Angiographic patterns of restenosis after drug-coated balloon angioplasty for femoropopliteal lesions and 1-year prognosis after repeat endovascular therapy.

Abstract

AIM:

The aim of the current study sought to investigate the angiographic patterns of restenosis after drug-coated balloon (DCB) angioplasty for femoropopliteal (FP) lesions and which repeat endovascular therapy (EVT) for DCB restenosis would provide more freedom from recurrent restenosis.

METHODS:

This retrospective multicenter study included 119 limbs (chronic limb-threatening ischemia [CLTI]: 55%, lesion length: 136.9 ± 89.6 mm, chronic total occlusion: 25%) of 95 patients (diabetes mellitus: 70%, hemodialysis: 56%) who were diagnosed with DCB restenosis between January 2018 and December 2019. The cases were classified into three groups based on angiographic patterns of restenosis: Class I: focal lesions ≤50 mm, Class II: diffuse lesions >50 mm, and Class III: totally occluded lesions. The DCB restenosis patterns and frequency and predictors of recurrent restenosis after repeated EVT (re-EVT) were investigated.

RESULTS:

The mean follow-up duration was 29.8 ± 9.5 months. Groups I, II, and III comprised of 30 (25.2%), 55 (46.2%), and 34 (29.0%) cases, respectively. The overall rate of 1-year freedom from recurrent restenosis was 58.2%. One-year rate of freedom from recurrent restenosis after repeat DCB was not statistically different from that after scaffolding (71.1% vs. 74.6%, respectively, p = 0.911); however, it was significantly better than that after noncoated balloon angioplasty (repeat DCB vs. noncoated balloon angioplasty: 71.1% vs. 25.7%, respectively, p < 0.001). Multivariate analysis demonstrated that CLTI (hazard ratio [HR]: 5.15, p < 0.001) and re-EVT with noncoated balloon (HR: 3.16, p < 0.001) were significantly associated with recurrent restenosis; however, Class III pattern of DCB restenosis was not associated with recurrent restenosis (HR: 1.04, p = 0.918).

CONCLUSIONS:

This study revealed the angiographic patterns of restenosis after DCB therapy for FP lesions and the 1-year rate of recurrent restenosis after repeat revascularization. Repeat DCB therapy demonstrated acceptable 1-year recurrent restenosis rates.

• Authors: Naoko Higashino, Osamu Iida, Takayuki Ishihara, Yosuke Hata, Taku Toyoshima, Tomofumi Tsukizawa, Kunihiko Nishian, Masahiko Fujihara, Daizo Kawasaki, Toshiaki Mano
• Journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions (Catheter Cardiovasc Interv) Vol. 102 Issue 6 Pg. 1114-1121 (11 2023) ISSN: 1522-726X [Electronic] United States
• PMID: 37855184 (Publication Type: Multicenter Study, Journal Article)
• Copyright: © 2023 Wiley Periodicals LLC.

Chemical References

• Coated Materials, Biocompatible

Topics

• Humans
• Popliteal Artery (diagnostic imaging)
• Treatment Outcome
• Femoral Artery (diagnostic imaging)
• Angioplasty, Balloon (adverse effects)
• Prognosis
• Endovascular Procedures
• Coated Materials, Biocompatible
• Peripheral Arterial Disease (diagnostic imaging, therapy)
• Vascular Patency