| Purpose: To evaluate the clinical efficacy and safety of domestic Drug Coated Balloon（DCB）in the treatment of femoropopliteal arterial occlusive disease.Methods: Clinical data of 159 patients with Lower extremity arteriosclerosis obliterans（ASO）who underwent surgery in our hospital from February 2017 to October 2020 were retrospectively analyzed.They were divided into domestic DCB group（n = 40）and standard balloon angioplasty,SBA group（n = 119）according to endovascular treatment methods.General clinical data,preoperative laboratory examination results,operative data and postoperative follow-up data（primary patency rate of target vessels,target lesion revascularization,limb salvage rate and survival rate）were compared between the two groups.Results: There were no statistical differences in general clinical data,preoperative laboratory examination results and operative data between the two groups.There was no significant difference in primary patency rate between DCB group and SBA group at the third month after surgery（89.5% vs.75.0%,P = 0.059）,and the results of 6 and12 months after surgery showed that DCB group was significantly better than SBA group（86.8% vs.62.6%,78.4% vs.55.9%,P < 0.05）.There was no significant difference in the rate of freedom from target lesion revascularization between the two groups at 3 months after surgery（94.7% vs.89.4%,P = 0.519）,and the results at 6 and12 months after surgery showed that DCB group was significantly better than SBA group（94.7% vs.79.1%,89.2% vs.71.4%,P < 0.05）.There were no significant differences in limb salvage rate and survival rate between the two groups at 3,6 and 12 months after surgery（P >0.05）.Conclusion: This study showed that domestic DCB was safe and effective in 1-year follow-up,and the primary patency rate of target vessels and the rate of freedom from target lesion revascularization at 6 and 12 months were better than those in the common balloon group.There is no significant difference in limb salvage rate and survival rate between the two groups.Purpose: Femoropopliteal artery in-stent restenosis（ISR）remains a challenging treatment.We performed a network meta-analysis for femoropopliteal artery ISR to explore the safety and efficacy of endovascular therapeutic strategies and the role of drug-coated balloon in the treatment.Methods: The Medline,Embase,Web of Science,and Cochrane databases were used as data sources.The network meta-analysis（NWM）approach used random-effects models based on the frequentist framework.We compared the technical success rate of various treatments for femoral popliteal artery ISR and the rate of primary patency,target lesion revascularization（TLR）and major amputation at 6 and 12 months of follow-up.Results: In total,14 eligible studies [10 prospective and 4 retrospectives;1348 patients;and 8 treatment modalities standard balloon angioplasty（SBA）,drug-coated balloon（DCB）,peripheral cutting balloon angioplasty（PCBA）,Viabahn endoprosthesis（VBE）,directional atherectomy（DA）,excimer laser atherectomy（ELA）,and combinations] were included.The primary patency rates（at 6 months）were significantly higher for DCB and ELA+DCB than for SBA and ELA+SBA.ELA+DCB had higher primary patency rates（at 12 months）than ELA+SBA and SBA.The technical success rates were significantly lower for DCB and SBA than for VBE（DCB: OR 32.93,95% CI 1.30-831.32;SBA: OR 18.40,95% CI 1.03-330.18）.The major amputation rates were significantly lower for ELA+DCB than for DCB（OR 0.16,95% CI 0.03-0.75）.Based on the surface values under the cumulative ranking curve（SUCRA）,ELA+DCB was considered the best treatment in terms of primary patency at 6 months（SUCRA=91.1）,primary patency at 12 months（SUCRA=82.3）,and TLR（SUCRA=83.4）.Conclusion: ELA+DCB showed positive encouraging results in primary patency（6,12 months）,TLR and major amputation in femoropopliteal ISR.The efficacy and safety of ELA+DCB are worthy of further investigation.（PROSPERO ID No.: CRD42021246674）... |
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