Clinical Comparison of High- and Low-Dose Drug-Coated Balloons for De Novo Chronic Total Occlusive Femoropopliteal Lesions.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Circulation Journal Pub Date : 2025-02-28 DOI:10.1253/circj.CJ-24-0813

Kenji Ogata, Kensaku Nishihira, Keiichiro Komiya, Kensho Baba, Yasuhiro Honda, Keisuke Yamamoto, Kosuke Kadooka, Toshiyuki Kimura, Takeaki Kudo, Keiichi Ashikaga, Yoshisato Shibata, Kenichi Tsujita

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引用次数: 0

Abstract

Background: Endovascular therapy (EVT) with a drug-coated balloon (DCB) is an established treatment for patients with atherosclerotic lesions in the femoropopliteal (FP) artery, including complex lesions. Currently, 3 types of DCBs are available, but the most effective DCB for FP chronic total occlusive (CTO) lesions is unknown.

Methods and results: In this retrospective, single-center study, we enrolled 539 consecutive patients (562 FP lesions) treated with EVT between January 2018 and December 2022. Of these patients, 161 with FP CTO lesions who underwent EVT with DCBs were included. Propensity-score matching was performed to compare the clinical outcomes of the high-dose (HD) and low-dose (LD) DCB groups, resulting in the analysis of 56 matched pairs. Primary patency and freedom from target lesion revascularization were significantly higher with HD-DCB than with LD-DCB (89.9% vs. 70.8%, respectively P=0.03; and 93.6% vs. 79.7%, respectively, P=0.046). Multivariate analysis showed that a larger minimum lumen area and the use of HD-DCB (vs. LD-DCB) were favorable predictors of primary patency at 1 year, while a small vessel diameter (≤4.5 mm) was an unfavorable predictor.

Conclusions: For FP CTO lesions, EVT performed with HD-DCB is superior to that with LD-DCB.

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背景：使用药物涂层球囊（DCB）进行血管内治疗（EVT）是治疗股腘动脉（FP）动脉粥样硬化病变（包括复杂病变）患者的一种成熟疗法。目前有 3 种 DCB 可供选择，但对 FP 慢性全闭塞（CTO）病变最有效的 DCB 尚不清楚：在这项回顾性单中心研究中，我们纳入了 2018 年 1 月至 2022 年 12 月间接受 EVT 治疗的 539 例连续患者（562 个 FP 病变）。在这些患者中，有161名FP CTO病变患者接受了使用DCB的EVT治疗。为比较高剂量（HD）和低剂量（LD）DCB组的临床结果，进行了倾向分数匹配，最终分析了56对匹配的患者。HD-DCB的初治通畅率和靶病变血运重建自由度明显高于LD-DCB（分别为89.9%对70.8%，P=0.03；93.6%对79.7%，P=0.046）。多变量分析显示，较大的最小管腔面积和使用HD-DCB（与LD-DCB相比）是1年后一次通畅的有利预测因素，而血管直径较小（≤4.5毫米）则是不利的预测因素：结论：对于 FP CTO 病变，使用 HD-DCB 进行 EVT 优于使用 LD-DCB。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Circulation Journal 医学-心血管系统

CiteScore

5.80

自引率

12.10%

发文量

471

审稿时长

1.6 months

期刊介绍： Circulation publishes original research manuscripts, review articles, and other content related to cardiovascular health and disease, including observational studies, clinical trials, epidemiology, health services and outcomes studies, and advances in basic and translational research.