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Journal article

The mid-term clinical follow-up using drug-eluting balloons on tibial artery "de novo" lesions in patients with critical limb ischemia: A cohort study

Abstract:

Rationale

Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery "de novo" lesions.

Methods

Aretrospective analysis was performed and included all consecutive patients who underwent endovascular treatment for CLI in our centers between January 2011 and March 2013. Inclusion criteria were (1) "de novo" tibial artery stenosis and (2) Rutherford class >4. Lesions were further divided by TransAtlantic Inter-Societal Consensus (TASC) classification into groups A, B, C, and D.

Results

Between January 2010 and March 2013, a total of 138 patients underwent simple PTA or DEB for CLI, and the groups were clinically and demographically homogenous. We decided to use DEBs in 70 cases. An improvement in the Rutherford Scale in cumulative and single TASC lesions classification was better in the DEB group (74% vs 51%; P=.024) at 24 months than in the PTA group. In the DEB group, the increase in ankle–brachial index was significantly higher than in the PTA group (P=.039)

Conclusions

Our experience in addition to the existing literature supports the use of DEB in patients with CLI Rutherford class >3.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1177/1538574416647500

Authors

More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Surgical Sciences
Role:
Author


Publisher:
SAGE Publications
Journal:
Vascular and Endovascular Surgery More from this journal
Volume:
50
Issue:
5
Pages:
304-308
Publication date:
2016-07-01
Acceptance date:
2016-04-06
DOI:
ISSN:
1538-5744


Keywords:
Pubs id:
pubs:622861
UUID:
uuid:3a68996f-de5f-455c-801b-14684ccd8c66
Local pid:
pubs:622861
Source identifiers:
622861
Deposit date:
2016-05-18
ARK identifier:

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