Comparison Of Efficacy Between Drug-coated Balloons Combined With Atherectomy And Pure Drug-coated Balloons In The Treatment Of Arteriosclerosis Obliterans

Research background and objectivePercutaneous transluminal angioplasty(PTA)and stenting are the main microinvasive surgery methods for the treatment of chronic ischemia caused by Arteriosclerosis obliterans(ASO)in the world,but restenosis(RS)reduces its long-term therapeutic effect,how to reduce RS,and maintain the long-term patency of target vessels becomes an urgent problem to be solved.Drug coated balloon(DCB)combined with Directional atherectomy(DA)for lower limb ASO provides us with new ideas,but there are few related studies,and its effectiveness and safety are not sufficient confirmed.This study aimed to compare the efficacy and safety of drug-coated balloon combined with atherectomy and simple drug-coated balloon in the treatment of lower limb ASO.It is hoped that it can provide some reference value for the choice of lower limb ASO.Research methodsClinical data of 125 patients with lower extremity ASO that were diagnosed by combined CT tomography angiography(CTA)with medical history and clinical symptoms from September 2016 to December 2017 were collected.According to the surgical method,there were 40 cases of pure drug-coated balloons dilatation(group A).Combined drug-coated balloons dilatation and silverhawk plaque resection in 85 cases(group B).The patients were followed up after surgery,which by outpatient,telephone,WeChat,etc.The patients underwent CTA or vascular color Doppler ultrasound.The results were calculated by SPSS21.0 statistical software.Comparing the adverse event rates and Rutherford classification,ankle brachial index(ABI),minimum lumen diameter(MLD),and Late lumen loss(LLL),restenosis rate,target lesion revascularization(TLR)at 6 and 12 months after operation(The difference of P<0.05 was statistically significant).To compare the efficacy and safety of drug-coated balloon combined with atherectomy and simple drug-coated balloon in the treatment of lower limb ASO.Results1.After death and loss of visitors were excluded,38 cases in group A and 79 cases in group B were confirmed.There was no statistically significant difference in general condition,risk factors and target lesion length between the two groups(P> 0.05).2.Adverse events occurred: 1 case had a non-restricted dissection during operation in the group A.In the group B,2 cases had hematoma at the puncture site,1 case had a restrictive dissection during operation,1 case had a non-restricted dissection,and 1 case had died of cerebral infarction in postoperative one month,and one patient had died of pulmonary heart disease in postoperative ten month.There was no significant difference in the total incidence rate(P>0.05).3.The Rutherford classification,restenosis rate and LLL in group A were lower than those in group B,ABI and MLD were higher than those in group B(P<0.05),and TLR was not statistically significant between the two groups(P>0.05).ConclusionsFor lower extremity arteriosclerosis obliterans,drug-coated balloon combined with atherectomy has a better near-middle-term effect than drug-coated balloons alone,the safety is similar.