Impact of Below-the-Knee Runoff in Patients With Lower Extremity Artery Disease Who Underwent Endovascular Therapy Using Drug-Coated Balloons in Femoropopliteal Lesions

IF 2.1 3区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Catheterization and Cardiovascular Interventions Pub Date : 2024-12-24 DOI:10.1002/ccd.31375

Takehiro Yamada, Takahiro Tokuda, Naoki Yoshioka, Akio Koyama, Ryusuke Nishikawa, Kiyotaka Shimamura, Takuya Tsuruoka, Hiroki Mitsuoka, Yusuke Sato, Takuma Aoyama

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Abstract

Background

The impact of below-the-knee (BK) runoff after drug-coated balloon (DCB) treatment in femoropopliteal (FP) lesions has not been well investigated.

Methods

This retrospective multicenter observational study enrolled 291 consecutive patients with lower extremity artery disease who underwent endovascular therapy with DCBs for FP lesions between January 2018 and December 2021. Patients were classified into four groups based on the BK runoff. Outcome measures included primary patency, freedom from clinically driven target lesion revascularization (CD-TLR) and amputation, and overall survival rates at 24 months. The predictors of restenosis at 24 months were also investigated.

Results

In total, 43, 98, 117, and 33 patients were classified into three, two, one, and no BK runoff groups, respectively. In three, two, one, and no BK runoff groups, the primary patency rates were 72.1%, 67.3%, 61.4%, and 44.1% (p = 0.028); freedom from CD-TLR rates were 87.1%, 78.8%, 71.7%, and 47.1% (p < 0.001); freedom from amputation rates were 95.2%, 97.9%, 92.8%, and 91.5% (p = 0.499); and overall survival rates were 89.4%, 83.2%, 76.6%, and 61.2% (p = 0.007), respectively, at 24 months. Multivariate analysis showed that chronic limb-threatening ischemia, no BK runoff, Lutonix use, and residual stenosis > 30% were independent predictors of primary patency loss at 24 months. The risk score, calculated as the number of predictors, reflected the risk of restenosis.

Conclusion

No BK runoff was associated with worse midterm primary patency, freedom from CD-TLR, and overall survival rates than at least one BK runoff.

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下肢动脉疾病患者在股腘动脉病变处使用药物包覆球囊进行血管内治疗后，膝关节下径流的影响

背景：药物包被球囊（DCB）治疗股腘（FP）病变后膝下（BK）径流的影响尚未得到很好的研究。方法：这项回顾性多中心观察性研究纳入了291例连续下肢动脉疾病患者，这些患者在2018年1月至2021年12月期间接受了血管内dcb治疗FP病变。根据BK径流量将患者分为四组。结局指标包括原发性通畅、无临床驱动的靶病变血运重建术（CD-TLR）和截肢，以及24个月时的总生存率。我们还研究了24个月时再狭窄的预测因素。结果：3组43例，2组98例，1组117例，无BK径流组33例。在3、2、1和无BK径流组中，原发性通畅率分别为72.1%、67.3%、61.4%和44.1% (p = 0.028)；CD-TLR解除率分别为87.1%、78.8%、71.7%和47.1% (p = 30%)，是24个月原发性通畅丧失的独立预测指标。风险评分以预测因子的数量计算，反映再狭窄的风险。结论：与至少一次BK径流相比，没有BK径流与更差的中期原发性通畅、CD-TLR的自由和总生存率相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Catheterization and Cardiovascular Interventions 医学-心血管系统

CiteScore

5.40

自引率

8.70%

发文量

419

审稿时长

2 months

期刊介绍： Catheterization and Cardiovascular Interventions is an international journal covering the broad field of cardiovascular diseases. Subject material includes basic and clinical information that is derived from or related to invasive and interventional coronary or peripheral vascular techniques. The journal focuses on material that will be of immediate practical value to physicians providing patient care in the clinical laboratory setting. To accomplish this, the journal publishes Preliminary Reports and Work In Progress articles that complement the traditional Original Studies, Case Reports, and Comprehensive Reviews. Perspective and insight concerning controversial subjects and evolving technologies are provided regularly through Editorial Commentaries furnished by members of the Editorial Board and other experts. Articles are subject to double-blind peer review and complete editorial evaluation prior to any decision regarding acceptability.