One Year Primary Patency of Infrapopliteal Angioplasty Using Drug- Eluting Balloons: Single Center Experience at King Hussein Medical Center.

Autor:	Haddad SE; Department of Interventional Radiology, King Hussein Medical Center, Amman, Jordan., Shishani JM; Department of Vascular Surgery, Vascular Surgery Unit, King Hussein Medical Center, Amman, Jordan., Qtaish I; Department of Interventional Radiology, King Hussein Medical Center, Amman, Jordan., Rawashdeh MA; Department of Vascular Surgery, Vascular Surgery Unit, King Hussein Medical Center, Amman, Jordan., Qtaishat BS; Department of Anasthesiology, King Hussein Medical Center, Amman, Jordan.
Jazyk:	angličtina
Zdroj:	Journal of clinical imaging science [J Clin Imaging Sci] 2017 Aug 03; Vol. 7, pp. 31. Date of Electronic Publication: 2017 Aug 03 (Print Publication: 2017).
DOI:	10.4103/jcis.JCIS_34_17
Abstrakt:	Objective: Conventional percutaneous transluminal angioplasty (PTA) for long lesions in the below-the-knee (BTK) arteries in patients presenting with critical limb ischemia (CLI) has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug-eluting balloons (DEB) have higher 1 year primary patency rates compared to conventional PTA. Methods: This is a single-center, prospective, randomized trial that was conducted from June 2013 to December 2015. The aim of the study was to compare 1 year primary patency rates of DEB and PTA in BTK arteries in CLI patients. Inclusion criteria were patients presenting with CLI (Rutherford class 4 or greater), stenosis or occlusion ≥30 mm of at least one tibial artery, and agreement to 12-month evaluation. Exclusion criteria were life expectancy <1 year, allergy to paclitaxel, and contraindication to combined antiplatelet treatment. Follow-up was performed by clinical assessment, ankle brachial pressure index, Doppler ultrasound imaging, and conventional angiogram if indicated. Primary end point was 1 year primary patency, and secondary end points were target lesion revascularization (TLR) and major amputation. Statistical analysis was performed using Fischer's exact test. Results: Ninety-three patients with 106 lesions in the BTK arteries were enrolled in this study. One year primary patency was achieved in 26 (65%) and seven (17%) in the DEB and PTA groups ( P = 0.006), respectively. TLR was performed in nine lesions (23%) and 29 lesions (71%) in DEB and PTA groups ( P = 0.009), respectively. Major amputations occurred in one limb (2%) and two limbs (4%) in DEB and PTA groups ( P = 0.6), respectively. Conclusion: Paclitaxel DEB has significantly higher 1 year primary patency rate associated with significantly less TLR than conventional PTA, following endovascular recanalization of BTK arteries in patients presenting with CLI. Competing Interests: There are no conflicts of interest.
Databáze:	MEDLINE
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