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Rivaroxaban and Aspirin in Drug-Coated Balloon Angioplasty for Femoropopliteal In-Stent Restenosis: A Retrospective
Zhihong Wang1, Lei Sheng1, Hongbin Gu1
1Department of Vascular Surgery, The Ninth Medical Center of the Chinese People's Liberation Army General Hospital, Beijing, China.
Insights
Rivaroxaban and aspirin effectively treat femoropopliteal artery in-stent restenosis after drug-coated balloon intervention, reducing recurrence and improving vascular patency safely compared to dual antiplatelet therapy.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Pharmacology
Background:
- Femoropopliteal artery in-stent restenosis (ISR) after drug-coated balloon (DCB) treatment can lead to target lesion restenosis.
- Optimizing antithrombotic therapy post-DCB intervention is crucial for managing ISR.
Purpose of the Study:
- To evaluate the efficacy and safety of rivaroxaban combined with aspirin (RA Group) versus dual antiplatelet therapy (DAPT) for ISR following DCB intervention.
- To compare clinical outcomes and vascular patency rates between the two treatment groups.
Main Methods:
- A consecutive cohort of 92 patients with femoropopliteal ISR post-DCB intervention were analyzed.
- Patients were divided into an RA group (rivaroxaban + aspirin) and a DAPT group.
- Outcomes were compared over a 12-month follow-up period.
Main Results:
- The RA group demonstrated significantly lower rates of ISR recurrence and clinically driven target lesion revascularization compared to the DAPT group (P < 0.05).
- Vascular patency rates were higher in the RA group at both 6 and 12 months post-intervention (P < 0.05).
- No major adverse events (death, MI, stroke, amputation, major bleeding) were observed; only minor bleeding occurred in 5 patients.
Conclusions:
- Rivaroxaban combined with aspirin offers a safe and effective alternative to DAPT for managing femoropopliteal ISR after DCB intervention.
- This regimen improves key follow-up outcomes, including reduced restenosis and enhanced vascular patency.
Background:
After drug-coated balloon (DCB) treatment of the femoropopliteal artery in-stent restenosis (ISR), a certain proportion of patients also experience target lesion restenosis. The purpose of this study was to explore the efficacy and safety of rivaroxaban combined with aspirin in the treatment of ISR after DCB intervention.
Methods:
Patients who underwent DCB treatment for ISR after femoropopliteal artery intervention at our center from March 2017 to February 2022 were included consecutively. According to the drug treatment after DCB intervention of ISR, the patients were divided into rivaroxaban and aspirin group (RA Group) and dual antiplatelet therapy (DAPT) group. The outcomes of 2 groups during the 12-month follow-up after DCB intervention were compared.
Results:
A total of 92 patients were included in final analysis, with 43 in RA group and 49 in DAPT group. During 12-month follow-up, a total of 15 cases of recurrent ISR were detected, and the recurrence rate of ISR and clinically driven target lesion revascularization in the RA group were lower than those in the DAPT group (P < 0.05). The vascular patency rate in the RA group was higher than that in the DAPT group at 6 and 12 months of follow-up (P < 0.05). During the follow-up, there were no adverse events such as death, myocardial infarction, stroke, amputation, or major bleeding, and only a total of 5 cases of minor bleeding occurred.
Conclusions:
Compared with the standard DAPT regimen, rivaroxaban combined with aspirin can safely improve the follow-up outcome after DCB for femoropopliteal ISR.
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