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Roles of Angioplasty With Drug-Coated Balloon for Chronic Ischemia in Wound Healing.
Hata, Yosuke; Iida, Osamu; Ito, Nobuhiro; Soga, Yoshimitsu; Fukunaga, Masashi; Kawasaki, Daizo; Fujihara, Masahiko; Kozuki, Amane; Takahara, Mitsuyoshi; Mano, Toshiaki.
Afiliação
  • Hata Y; Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
  • Iida O; Cardiovascular Center, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan.
  • Ito N; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
  • Soga Y; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Fukuoka, Japan.
  • Fukunaga M; Department of Cardiology, Morinomiya Hospital, Osaka, Japan.
  • Kawasaki D; Department of Cardiology, Morinomiya Hospital, Osaka, Japan.
  • Fujihara M; Department of Cardiology, Kishiwada Tokushukai Hospital, Kishiwada, Osaka, Japan.
  • Kozuki A; Department of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
  • Takahara M; Department of Metabolic Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
  • Mano T; Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, Osaka, Japan.
J Endovasc Ther ; 28(5): 778-787, 2021 10.
Article em En | MEDLINE | ID: mdl-34152229
ABSTRACT

PURPOSE:

Clinical trials have demonstrated sustained benefits of drug-coated balloon (DCB) angioplasty compared with noncoated balloon angioplasty in symptomatic peripheral artery disease (PAD) presenting with femoropopliteal (FP) artery disease. However, there is still controversy whether particulate embolization caused by crystalline paclitaxel, the so-called "downstream effect," is adversely associated with clinical outcomes after use of FP DCB among chronic limb-threatening ischemia (CLTI) patients. The current RADISH (Roles of Angioplasty with Drug-coated balloon for chronic ISchemia in wound Healing) study investigated wound healing following DCB therapy vs non-DCB therapy for real-world CLTI patients presenting with FP lesions. MATERIALS AND

METHODS:

This multicenter, retrospective study analyzed 927 patients with CLTI (mean age, 76±10 years; male, 57.8%; diabetes mellitus, 64.5%; dialysis, 50.7%) presenting with FP lesions and treated endovascularly via DCB (138 patients) vs non-DCB therapy (789 patients) between April 2014 and March 2019. The primary outcome measure was 1-year wound healing, while the secondary outcome measure was 1-year primary patency. Clinically-driven target lesion revascularization (CD-TLR), limb salvage and overall survival were also analyzed by using propensity score matching analysis.

RESULTS:

The propensity score matching extracted 111 pairs (as many patients in the DCB group and 629 patients in the non-DCB group). The 1-year cumulative incidence of wound healing (95% CI) was 74.4% (62.6% to 82.5%) in the DCB group and 71.9% (60.4% to 80.1%) in the non-DCB group, with no significant intergroup difference (p=0.93). The DCB group had a higher rate of primary patency (p=0.002) and freedom from CD-TLR (p=0.010) than the non-DCB group, whereas there was no significant intergroup difference in limb salvage (p=0.21) or overall survival (p=0.93).

CONCLUSION:

The current analysis of data from the RADISH study demonstrated that DCB therapy did not lead to delayed wound healing and reduced restenosis rate in CLTI patients presenting FP lesions. From this results, DCB therapy would be a reasonable treatment option for CLTI patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preparações Farmacêuticas / Angioplastia com Balão / Doença Arterial Periférica Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Preparações Farmacêuticas / Angioplastia com Balão / Doença Arterial Periférica Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article