药物涂层球囊治疗股腘动脉原发病变的预后评分模型及联合定向经皮腔内斑块旋切术的效果评价

Translated title of the contribution: Grading model for drug‐coated balloon treating femoropopliteal de novo lesions and potential benefit from debulking

Haocheng Ma, Tao Zhang, Xuemin Zhang, Wei Li, Qingle Li, Jingjun Jiang, Yang Jiao, Xiaoming Zhang

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives To establish a grading model on prognosis of drug‐coated balloon (DCB) treatment on femoropopliteal de novo lesions, and assess whether patients at high risk could benefit from combination of directional atherectomy(DA). Methods The clinical data of 114 patients with femoropopliteal de novo lesions admitted to Department of Vascular Surgery, Peking University People′s Hospital from October 2015 to January 2019 were collected retrospectively. There were 95 patients(108 limbs) underwent DCB treatment, including 66 males and 29 females, aged 71.9 years old(range:48 to 91 years), and 19 patients (21 limbs) underwent DA combined with DCB treatment, including 13 males and 6 females, aged 69.5 years old(range: 62 to 80 years). The demographic data, intraoperative and postoperative conditions of the patients were collected. Cox regression model was performed for modeling and then goodness of fit was tested. Kaplan‐Meier estimate was carried out between the two groups for patients at high risk and low risk, respectively. Results All patients were followed up for more than 24 months. Restenosis occurred on 34 limbs in DCB group and 3 limbs in DA+DCB group. Severe calcification(HR=3.804, 95%CI:2.460 to 5.883), popliteal artery involvement (HR=2.104, 95%CI: 1.368 to 3.236), long lesion (HR=1.824, 95%CI: 1.196 to 2.780), poor runoff(HR=1.736, 95%CI:1.025 to 2.940), chronic kidney disease(HR=1.601, 95%CI:1.040 to 2.463) were independent risk factors of restenosis after DCB treatment, and were defined 3, 2, 1, 1 and 1 points, respectively. Total points≥3 was regarded as high risk group. Kaplan‐Meier analysis showed that patients in low risk group did not benefit from DA+DCB comparing with DCB with regard to primary patency at 24 months (77.78% vs. 90.31%, P=0.271) while patients benefited from DA+DCB comparing with DCB in high risk group(88.26% vs. 20.80%, P<0.01). Conclusions The grading model shows satisfying clinical value. The clinical effect of DA+ DCB is better than DCB along in high risk group. Patients at high risk are supposed to receive aggressive vessel preparation like DA.

Translated title of the contributionGrading model for drug‐coated balloon treating femoropopliteal de novo lesions and potential benefit from debulking
Original languageChinese (Traditional)
Pages (from-to)854-860
Number of pages7
JournalZhonghua Wai Ke Za Zhi / Chinese Journal of Surgery
Volume59
Issue number10
DOIs
StatePublished - 1 Oct 2021
Externally publishedYes

Keywords

  • Arteriosclerosis obliterans
  • Directional atherectomy
  • Drug‐coated balloon
  • Grading model
  • Peripheral arterial disease

Fingerprint

Dive into the research topics of 'Grading model for drug‐coated balloon treating femoropopliteal de novo lesions and potential benefit from debulking'. Together they form a unique fingerprint.

Cite this