Prognostic Factors in Patients Treated with Drug- Coated Balloon Angioplasty for Symptomatic Peripheral Artery Disease

Fragiska Sigala; George Galyfos; Kyriakos Stavridis; Konstantinos Tigkiropoulos; Ioannis Lazaridis; Dimitrios Karamanos; Vangelis Mpontinis; Nikolaos Melas; Ioulia Zournatzi; Konstantinos Filis; Nikolaos Saratzis

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저자정보: Fragiska Sigala (Aristotle University of Thessaloniki) George Galyfos (Ethnikon and Kapodistriakon University of Athens) Kyriakos Stavridis (Aristotle University of Thessaloniki) Konstantinos Tigkiropoulos (Aristotle University of Thessaloniki) Ioannis Lazaridis (Aristotle University of Thessaloniki) Dimitrios Karamanos (Aristotle University of Thessaloniki) Vangelis Mpontinis (Aristotle University of Thessaloniki) Nikolaos Melas (Aristotle University of Thessaloniki) Ioulia Zournatzi (Aristotle University of Thessaloniki) Konstantinos Filis (Ethnikon and Kapodistriakon University of Athens) Nikolaos Saratzis (Aristotle University of Thessaloniki)

저널정보: 대한혈관외과학회 Vascular Specialist International Vascular Specialist International Vol.34 No.4

발행연도: 2018.1

수록면: 94 - 102 (9page)

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Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was 24.2±2.3 months. Results: Overall, 149 patients (mean age: 68.6±8.3 years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

참고문헌 (28)

참고문헌 신청

Lumsden AB / 2009 / Medical and endovascular management of critical limb ischemia / J Endovasc Ther 16(2 Suppl 2):31~62

Aihara H / 2014 / RECANALISE Registry Investigators. Comparison of long-term outcome after endovascular therapy versus bypass surgery in claudication patients with Trans-Atlantic Inter-Society Consensus-II C and D femoropopliteal disease / Circ J 78:457~464

Söderström MI / 2010 / Infrapopliteal percutaneous transluminal angioplasty versus bypass surgery as first-line strategies in critical leg ischemia: a propensity score analysis / Ann Surg 252:765~773

Romiti M / 2008 / Meta-analysis of infrapopliteal angioplasty for chronic critical limb ischemia / J Vasc Surg 47:975~981

Bosiers M / 2012 / Randomized comparison of everolimuseluting versus bare-metal stents in patients with critical limb ischemia and infrapopliteal arterial occlusive disease / J Vasc Surg 55:390~398

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