Early outcomes of drug-coated balloon angioplasty of infrapopliteal lesions in diabetic foot

Author:

Guo Julong1,Ye Meng2,Zhang Wei3,Wu Ziheng4,Feng Zibo5,Fang Xin6,Li Qiang7,Sang Hongfei8,Shi Zhenyu9,Shi Weihao10,He Chunshui11,Gao Xixiang1,Guo Jianming1,Tong Zhu1,Guo Lianrui1

Affiliation:

1. Department of Vascular Surgery, Xuanwu Hospital Capital Medical University, Beijing, China

2. Department of Vascular Surgery, School of Medicine, Renji Hospital, Shanghai Jiaotong University, Wuhan, China

3. Biomedical Informatics and Statistics Center, School of Public Health, Fudan University, Wuhan, China

4. Department of Vascular Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine, Wuhan, China

5. Department of Vascular Surgery, Liyuan Hospital Affiliated Tongji Medical Collage of Huazhong University of Science and Technology, Wuhan, China

6. Department of Vascular Surgery, Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine, Hangzhou, China

7. Department of Vascular Surgery, The Affiliated Qingdao Hiser Hospital of Qingdao University, Qingdao, China

8. Department of Vascular Surgery, The Second Affiliated Hospital of Soochow University, Suzhou, China

9. Department of Vascular Surgery, Zhongshan Hospital Fudan University, Shanghai, China

10. Department of Vascular Surgery, Huashan Hospital Fudan University, Shanghai, China

11. Department of Vascular Surgery, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China

Abstract

Abstract: PURPOSE: To evaluate 6-month outcomes of drug-coated balloon (DCB) angioplasty of infrapopliteal lesions in patients with diabetic foot. METHODS: We analyzed 6-month follow-up data from the prospective PRIME-WIFI study with 203 consecutive patientswith diabetic foot who underwent DCB angioplasty for infrapopliteal arterial occlusive disease. The primary outcome was freedom from major adverse event (MAE), a composite of major amputation, all-cause death, and clinically-driven target limb reintervention (CD-TLR). Secondary outcomes included amputation-free survival (AFS), freedom from each primary outcome component, and complete wound healing. RESULTS: The mean age was 69.78 ± 9.50 years and 61 were female. A total of 271 lesions, with an average length of 26.02 ± 12.94 cm, accepted DCB angioplasty. Both infrapopliteal runoff score and pedal runoff score improved significantly after procedure compared with baseline. The score changes were − 5.73 and − 0.39, respectively (P < 0.001 for both). Within 6-month follow-up, 16 of the 203 patients died and 32 (15.76%) were lost to follow-up. By Kaplan–Meier analysis, at 6 months postprocedure, freedom from MAE was 85.77% (95% confidence interval [CI], 80.92%–90.91%); AFS was 88.88% (95% CI, 84.49%–93.49%); and freedom from major amputation, all-cause death, and CD-TLR were 95.65% (95% CI, 92.73%–98.65%), 92.57% (95% CI, 88.88%–96.4%), and 95.51% (95% CI, 92.51%–98.61%), respectively. During the 6-month follow up, complete wound healing was achieved in 67.11% patients. CONCLUSION: In patients with diabetic foot, DCB angioplasty of infrapopliteal lesions was effective and safe.

Publisher

Medknow

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