Effect Of Calcification Level On Treatment Of Tasc TASCⅡ A And B Grade Femoropopliteal Arteriosclerosis Occlusion

ObjectiveFemoral popliteal Atherosclerotic Occlusive Disease(FPAOD)was a common Disease of vascular surgery,and the presence of calcified lesion of target vessels had a serious influence on the clinical symptoms and prognosis of patients.Although drug-coated(DCB)balloons have achieved good results in the treatment of FPAOD,complex lesions with calcification hinder drug penetration and balloon dilation,leading to a high rate of restenosis after surgery.DA creates better vascular conditions for the application of DCB by rotating the proliferative calcified plaques.The combined application of DA and DCB in the treatment of femoropopliteal arteriosclerosis occlusion has been gradually promoted in clinical practice.The purpose of this study was to evaluate the effect of calcification on the short-to-medium term clinical efficacy of DA combined with DCB or DCB alone in the treatment of Grade TASC II A and B in femoropopliteal arteriosclerosis occlusion.MethodsWere retrospectively analyzed in October 2016 to June 2019 by intracavitary treatment of 82 cases of femoral popliteal arteries occlusion in patients with clinical data,including light,moderate calcification 52 people,severe calcification 30 people,randomly divided into two groups,group A(42 cases)line DA combined DCB treatment,B group(40 cases)line of pure DCB treatment,through after 6 months,12 months of color doppler ultrasound,blood flow diagram,CT angiography and DSA(Digital subtraction angiography,Digital subtraction angiography)to assess vascular patency,The changes of target vessel initial patidity rate,free target revascularization(FTLR),ankle-brachial index(ABI),minimal lumen diameter(MLD)and other indexes were recorded,and the data were analyzed using SPSS.26 statistical software.ResultsAll the 86 patients were successfully opened,of which the technical success rate was 95.3%(n=82).During the operation,1 case of femoral artery perforation and 3cases of flow limiting dissection were observed.The rate of salvage stent implantation was 4.6%(n=4).1.The patency rate of target vessels at 12 months: in patients with mild to moderate calcification lesions,the patency rate of primary stage in group A and group B was 94.4% and 96.0%,respectively,without statistical significance(P > 0.05).In patients with severe calcification,the first-stage patency rates of group A and group B were 86.7% and 53.3%,respectively(P < 0.05).2.ABI and Rutherford grading status: ABI and Rutherford grading status of all patients were significantly improved compared with preoperative status;There was no significant difference in ABI between group A and group B in patients with mild-moderate calcification 6 and 12 months after surgery,while there was significant difference between group A and group B in patients with severe calcification(P <0.05).3.MLD: Compared with group B,there was no significant difference in MLD 6and 12 months after surgery between group A and group B in patients with mild-moderate calcification lesions(P > 0.05).In the patients with severe calcification,the 12-month MLD in group A was higher than that in group B(all P <0.05).ConclusionIn patients with femoropopliteal arteriosclerosis occlusive syndrome(TASC II A and B),there was no significant difference in the clinical effect of DA combined with DCB in the treatment of lesions with mild calcification compared with DCB alone.DA combined with DCB in lesions with moderate to severe calcification was superior to DCB alone,with good short-term efficacy.