Analysis And Clinical Curative Effect In The Treatment Of Infrapopliteal Arteriosclerosis Occlusive Disease

Objective: To compare the clinical efficacy of balloon dilation and drug coated balloon in the treatment of infrapopliteal arteriosclerosis occlusive disease.Method: This paper analyzed retrospectively 64 cases patients who diagnosed with infrapopliteal arteriosclerosis occlusive disease between December 2017 and March2020 in the First Affiliated Hospital of Bengbu Medical University of vascular surgery.According to different treatment methods,it is divided into(PTA)group 43 cases and(DCB)group 21 cases.Through the analysis and summary of the clinical data of the two groups,the clinical characteristics,the improvement of clinical symptoms before and after treatment,the Rutherford grading changes,the changes of the ankle brachial index(ABI)before and after surgery,the primary patency rate,restenosis rate,amputation rate and mortality rate were compared.The results were statistically analyzed,and P <0.05 was considered as a significant limit.Results:In this study,there were 43 people in the PTA group,including 31 males and12 females,with an average age of 65.14±5.95 years old.There were 21 people in the DCB group,including 14 males and 7 females,with an average age of 66.57±5.71 years old.There was no statistical significance in age,gender,smoking history,past medical history and Rutherford grading between two groups(P>0.05).The preoperative mean Rutherford grade of the PTA group and the DCB group respectively was 3.51±0.96 and 3.67±1.06,and the postoperative mean Rutherford grade respectively was 2.19±0.59 and 1.95±0.86.The preoperative and postoperative differences were statistically significant(P < 0.05).There was no significant difference in the ABI values between the two groups before surgery and 3 days after surgery(P>0.05).The ABI of the two groups respectively was 0.70±0.07 and 0.74±0.08 in 3months after surgery,0.64±0.07 and 0.69±0.07 in 6 months after surgery,and0.52±0.04 and 0.59±0.06 in 12 months after surgery,The differences were statistically significant(P < 0.05).Followed up for 3 months,two groups of patients with the first phase of patency rate compared with restenosis rate,there was no obvious statistical significance difference(P > 0.05);and followed up for 6 months,The first phase patency rate of PTA group was 53.85%,the restenosis rate was 23.08%,DCB group respectively was 78.94% and 5.26%,the difference was statistically significant(P <0.05);followed up for 1 year,DCB group has a higher patency rate and lower restenosis rate than PTA group,the rate respectively is 61.11% vs.25.93% and 27.78%vs.62.96%,the difference is statistically significant(P < 0.05);two patients with amputation a PTA group and 1 case of acute myocardial infarction due to coronary heart disease recurrence and death in patients with DCB group,no cases of amputation and death,but there was no statistically significant difference between the two(P > 0.05).Conclusion: Balloon dilation combined with DCB is safe,effective and feasible in the treatment of infrapopliteal arteriosclerosis occlusive disease and the intermediate efficacy is better than PTA.