Treatment of femoropopliteal arterial lesions with excimer laser atherectomy and drug-coated balloon

Abstract

Objectives

Proximal to mid-term effects of contrast excimer laser atherectomy (ELA) + drug-coated balloon (DCB) versus PTA + drug-coated balloon (DCB) in the treatment of new lesions in the femoral popliteal segment of patients with lower extremity arteriosclerosis and occlusion.

Methods

The clinical data of 105 patients with CT-confirmed femoropopliteal segment lesions (Rutherford grades 3–6) were retrospectively analyzed. According to the computerized randomization method, 58 patients (44 males, mean 72.41 ± 10.58 years) were divided into group A ELA + DCB dilation and 47 patients (35 males, mean 73.83 ± 11.56 years) in group B PTA + DCB dilation. The clinical indexes mainly included the occurrence of Rutherford grade, freedom from target lesion revascularization rate (FTLR), ankle-brachial index (ABI), stage I survival rate, and postoperative complications before, 6 months, and 12 months after surgery and were compared between the two groups.

Results

The treatment success rate was 100% in all patients. The Rutherford grading at 12 months after operation was significantly improved in both groups, but statistical analysis showed that the improvement was more significant in group A (87.93% vs 72.34%, p = 0.043); ABI (0.77 ± 0.22^abc vs 0.65 ± 0.10^abc, p = 0.001); FTLR (93.10% vs 78.72%, p = 0.031), respectively. First-stage patency rate (91.38% vs 74.47%, p < 0.001),; complications, and adverse events were not statistically significant between the two groups (p > 0.05).

Conclusions

ELA + DCB significantly improved the 1-year freedom from target lesion revascularization rate and stage 1 patency rate with no significant increase in complications or adverse events.

Keywords

Excimer laser atherectomy drug-coated balloon arteriosclerosis obliterans of the lower extremities femoral popliteal lesions freedom from target lesion revascularization

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