ABSTRACT
Complex femoropopliteal artery lesions (CFPAL) is a clinical difficulty. Dug-coated balloon (DCB) can carry the drug directly to the lesion site for release, so that the drug can accumulate at the target site in a high concentration and inhibit intimal hyperplasia. Directional atherectomy (DA) can make the drug carried by DCB penetrate into the vascular wall better by removing the vascular plaque, and improve the clinical therapeutic effect. The application advances of DCB or/and DA in treatment of CFPAL were reviewed in this paper.
ABSTRACT
Objective: To observe the effect of Turbohawk atherectomy combined with percutaneous transluminal angioplasty (PTA) using drug-coated balloon (DCB) for treatment of in-stent restenosis (ISR) after femoropopliteal artery stent implantation. Methods: Clinical data of 63 ISR patients after femoropopliteal artery stent implantation were retrospectively analyzed. The patients were divided into 2 groups, those in observation group (n=28) were treated with atherectomy combined with DCB, while in control group (n=35) were treated with DCB alone. The therapeutic effect and prognosis were compared between 2 groups. Results: All 63 patients were successfully treated without death nor amputation. There was no significant difference of ankle brachial index (ABI) before procedure, 7 days and 6 months after procedure between 2 groups. The difference of minimum lumen diameter (MLD) before procedure, immediately and 6 months after procedure were not statistically significant (all P> 0.05). ABI and MLD in the observation group were higher than those in control group 12 months after procedure, while the rate of late lumen loss (LLL) was lower than that in control group (both P 0.05), while primary patency rate of observation group was higher than that of control group 12 months after procedure (P=0.028). Conclusion: Atherectomy combined with DCB is effective in treatment of femoropopliteal artery ISR, especially in the near and middle terms.
