Endovascular balloon angioplasty for infrainguinal arterial occlusive disease: Efficacy analysis

Background: We present early and mid-term clinical outcomes of endovascular revascularization for femoropopliteal involvement of peripheral arterial disease. Methods: A total of 128 patients (113 males, 15 females; mean age: 63.4 +/- 9.9 years; range, 32 to 87 years) who underwent percutaneous transluminal angioplasty for femoropopliteal lesions between August 2016 and April 2018 were analyzed retrospectively. Treatment with Luminor (R) paclitaxel-coated drug-eluting balloon catheter or bailout therapy with iVolution (R) self-expanding nitinol stent were performed. Overall patency rates and freedom from reintervention rates were analyzed using the Kaplan-Meier analysis. The primary patency and freedom from reintervention to target lesion rates at 12 and 24 months were evaluated. Results: Technical success was achieved in 133 (93%) of the interventions with a median follow-up of 11 (range, 1 to 35) months. At 12 and 24 months, the mean overall patency rates were 85.6 +/- 3.7% and 66.8 +/- 6.7%, respectively and the mean freedom from reintervention to target lesion rates were 91.6 +/- 2.9% and 78.1 +/- 6.3%, respectively. The primary patency and freedom from reintervention to target lesion rates were significantly higher in the bailout stenting group than the drug-eluting balloon group at 12 months (97.3 +/- 2.7% vs. 94.8 +/- 6.1%, respectively, p=0.025 and 97.1 +/- 2.9% vs. 84.2 +/- 5.5%, respectively, p=0.005) and at 24 months (76.9 +/- 7.9% vs. 55.8 +/- 13.4%, respectively, p=0.025 and 85.2 +/- 7.0% vs. 70.2 +/- 13.6%, respectively, p=0.005). Conclusion: Endovascular procedures including drug-eluting balloon and bailout stenting seem to be effective alternative treatment modalities for treatment of infrainguinal peripheral arterial disease and can be also used in patients with long lesions and/or total occlusion of femoropopliteal arteries.