Application Research Of Drug-coated Balloon In Endovascular Treatment Of Postoperative In-stent Restenosis In Patients With Arteriosclerosis Obliterans In Lower Extremity

Objective: Arteriosclerosis obliterans in lower extremity is the most common peripheral arterial disease in vascular surgery,which can cause clinical manifestations of lower extremity ischemia and seriously affect the quality of life of patients.Although the endovascular treatment of arteriosclerosis obliterans can improve the blood flow of lower limbs,the incidence of in-stent restenosis is high.Therefore,in order to reduce the incidence of in-stent restenosis,Drug-coated balloon technology emerged as the times require.The purpose of this study was to evaluate the efficacy and safety of DCB in endovascular treatment of ISR in patients with arteriosclerosis obliterans of lower extremities.Matterials and Methods: From December 2017 to October 2018,21 patients with in-stent restenosis after endovascular therapy for lower extremity arteriosclerosis obliterans were treated with DCB at the First Affiliated Hospital of Bengbu Medical university.The patients were followed up for 6 months through a single-arm,singlecenter,prospective clinical study by DCB treatment.CT angiography and Doppler ultrasound were used to record peak systolic velocity ratio to evaluate the primary patency of target lesions.The ankle-brachial index,Rutherford classification and clinical-driven target lesion reconstruction were also recorded.During the whole follow-up period,the clinical significance of laboratory tests and the incidence of major adverse events were recorded.Results:The successful rate of operation was 100% in all ISR patients treated with DCB.Nineteen patients were followed up for 6 months.The follow-up rate was90.5%(19/21),including 12 males and 7 females.The average age was(71.89 ±6.45)years,and the average length of lesions was(69±36)mm.The clinical symptoms of the patients were significantly improved after operation.ABI increased from(0.39±0.11)before operation to(0.85±0.13)within one week after operation,and increased from(0.46±0.13)after operation(P < 0.05).The primary patency of the main followup results was 89.5%(17/19)after 6 months..Among them,restenosis occurred in 2cases,and the CD-TLR rate was 9.5%(2/21).No cardiovascular death,amputation Above ankle joint and thrombosis of target lesion occurred in all patients,and the incidence of MAE was 0%.Conclusions:DCB is safe and effective in the treatment of lower extremity arteriosclerosis obliterans with in-stent restenosis within 6 months after endovascular treatment.