[MO-35] Presentation Awards
Comparison of balloon angioplasty using scoring versus high-pressure balloons in femoropopliteal lesions.
Background: Since drug coated balloon can be available in Japan, vessel preparation by balloon angioplasty (BA) is a key of achieving “leave nothing behind strategy”. However, there are few reports that evaluated the impact of types of balloons on successful BA. We compared the efficacy of scoring and high-pressure balloons (HP) in femoropopliteal (FP) lesions.
Methods & Results: We analyzed retrospectively the clinical outcomes of 119 patients with 128 FP lesions who underwent balloon angioplasty using scoring (n=51; scoring-group) or HP balloons (n=77; HP-group) from 2013 to 2018 in our hospital. In both groups, the lesions were dilated entirely by long balloons for at least three minutes; however, long inflation was performed after vessel preparation using scoring balloons in the scoring-group. Although the scoring-group included less patients with chronic total occlusion (9.4% vs. 21.1%, p=0.03), there were no difference in the other baseline characteristics. The rate of balloon rupture (3.9% vs. 3.9%, p=0.76) and uncrossability of balloons (3.1% vs. 4.7%, p=0.72) were comparable between both groups. There was no significant difference in the incidence of severe dissection defined as type C or higher after balloon angioplasty (8.6% vs 14.1%, p=0.36) and in the rate of provisional stenting (7.0 vs 14.1%, p=0.11) between both group. However, in the lesions with PACSS grade 4, use of scoring balloons (n=14) were significantly associated with the less incidence of severe dissection after balloon angioplasty, compared with HP balloons (n=22) (2.78% vs 30.6%, p=0.01). As well as, provisional stenting was performed less frequently in lesions treated with scoring balloons (5.6% vs. 27.8%, p=0.04).
Conclusion: the present study demonstrated that the scoring and HP balloons had the similar impact on achieving the successful balloon angioplasty in FP lesions. However, the scoring balloons might prevent post-procedural severe dissection in PACSS-grade4 lesions, compared with HP balloons.
Methods & Results: We analyzed retrospectively the clinical outcomes of 119 patients with 128 FP lesions who underwent balloon angioplasty using scoring (n=51; scoring-group) or HP balloons (n=77; HP-group) from 2013 to 2018 in our hospital. In both groups, the lesions were dilated entirely by long balloons for at least three minutes; however, long inflation was performed after vessel preparation using scoring balloons in the scoring-group. Although the scoring-group included less patients with chronic total occlusion (9.4% vs. 21.1%, p=0.03), there were no difference in the other baseline characteristics. The rate of balloon rupture (3.9% vs. 3.9%, p=0.76) and uncrossability of balloons (3.1% vs. 4.7%, p=0.72) were comparable between both groups. There was no significant difference in the incidence of severe dissection defined as type C or higher after balloon angioplasty (8.6% vs 14.1%, p=0.36) and in the rate of provisional stenting (7.0 vs 14.1%, p=0.11) between both group. However, in the lesions with PACSS grade 4, use of scoring balloons (n=14) were significantly associated with the less incidence of severe dissection after balloon angioplasty, compared with HP balloons (n=22) (2.78% vs 30.6%, p=0.01). As well as, provisional stenting was performed less frequently in lesions treated with scoring balloons (5.6% vs. 27.8%, p=0.04).
Conclusion: the present study demonstrated that the scoring and HP balloons had the similar impact on achieving the successful balloon angioplasty in FP lesions. However, the scoring balloons might prevent post-procedural severe dissection in PACSS-grade4 lesions, compared with HP balloons.