Interim Efficacy Of Drug Coated Balloon In Treatment Of Femoral Popliteal Arteriosclerosis Obliterans

Study Objective:Drug coated balloon(Drug-coated balloon,DCB),balloon angioplasty alone(Plain old balloon angioplasty,POBA),bare metal stent(Bare metal stent retrospective analysis of single-center,BMS)three ways to treat lower limb arteriosclerosis obliterans patients with femoropopliteal in long-term efficacy and adverse events,make better integrated program for the treatment of femoropopliteal arteriosclerosis obliterans.Methods:In this The second affiliated hospital of guangzhou medical university vascular surgery were retrospectively analyzed in November 2014 to June 2018,according to the differences in treatment of surgical operation in treating using cavity treatment conforms to the inclusion criteria and exclusion criteria,93 cases of femoral popliteal arteries occlusion patients,32 patients were included in the drug-coated balloon treatment group(DCB),30 cases in normal group(group POBA)balloon expansion,31 cases in group bare metal stent(BMS),for patients with postoperative 1,6,12,24 months of follow-up,clinical efficacy evaluation index,Follow-up process through artery doppler ultrasound or CT angiography(CTA)observation target vascular patency,three groups of patients with perioperative and postoperative complications,ankle brachial index(ABI),Rutherford classification,target lesion minimum target vascular lumen diameter(MLD),late lumen loss(the name 'LLL),vascular restenosis,issue of patency rate,incidence of adverse events such as indicators,through SPSS25.0 statistical software for two groups of patients with ABI,MLD,the name' LLL,restenosis rate,the first phase of patency rate follow-up indexes such as statistical analysis,compare the efficacy and safety of these indicators.Results:Accord Accord with the standard set of 93 patients were successfully completed the intracavitary treatment,patients aged 50-83,mean age 75.05 + /-10.36 years of age,length of lesions in 10.59 + /-5.51 cm,51 cases of men,women,42 cases,82 cases of patients suffering from hypertension bolted conditions 25 cases,52 cases of diabetes,hyperlipidemia 48 cases,has a history of smoking in 75 cases,follow-up of 16 to 26 months,an average of 23 + /-4.05 months.The mean lesion length of 32 patients in the DCB group was 10.39 ± 0.89 cm.The rutheford grading was 4 ± 0.95,3.22 ± 1.13,3.25 ± 1.11,3.25 ± 1.11,3.44 ± 1.21,respectively,before surgery,1 month after surgery,6 months after surgery,12 months after surgery,and 24 months after surgery.The ABI was 0.39 ± 0.24,0.95 ± 0.13,0.92 ± 0.17,0.90 ± 0.16,and 0.81 ± 0.12,respectively,on the first day after surgery,6 months after surgery,12 months after surgery,and 24 months after surgery.Adverse events occurred in 14 people.The mean lesion length of 31 patients in the BMS group was 9.68±1.13 cm.The rutherford grading was 3.57±0.87,3.05±0.92,3.05±0.92,3.1±0.83,3.14±0.91 before,1 month after,6 months after,and 24 months after surgery,respectively.The ABI was 0.29±0.10,0.92±0.14,0.88±0.15,0.87±0.07,0.87±0.06 on the first day after surgery,6 months after,12 months after surgery,and 0.87±0.06 after surgery,respectively.The number of adverse events was 12.The mean lesion length of 30 patients in the POBA group was 8.25±0.58 cm.The rutherford grading was 3.13±0.92,2.67±0.72,2.87±0.74,3±0.85,3.33±0.98,respectively,before surgery,1 month after surgery,6 months after surgery,12 months after surgery,and 24 months after surgery.The ABI was 0.46±0.39,0.93±0.08,0.92±0.29,0.78±0.27,0.73±0.12,respectively,on the first day after surgery,6 months after surgery,12 months after surgery,and 0.73±0.12,respectively.The number of adverse events was 18.Three groups of patients with preoperative baseline data,Rutherford stage changes,the incidence of adverse events,there was no statistically significant difference in postoperative patients with clinical symptoms improve,ABI from increased significantly(P < 0.05),postoperative June ABI difference between three groups was statistically significant,DCB,BMS group clinical evaluation index is relatively high POBA group(P < 0.05),DCB with BMS group after 6 months,12 months and 24 months quite a clinical evaluation index;Postoperative restenosis rate differences between December three groups was statistically significant,DCB,BMS group is lower than POBA group difference was statistically significant,24 months of postoperative restenosis rate no statistical difference between the three groups,adverse events,the first year after adverse events no statistical difference between the three groups,group POBA adverse events from DCB,BMS group is high,three sets of 24 months of postoperative adverse events difference was statistically significant,mainly for the DCB group of death cases appeared in the process of follow-up,the causes of death cases of postoperative acute renal failure,follow-up found that patients with heart failure symptoms,Whether toxicity with DCB drugs causes symptoms still needs further study.Conclusions: 1.DCB was effective in the treatment of femoral popliteal arteriosclerosis obliterans.Postoperative ABI,Rutherford grading and minimum lumen diameter were significantly improved.2.The short-term efficacy of DCB,BMS and POBA in the treatment of femoral popliteal arteriosclerosis obliterans is similar,and the medium-term efficacy of DCB is better than that of BMS and POBA,which is mainly manifested in higher primary patency rate and lower restenosis rate.3.The efficacy of DCB was safe in the mid-term,and the incidence of adverse events was lower than that of BMS and POBA.