Avoiding revascularization strategy versus revascularization with drug-coated balloon for the treatment of superficial femoral artery occlusive disease

Objective:The aim of this study was to compare the efficacy,safety and treatment costs of superficial femoral artery revascularization(SFA)with drug-coated balloon(DCB)versus avoiding revascularization strategy for the treatment of symptomatic SFA disease.Methods:This retrospective single-center study reviewed 96 patients(113 limbs)with severe stenosis and occlusive SFA disease.All patients underwent either DCB(Group 1:n=55 limbs)or nonrevascularization(Group2:n=58 limbs)between March 2015 and June 2019.The improvement of Rutherford class,walking impairment questionnaire score(WIQ),target limb reintervention,perioperative major adverse events,the catheterization laboratory cost and length of hospital stay were compared.The limb salvage and survival rates were calculated using the Kaplan-Meier method.Univariate and multivariate logistic regression analysis were performed to assess the association between factors and the improvement of Rutherford category at 12 months.Results:The median follow-up time of Groups 1 and 2 was 17 and 33 months,respectively.At 12 months,the Rutherford category significantly decreased in both groups(P<0.001),with no significant difference(79.7%vs.64.3%,P=0.074).Furthermore,multivariate analysis showed that the selected therapeutic method was not an influential factor for the improvement of Rutherford class at 12 months.The WIQ overall score as well as three subscales scores(distance,speed and stair-climbing),the survival rate,limb salvage rate and the length of stay between the two groups were comparable.The perioperative adverse events rate and catheterization laboratory cost in Group 2 was significantly lower compared to Group 1[(34253.69±28172.87)yuan vs.(56936.76±41278.36)yuan,P=0.001].Conclusions:This study suggests that avoiding superficial femoral artery revascularization strategy has favorable efficacy and safety outcomes compared to combining revascularization with DCB in selected patients.

Comparison of the postoperative pain change and spinal stenosis rate between percutaneous vertebroplasty combined with radiofrequency ablation and with ^(125)I particle implantation in the treatment of metastatic spinal cord compression:A retrospective st

Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.