Efficacy Analysis Of Drug-coated Balloon Versus Bare Metal Stent In The Treatment Of Patients With Femoral Popliteal Atherosclerosis

Objective:To summarize the experience of our center in the treatment of long segment of femoral popliteal atherosclerosis patients.To compare the efficacy of drug-coated balloon(DCB)and self-expanding bare metal stent(BMS)in the treatment of such patients and to provide a basis for more reasonable selection of surgical methods in long lesions of ASO.Methods:Analyze the clinical data of 89 patients with femoral popliteal arteriosclerosis in the Department of Vascular Surgery,Second Affiliated Hospital of Nanchang University from Sep,2016 to Sep,2018.All patients underwent CTA and were diagnosed as femoral popliteal arteriosclerosis,including 33 cases of DCB,56 cases of BMS.Six-month follow-up was performed.General information of patients was recorded.ABI was measured preoperative,the first day after surgery and half-year postoperative and the difference between preoperative and half year postoperative was also recorded.Change of Rutherford stage was recorded preoperative and half-year postoperative.The restenosis rate,clinically-directed target lesion rate(CDTLR)and adverse events half-year postoperative were also recorded.Statistical methods were used to compare the efficacy and safety of the above indicators.Results:All 89 patients were successfully treated with DCB and BMS,and were followed up for half-year.6 patients in the DCB group and 11 patients in the BMS group were lost to follow-up.There are 27 patients in DCB group,the average length of lesions was 13.8±6.4cm,preoperative Rutherford stage which was less than or equal to 3 counted for 44.4%,the stage which was more than 3 counted for 55.6%.ABI of preoperative、the first day after surgery、half-year postoperative and the difference between preoperative and half-year postoperative was 0.38±0.06 、 0.76±0.07 、0.65±0.09 and 0.27±0.10 respectively.The Rutherford stage postoperative which was less than or equal to 3 counted for 85.2% while more than 3 counted for 14.8%、the restenosis rate and CDTLR of half-year postoperative was 18.5% and 14.8% respectively.There were eight adverse events in DCB group.There are 45 patients in BMS group,the average length of lesion was 14.7±5.5cm.Preoperative Rutherford stage which was less than or equal to 3 counted for 55.6%,the one which was more than 3 counted for 44.4%.ABI of preoperative、the first day after surgery、half-year postoperative and the difference between preoperative and half-year postoperative was 0.39 ± 0.07、0.74 ± 0.07、0.59±0.08 and 0.21±0.12 respectively.The stage half-year postoperative which was less than or equal to 3 counted for 82.2% while more than 3 counted for 17.8%、the restenosis rate and CDTLR of half-year postoperative was 24.4% and 17.8% respectively.While twelve patients suffered from adverse events.The baseline data of patients、Rutherford stage of half-year postoperative、the restenosis rate、CDTLR and the adverse event number between two groups were no statistical difference.ABI of half-year postoperative and the difference between preoperative and postoperative of two groups were statistical significance.Conclusion:1.There is no obvious efficacy and safety difference between DCB and BMS in the treatment of long segment lesions of the femoral popliteal atherosclerosis half-year postoperative.2.ABI of half-year postoperative and the difference between preoperative and half-year postoperative in DCB is better than that of BMS.