Angiographic patterns of restenosis after drug-coated balloon angioplasty for femoropopliteal lesions and 1-year prognosis after repeat endovascular therapy.

Autor: Higashino N; Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Hyogo, Japan., Iida O; Cardiovascular Division, Osaka Police Hospital, Osaka, Japan., Ishihara T; Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Hyogo, Japan., Hata Y; Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Hyogo, Japan., Toyoshima T; Cardiovascular Division, Osaka Police Hospital, Osaka, Japan., Tsukizawa T; Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan., Nishian K; Department of Cardiology, Morinomiya Hospital, Morinomiya, Osaka, Japan., Fujihara M; Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan., Kawasaki D; Department of Cardiology, Morinomiya Hospital, Morinomiya, Osaka, Japan., Mano T; Kansai Rosai Hospital, Cardiovascular Center, Amagasaki, Hyogo, Japan.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2023 Nov; Vol. 102 (6), pp. 1114-1121. Date of Electronic Publication: 2023 Oct 19.
DOI: 10.1002/ccd.30856
Abstrakt: Aim: The aim of the current study sought to investigate the angiographic patterns of restenosis after drug-coated balloon (DCB) angioplasty for femoropopliteal (FP) lesions and which repeat endovascular therapy (EVT) for DCB restenosis would provide more freedom from recurrent restenosis.
Methods: This retrospective multicenter study included 119 limbs (chronic limb-threatening ischemia [CLTI]: 55%, lesion length: 136.9 ± 89.6 mm, chronic total occlusion: 25%) of 95 patients (diabetes mellitus: 70%, hemodialysis: 56%) who were diagnosed with DCB restenosis between January 2018 and December 2019. The cases were classified into three groups based on angiographic patterns of restenosis: Class I: focal lesions ≤50 mm, Class II: diffuse lesions >50 mm, and Class III: totally occluded lesions. The DCB restenosis patterns and frequency and predictors of recurrent restenosis after repeated EVT (re-EVT) were investigated.
Results: The mean follow-up duration was 29.8 ± 9.5 months. Groups I, II, and III comprised of 30 (25.2%), 55 (46.2%), and 34 (29.0%) cases, respectively. The overall rate of 1-year freedom from recurrent restenosis was 58.2%. One-year rate of freedom from recurrent restenosis after repeat DCB was not statistically different from that after scaffolding (71.1% vs. 74.6%, respectively, p = 0.911); however, it was significantly better than that after noncoated balloon angioplasty (repeat DCB vs. noncoated balloon angioplasty: 71.1% vs. 25.7%, respectively, p < 0.001). Multivariate analysis demonstrated that CLTI (hazard ratio [HR]: 5.15, p < 0.001) and re-EVT with noncoated balloon (HR: 3.16, p < 0.001) were significantly associated with recurrent restenosis; however, Class III pattern of DCB restenosis was not associated with recurrent restenosis (HR: 1.04, p = 0.918).
Conclusions: This study revealed the angiographic patterns of restenosis after DCB therapy for FP lesions and the 1-year rate of recurrent restenosis after repeat revascularization. Repeat DCB therapy demonstrated acceptable 1-year recurrent restenosis rates.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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