巧克力球囊辅助药物涂层球囊血管成形术治疗TASCⅡ C/D型股腘动脉病变的疗效分析

doi:10.3969/j.issn.1006-5725.2023.23.015

Abstract

Abstract:

Objective To evaluate the efficacy and safety of chocolate balloon assisted drug-coated balloon （DCB） angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions. Methods The clinical data of 58 patients with TASC Ⅱ type C/D femoropopliteal artery lesions treated with chocolate balloon +DCB or plain balloon+DCB at Fuwai Central China Cardiovascular Hospital from January 2021 to October 2022 were retrospectively analyzed. A total of 27 cases were assigned to the observation group （chocolate balloon + DCB）and 31 cases tothe control group （plain balloon + DCB）. The rate of dissection and the clinical outcomes between the two groups were compared. Results The technical success rates of the observation and control groups were 88.9% and 80.6%， respectively. The rates of dissection， flow-limiting dissection， and bailout stenting were significantly lower in the observation group than of the control group （all P < 0.05）. Postoperative clinical symptoms of patients in both groups improved significantly compared with the preoperative period. The 12-month cumulative primary patency rate of the observation group was significantly higher than that of the control group （P < 0.05）. There was no significant difference in the 12-month cumulative freedom from clinically driven-target lesion revascularization rate between the two groups （P > 0.05）. Conclusion Chocolate balloonassisted DCB angioplasty was safe and effective for TASC Ⅱ type C/D femoropopliteal artery lesions. It reduced the rates of dissection and bailout stenting， and had better near-term outcomes than plain balloon + DCB.

Key words: femoropopliteal lesion, arteriosclerosis obliterans, chocolate balloon, drug-coated balloon, angioplasty

CLC Number:

R654.4

Panfeng LI,Xiaojian LI,Hao. NIU. Efficacy of chocolate balloon assisted drug⁃coated balloon angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions[J]. The Journal of Practical Medicine, 2023, 39(23): 3111-3115.

Figures/Tables 4

Tab.1

Comparison of baseline data between the two groups"

临床资料	观察组（ $n$ =27）	对照组（ $n$ =31）	$χ 2$ / $t$ 值	P值
年龄（x ± s，岁）	71.59 ± 8.31	67.68 ± 7.28	1.912	0.061
男性	20（74.1）	18（58.1）	1.637	0.201
危险因素
冠心病	10（37.0）	14（45.2）	0.393	0.531
高血压	18（66.7）	17（54.8）	0.844	0.358
高血脂	10（37.0）	15（48.4）	0.758	0.384
2型糖尿病	11（40.7）	15（48.4）	0.341	0.559
肾功能不全	4（14.8）	6（19.4）	0.208	0.648
长期吸烟	16（59.3）	14（45.2）	1.149	0.284
Rutherford分级			0.417	0.812
3级	16（59.3）	16（51.6）
4级	6（22.2）	9（29.0）
5级	5（18.5）	6（19.4）
病变类型			0.088	0.766
闭塞性病变	20（74.1）	24（77.4）
狭窄性病变	7（25.9）	7（22.6）
病变长度（x ± s，cm）	20.47 ± 3.10	19.24 ± 2.91	1.548	0.127
病变部位			1.479	0.224
股动脉	8（29.6）	14（45.2）
累及腘动脉	19（70.4）	17（54.8）

Tab.1

Tab.2

Comparison of ABI between the two groups of patients"

观察指标	观察组	对照组	$t$ 值	P值
术前ABI	0.46 ± 0.13	0.42 ± 0.12	1.274	0.208
术后ABI	0.76 ± 0.14	0.71 ± 0.17	1.137	0.261
$t$ 值	12.983	17.378
P值	0.000	0.000

Tab.2

Fig.1

Fig.2

References 25

1	LIN Y， LI W， LIU W， et al. Mid-term outcomes of endovascular treatment and risk factors for recurrence in patients with Trans-Atlantic-Inter-Society Ⅱ C/D femoropopliteal lesions［J］. Quant Imag Med Surg， 2021， 11（5）：2028-2039.
2	FARHAN S， ENZMANN F K， BJORKMAN P， et al. Revascularization strategies for patients with femoropopliteal peripheral artery disease［J］. J Am Coll Cardiol， 2023， 81（4）：358-370.
3	FUKASE T， DOHI T， KATO Y， et al. Long-term clinical outcomes and cause of death after endovascular treatment for femoropopliteal artery lesions［J］. J Cardiol， 2021， 77（4）：417-423.
4	LAIRD J R， YEO K K. The treatment of femoropopliteal in-stent restenosis： Back to the future［J］. J Am Coll Cardiol， 2012， 59（1）：24-25.
5	DAVAINE J M， AZEMA L， GUYOMARCH B， et al. One-year clinical outcome after primary stenting for Trans-Atlantic Inter-Society Consensus （TASC） C and D femoropopliteal lesions （the STELLA "STEnting Long de L'Artèrefémoralesuperficielle" cohort）［J］. Eur J Vasc Endovasc， 2012， 44（4）：432-441.
6	LIN Y， TANG X， FU W， et al. Stent fractures after superficial femoral artery stenting： risk factors and impact on patency［J］. J Endovasc Ther， 2015， 22（3）：319-326.
7	SCHEINERT D， SCHEINERT S， SAX J， et al.Prevalence and clinical impact of stent fractures after femoropopliteal stenting［J］. J Am Coll Cardiol， 2005， 45（2）：312-315.
8	中华医学会外科学分会血管外科学组.下肢动脉硬化闭塞症诊治指南［J］. 中华医学杂志， 2015， 95（24）：1883-1896.
9	李跃，王兵，牛晓阳，等.药物涂层球囊在自体动静脉瘘狭窄治疗中的应用［J］. 实用医学杂志， 2023，39（6）：724-729.
10	崔风强，陈江浩，王辉，等. Acotec药物涂层球囊治疗下肢动脉硬化闭塞症的临床效果［J］. 实用医学杂志， 2021，37（24）：3184-3187.
11	TEPE G， LAIRD J， SCHNEIDER P， et al. Drug-coated balloon versus standard percutaneous transluminal angioplasty for the treatment of superficial femoral and popliteal peripheral artery disease： 12-month results from the IN.PACT SFA randomized trial［J］. Circulation， 2015， 131（5）：495-502.
12	JIA X， ZHANG J， ZHUANG B， et al. Acotec drug-coated balloon catheter： randomized， multicenter， controlled clinical study in femoropopliteal arteries： evidence from the AcoArt I trial［J］. JACC Cardiovasc Interv， 2016， 9（18）：1941-1949.
13	SPILIOPOULOS S， KARAMITROS A， REPPAS L， et al. Novel balloon technologies to minimize dissection of peripheral angioplasty［J］. Expert Rev Med Devices， 2019， 16（7）：581-588.
14	MUSTAPHA J A， LANSKY A， SHISHEHBOR M， et al.A prospective， multi-center study of the chocolate balloon in femoropopliteal peripheral artery disease： The Chocolate BAR registry［J］. Catheter Cardiovasc Interv， 2018， 91（6）：1144-1148.
15	SHIRAI S， MORI S， YAMAGUCHI K， et al. Impact of Chocolate percutaneous transluminal angioplasty balloon on vessel preparation in drug-coated balloon angioplasty for femoropopliteal lesion［J］. CVIR Endovasc， 2022，5（1）：46.
16	SIRIGNANO P， MANSOUR W， D'ADAMO A， et al. Early experience with a new concept of angioplasty nitinol-constrained balloon catheter （Chocolate^®） in severely claudicant patients［J］. Cardiovasc Interv Radiol， 2018， 41（3）：377-384.
17	IIDA O， TAKAHARA M， SOGA Y， et al. Shared and differential factors influencing restenosis following endovascular therapy between TASC （Trans-Atlantic Inter-Society Consensus） II class A to C and D lesions in the femoropopliteal artery［J］. JACC Cardiovasc Interv， 2014， 7（7）：792-798.
18	OKUNO S， IIDA O， SHIRAKI T， et al. Impact of calcification on clinical outcomes after endovascular therapy for superficial femoral artery disease： assessment using the peripheral artery calcification scoring system［J］. J Endovasc Ther， 2016， 23（5）：731-737.
19	WARD C， MENA-HURTADO C. Novel use of pillows and grooves： the Chocolate^® PTA balloon catheter［J］. Endovasc Today， 2014，13：24-28.
20	FUJIHARA M， TAKAHARA M， SASAKI S， et al. Angiographic dissection patterns and patency outcomes after balloon angioplasty for superficial femoral artery disease［J］. J Endovasc Ther， 2017， 24（3）：367-375.
21	KOBAYASHI N， HIRANO K， YAMAWAKI M， et al. Simple classification and clinical outcomes of angiographic dissection after balloon angioplasty for femoropopliteal disease［J］. J VascSurg， 2018， 67（4）：1151-1158.
22	ORMISTON W， DYER-HARTNETT S， FERNANDO R， et al. An update on vessel preparation in lower limb arterial intervention［J］. CVIR Endovasc， 2020， 3（1）：86.
23	GIANNOPOULOS S， VOLTEAS P， VIRVILIS D. Specialty balloons for vessel preparation during infrainguinal endovascular revascularization procedures a review of literature［J］. Vasc Endovasc Surg， 2023， 57（6）：599-606.
24	ABURAHMA A F， ABURAHMA Z T， SCOTT G， et al. Clinical outcome of drug-coated balloon angioplasty in patients with femoropopliteal disease： A real-world single-center experience［J］. J Vasc Surg， 2019， 70（6）：1950-1959.
25	MORI S， TAKAHARA M， NAKAMA T， et al. Impact of calcification on clinical outcomes after drug-coated balloon angioplasty for superficial femoral artery disease： Assessment using the peripheral artery calcification scoring system［J］. Catheter Cardio Interv， 2023，101（5）：892-899.

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Efficacy of chocolate balloon assisted drug⁃coated balloon angioplasty for the treatment of TASC Ⅱ type C/D femoropopliteal artery lesions

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