药物涂层球囊治疗股浅动脉支架内再狭窄

Clinical efficacy of a drug-coated balloon in the treatment of superficial femoral artery in-stent restenosis

目的观察药物涂层球囊(DCB)与普通球囊(CB)治疗股浅动脉支架再狭窄的临床疗效。方法选取2017年3月至2019年3月于我科行股浅动脉支架后出现再狭窄的病例98例,根据治疗方式不同分为DCB组(n=48)和CB组(n=50)。应用彩色多普勒超声、计算机断层扫描血管造影或数字减影血管造影进行定期随访检查。结果术后6个月及12个月,DCB组病变部位的再狭窄率(4.2%,18.0%)显著低于CB组(26.0%,84.0%),踝肱指数、最小管腔直径高于CB组,晚期管腔损失、平均峰值流速比低于CB组,差异均有统计学意义(均P<0.05)。术后12个月,DCB组Rutherford分级1、2级明显多于CB组(P<0.05)。结论DCB治疗股浅动脉支架内再狭窄的临床疗效好于CB。

Objective To observe the clinical efficacy of a drug-coated balloon(DCB)with that of a conventional balloon(CB)for the treatment of superficial femoral artery in-stent restenosis(ISR).Methods We selected 98 patients with restenosis after superficial femoral artery stent implantation in our department from March 2017 to March 2019.The patients were divided into the DCB(n=48)and CB groups(n=50)according to different treatment methods.Color doppler ultrasound(DUS),computed tomography angiography(CTA)or digital subtraction angiography(DSA)were used for regular follow-up examinations to compare the occurrence of ISR between the two groups.Results At 6 and 12 months after surgery,the restenosis rates of lesions in the DCB group(4.2%,18.0%)were significantly lower than those in the CB group(26.0%,84.0%).The ankle-brachial index and minimum lumen diameter were higher in the DCB group compared to the CB group.Late lumen loss and average peak velocity ratio were significantly lower in the DCB group,compared to the CB group(P<0.05).Twelve months after surgery,there were significantly more patients with Rutherford grade 1 and 2 scores in the DCB group compared to the CB group(P<0.05).Conclusion The DCB performs better than the CB for the treatment of stent restenosis of the superficial femoral artery.