Kalsifiye Stenotik Süperfisyal Femoral Arter Lezyonlarının Tedavisinde Direksiyonel Aterektomi ile Kombine Edilmiş Paklitaksel Salınımlı Balon Anjioplasti ve Kendiliğinden Açılan Nitinol Stent Uygulamasının Karşılaştırılması

Abstract

Aim: The frequency and variety of endovascular interventions have increased with the rise in peripheral arterial occlusive disease incidence and to lessen undesirable outcomes after peripheral vascular surgery. Extensive calcific stenotic lesions affect patency rates of endovascular interventions and enhance complication rates. In this study we aimed to compare paclitaxel eluting balloon angioplasty (PEBA) combined with directional atherectomy (DA) with self expandable nitinol stent (SENS) implantation in terms of patency rates.Material and Methods: Fifty-six patients (28 patients in each group) underwent endovascular interventions for calcific stenotic superficial femoral artery lesions between March 2013 and May 2014 at Cardiovascular Surgery clinic in Namık Kemal University Hospital were included in the study. Mean age was 65.4±7.6 and male to female ratio was 46/10. Patients were followed up with ankle brachial index (ABI), Rutherford score (RS) and Doppler ultrasonography (DUSG) from the pre-intervention period to sixth month after intervention.Results: Mean lesion length in DA and PEBA group was 66.4±24.8 mm and 65.0±20.6 mm in SENS group. Primary and secondary patency rates were 85.7% and 92.9% in DA and PEBA group, and 57.1% and 71.4% in SENS group in six months follow up. There was a statistically significant difference between groups. Significant improvement was detected in terms of ABI and RS in both groups.Conclusion: We conclude from this study results that PEBA combined with DA is better than SENS implantation, because of its successful early-term results, no intravascular foreign bodies, and continues the chance of surgery without affecting the anastomosis field.