Vasc Spec Int.  2018 Dec;34(4):94-102. 10.5758/vsi.2018.34.4.94.

Prognostic Factors in Patients Treated with Drug-Coated Balloon Angioplasty for Symptomatic Peripheral Artery Disease

• Sigala F
• Galyfos G
• Stavridis
• Tigkiropoulos K
• Lazaridis
• Karamanos
• Mpontinis
• Melas N
• Zournatzi
• Filis K
• Saratzis N

• KMID: 2435442
• DOI: http://doi.org/10.5758/vsi.2018.34.4.94

Abstract

PURPOSE
Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes.
MATERIALS AND METHODS
This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was 24.2±2.3 months.
RESULTS
Overall, 149 patients (mean age: 68.6±8.3 years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up.
CONCLUSION
PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

Keyword

Endovascular procedures; Balloon angioplasty; Peripheral artery disease

MeSH Terms

Amputation
Angioplasty, Balloon*
Coronary Artery Disease
Endovascular Procedures
Extremities
Femoral Artery
Follow-Up Studies
Gangrene
Humans
Intermittent Claudication
Ischemia
Mortality
Peripheral Arterial Disease*
Retrospective Studies
Wound Healing