Association between post-balloon angioplasty dissection and primary patency in complex femoropopliteal artery disease: 2-year clinical outcomes of the AcoArt I trial

Author:

Ren Hao12,Liu Jie13,Zhang Jiwei4,Zhuang Baixi5,Fu Weiguo6,Wu Danming7,Wang Feng8,Zhao Yu9,Guo Pingfan10,Bi Wei11,Wang Shenming12,Guo Wei13ORCID

Affiliation:

1. Medical School of Chinese PLA, Beijing, China

2. Department of Vascular Surgery, Dalian Municipal Central Hospital, Dalian, China

3. Department of Vascular and Endovascular Surgery, Chinese PLA General Hospital, Beijing, China

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

5. Department of Vascular Surgery, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China

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

7. Department of Vascular Surgery, The People’s Hospital of Liaoning Province, Shenyang, China

8. Department of Interventional Therapy, The First Affiliated Hospital of Dalian Medical University, Dalian, China

9. Department of Vascular Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China

10. Department of Vascular Surgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China

11. Department of Vascular Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, China

12. Department of Vascular Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China

Abstract

Objective To assess the association between post-balloon angioplasty dissection and the mid-term results of the AcoArt I trial evaluating complex femoropopliteal artery disease. Methods The outcome data for 144 patients from the AcoArt 1 trial were reanalysed. These patients were randomly divided into percutaneous transluminal angioplasty (PTA) and drug-coated balloons (DCB) groups. The primary endpoint was the primary patency (PP) rate and clinically-driven target lesion revascularisation at 24 months. Results After 24 months of follow-up, the PP rate of dissection cases in the PTA group was lower vs non-dissection cases. In patients receiving a bailout stent for dissection, the PP rate in the PTA group was lower vs the DCB group. Cox regression analysis showed that dissection decreased the PP rate; mild dissection reduced the PP rate as follows: 52%, PTA group and 19%, DCB group. With severe dissection, the PP rate reduction was as follows: 75%, PTA group and 73%, DCB group. Conclusions The mid-term follow-up showed that post-balloon angioplasty dissection reduced the PP rate in the PTA group but not in the DCB group. Additionally, in patients receiving a bailout stent for dissection, the DCB group had a better PP rate than the PTA group.

Publisher

SAGE Publications

Subject

Biochemistry (medical),Cell Biology,Biochemistry,General Medicine

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