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Atherectomy Plus Balloon Angioplasty for Femoropopliteal Disease Compared to Balloon Angioplasty Alone: A Systematic

Waiel Abusnina1, Ahmad Al-Abdouh2, Qais Radaideh1

  • 1Division of Cardiovascular Diseases, Creighton University School of Medicine, Omaha, Nebraska.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed

Insights

Atherectomy plus balloon angioplasty (ABA) may reduce target lesion revascularization and bailout stenting for femoropopliteal disease, but evidence from randomized trials is limited. Further research is needed to confirm these findings.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Device Technology

Background:

  • Femoropopliteal disease treatment is evolving.
  • The efficacy of atherectomy combined with balloon angioplasty (BA) is debated.
  • A meta-analysis was conducted to compare atherectomy plus balloon angioplasty (ABA) versus BA alone.

Purpose of the Study:

  • To compare the clinical efficacy and safety of atherectomy plus balloon angioplasty (ABA) versus balloon angioplasty (BA) alone.
  • To evaluate outcomes in patients with femoropopliteal disease.

Main Methods:

  • A systematic search of PubMed, Cochrane, EMBASE, and ClinicalTrials.gov was performed.
  • Nine studies (4 randomized, 5 retrospective) with 699 patients were included.
  • Random-effects models were used to calculate risk ratios for target lesion revascularization (TLR), primary patency, and bailout stenting.

Main Results:

  • Atherectomy plus balloon angioplasty (ABA) showed a significant decrease in TLR and bailout stenting in nonrandomized studies.
  • No significant difference in TLR was observed when including only randomized trials.
  • Primary patency did not differ significantly between the ABA and BA alone groups.

Conclusions:

  • Randomized trial data indicate no difference in TLR or primary patency between ABA and BA alone.
  • Observational studies suggest ABA may reduce TLR and bailout stenting.
  • Further research is necessary to clarify the role of ABA in femoropopliteal disease.
Abstract

Keywords:
atherectomyballoon angioplastydrug-coated balloonendovascular interventionfemoropopliteal artery

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