Drug-coated balloon vs. Conventional balloon angioplasty in dialysis patients with symptomatic femoropopliteal disease ― A matched comparison

Hsin Hua Chou, Hsuan Li Huang*, Chien An Hsieh, Shih Jung Jang, I. Shiang Tzeng, Yu Lin Ko

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

6 Scopus citations

Abstract

Background: Recent randomized trials have shown the treatment benefits of use of a drug-coated balloon (DCB) over conventional percutaneous transluminal angioplasty (PTA) in patients with femoropopliteal disease. However, the effectiveness and safety of DCB for dialysis patients remain unclear. Methods and Results: Consecutive dialysis patients, who underwent PTA or DCB for femoropopliteal disease, were assessed retrospectively via 2:1 propensity score matching. Effectiveness and safety endpoints, including binary restenosis, clinically driven target lesion revascularization (CD-TLR), amputations, major adverse cardiac events (MACE), and deaths, were compared between groups. A total of 278 dialysis patients with 339 limbs were eligible for matching: 84 limbs from 77 patients treated with PTA and 46 limbs from 37 patients treated with DCB were compared after matching. Baseline patient and lesion characteristics were not different between groups. Patients treated with DCB had significantly higher rates of freedom from binary restenosis (52.4% vs. 18.6%, P<0.001) and CD-TLR (56.4% vs. 25.9%, P=0.001) at 2 years compared with patients treated with PTA. Both groups had similar outcomes for amputation, MACE, and death. Cox proportional analysis showed that treatment with DCB was independently associated with a reduction of binary restenosis (hazard ratio [HR] 0.368, P=0.001) and CD-TLR (HR 0.390, P=0.004). Conclusions: This study suggested superior 2-year outcomes using DCB compared with PTA and similar safety profiles in dialysis patients with femoropopliteal disease.

Original languageEnglish
Pages (from-to)1908-1916
Number of pages9
JournalCirculation Journal
Volume82
Issue number7
DOIs
StatePublished - 2018
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2018, Japanese Circulation Society. All rights reserved.

Keywords

  • Dialysis
  • Drug-coated balloons
  • Endovascular therapy
  • Propensity score
  • Restenosis

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