Efficacy Analysis Of Drug-coated Balloon Treatment Of Superficial Femoral Artery In-stent Restenosis

Objective :To assessment the curative effect of drug-coated balloon angioplasty(DCB)and common balloon angioplasty(BA)in patients with in-stent restenosis in superficial femoral artery.Methods: This is a retrospective analysis of 43 patients with in-stent restenosis of superficial femoral artery who were admitted to the Department of vascular surgery of our hospital from September 2018 to September 2019.The diagnosis of in-stent restenosis was confirmed by color Doppler ultrasound or computed tomography angiography.According to the different treatment methods,they were divided into DCB group(n=26 cases,mean age 64.4 ± 8.9 years,male 18)and BA group(n=17 patients,mean age 62.1 ± 1.2 years,male 11).The basic information and medical history of the two groups were collected for statistical analysis to determine whether the baseline characteristics of the two groups were statistically different;and the two groups of patients were recorded,including the ankle brachial index(ABI),minimum lumen diameter(MLD),peak systolic velocity ratio(PSVR),late lumen loss(LLL),target lesion revascularization(TLR)and restenosis rate and Rutherford category of the patients were analyzed by statistical methods at seven days before operation,six months and twelve months after operation to evaluate whether the difference is significant.Besides,According to the history of diabetes,26 patients in the DCB group were divided into diabetes group(n = 16)and non diabetes group(n = 10)for intra group analysis to evaluate whether there were significant differences in related indicators of the two groups,and whether the diabetic patients affected the treatment of DCB.Results: there was no significant difference in ABI,MLD,PSVR and Rutherford category between DCB group and POBA group at 7 days after operation(P > 0.05).the restenosis rate(7.7% and 19.2%)of DCB group at six months and twelve months after operation was lower than BA group(41.2% and 88.2%).ABI of DCB group was obviously higher than BA group at 12 months after operation(0.80 ± 0.21 vs 0.49 ±0.17).there were obviously difference in MLD of DCB group and BA group at 6 months after operation(3.09 ± 0.28 vs 0.05)and MLD of DCB group and POBA group at 12 months after operation(3.00 ± 0.25 vs 1.71 ± 0.43).LLL in DCB group was significantly lower than that in BA group at 6 months((0.26 ± 0.22,0.35 ± 0.10)and twelve months(0.38±0.16,1.49±0.46)after operation;PSVR(2.15 ± 0.45,3.37 ± 0.74)in BA group was higher than DCB group(1.54 ± 0.41,1.49 ± 0.46)at six and twelve months after operation;The TLR was 15.4% in DCB group and 41.2% in BA group at twelve months after operation;there was statistical significance in Rutherford category between the two groups at twelve months after operation,but no statistical significance at six months after operation;the results of sub-analysis in DCB group showed that there was no obviously difference in LLL,ABI,PSVR and restenosis rate in diabetic group and non-diabetic group at six months and one year after operation.However,there was significant difference in MLD between diabetic group and non-diabetic group at 6months(2.95 ± 0.30 vs 3.18 ± 0.25,P = 0.046)and 12 months(2.87 ± 0.27 vs 3.08 ± 0.21,P = 0.033).No serious adverse events occurred in both groups。Conclusion :the short-term and medium-term curative effect of DCB group in patients with in-stent restenosis of superficial femoral artery better than BA group,and the history of diabetes can affect the efficacy of DCB.