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01-04-2022 | Arterial Diseases | Original Article

Clinical outcomes and predictors of restenosis in patients with femoropopliteal artery disease treated using polymer-coated paclitaxel-eluting stents or drug-coated balloons

Authors: Naoki Yoshioka, Takahiro Tokuda, Akio Koyama, Takehiro Yamada, Ryusuke Nishikawa, Kiyotaka Shimamura, Kensuke Takagi, Yasuhiro Morita, Akihito Tanaka, Hideki Ishii, Itsuro Morishima, Toyoaki Murohara, on the ASIGARU PAD investigators

Published in: Heart and Vessels | Issue 4/2022

Abstract

Both polymer-coated paclitaxel-eluting stents (PC-PESs) and drug-coated balloons (DCBs) are used in conjunction with endovascular therapy (EVT) for the treatment of peripheral artery disease (PAD). We aimed to identify the risk factors for the loss of patency following the use of PC-PES and DCB in a real clinical setting. We assessed the multi-center registry data of 151 lesions from 151 patients who underwent EVT for symptomatic PAD in the superficial femoral and proximal popliteal arteries using PC-PES or DCB. One-year primary patency (PP) and clinically driven target lesion revascularization (CD-TLR) were evaluated using Kaplan–Meier analysis. The predictive risk factors for 1-year outcomes were analyzed using the random survival forest method. PC-PES and DCB were used in 65 (43.0%) and 86 (57.0%) cases, respectively. There were no significant differences in 1-year PP or freedom from CD-TLR between PC-PES and DCB. PP occurred in 85.4% and 80.2% of cases in the PC-PES and DCB groups, respectively (log-rank p = 0.65), while freedom from CD-TLR was noted in 92.7% and 94.1% of cases in the PC-PES and DCB groups, respectively (log-rank p = 0.73). In order of importance, a Clinical Frailty Scale score ≥ 6, female sex, lower proximal vessel diameter, lower body mass index, and younger and older age were identified as predictive risk factors of restenosis in the PC-PES group. Peripheral artery calcification scoring system grade of ≥ 2, post-dissection pattern ≥ D, lower proximal and distal vessel diameter, and lesion length ≥ 100 mm were identified as predictive risk factors of restenosis, in order of importance, in the DCB group. Both PC-PES and DCB were associated with favorable clinical outcomes within 1 year in patients with femoropopliteal artery disease. Furthermore, several factors that could predict restenosis within 1 year following the use of each device were detected.

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Title: Clinical outcomes and predictors of restenosis in patients with femoropopliteal artery disease treated using polymer-coated paclitaxel-eluting stents or drug-coated balloons
Authors: Naoki Yoshioka
Takahiro Tokuda
Akio Koyama
Takehiro Yamada
Ryusuke Nishikawa
Kiyotaka Shimamura
Kensuke Takagi
Yasuhiro Morita
Akihito Tanaka
Hideki Ishii
Itsuro Morishima
Toyoaki Murohara
on the ASIGARU PAD investigators
Publication date: 01-04-2022
Publisher: Springer Japan
Keyword: Arterial Diseases
Published in: Heart and Vessels / Issue 4/2022
Print ISSN: 0910-8327
Electronic ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-021-01941-9

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Clinical outcomes and predictors of restenosis in patients with femoropopliteal artery disease treated using polymer-coated paclitaxel-eluting stents or drug-coated balloons

Abstract

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Abstract

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