant differences in the effect and safety of PTS versus DA in the treatment of TASCⅡ A and B superficial femoral artery lesions.

Directional atherectomy combined with drug-coated balloon dilatation for femoropopliteal artery diseases: recent advances in research / 介入放射学杂志

Femoropopliteal arteriosclerosis obliteration has been a common disease affecting human health. Currently, endovascular treatment has become the mainstream of operation, but the postoprative restenosis rate is still very high. Directional atherectomy (DA) can improve blood vessel compliance by removing plaque, but it has no obvious effect in reducing the restenosis rate. The emergence of drug-coated balloon (DCB) has brought the dawn to solve this problem. Through the entry of its loaded drug into the vascular wall to prevent the proliferation of endothelial cells and smooth muscle cells, DCB exerts its long-term anti-intimal hyperplasia effect. A number of studies have shown that DCB can reduce the late lumen loss and the restenosis rate, thus decrease the re-operation rate. Combination use of DA and DCB can improve the uptake of drugs, then, better results can be expected. However, the present research results are not sufficient to support the above theoretical speculation, and large sample and more multicenter randomized controlled studies need to be done before it can be validated.