This study will evaluate the effectiveness and safety of directional atherectomy plus local drug delivery using balloon catheter system in the treatment of femoropopliteal occlusive disease. Patients of femoropopliteal occlusive disease will randomly receive directional atherectomy plus local drug delivery using balloon catheter system and dilation using drug-coated balloon. Their clinical outcomes (e.g. 12-month late lumen loss rate, 1-year patency rate of target vessel) in 1 year after the treatment will be compared.
Femoropopliteal occlusive disease is a common type of peripheral arterial disease. Endovascular treatment has been the first-line treatment of femoropopliteal occlusive disease. However, the in-stent re-stenosis has been a major limitation of well long-term patency rate after stent implantation. The chronic inflammation induced by stenting could be a main reason of re-stenosis. Then the concept "leave nothing behind" is proposed, and some novel treatment methods and devices, such as paclitaxel-coated balloon dilation, directional atherectomy, are developed. Directional atherectomy can effectively remove the atherosclerosis plaque but leave the inflammatory reaction along the atherectomy route. Here, we propose the hypothesis that using local drug delivery with balloon system can relieve the inflammation induced by atherectomy. Therefore, 40 patients of femoropopliteal occlusive disease will be randomly allocated into the group "directional atherectomy+local drug delivery with balloon system" or "drug-coated balloon only". The 1-year patency rate, incidence of complications, imaging parameters will be compared between groups.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
combined use of directional atherectomy and locol drug delivery for the treatment of femoralpopliteal disease
use of drug-coated balloon dilation for the treatment of femoralpopliteal disease
late lumen loss rate
the rate of late lumen loss of target vessel
Time frame: 12 months
patency rate
the rate of patency of target vessel
Time frame: 6 months
patency rate
the rate of patency of target vessel
Time frame: 12 months
MLD
minimal lumen diameter of target vessel at 6 months
Time frame: 12 months
clinical outcomes
rate of re-intervention of target vessel
Time frame: 12 months
incidence of complications
incidence of treatment induced major complications
Time frame: 12 months
re-stenosis rate
the rate of re-stenosis (≥50)
Time frame: 12 months
adverse events
incidence of treatment related adverse events
Time frame: 12 months
Rutherford level
change of Rutherford level
Time frame: 12 months
ABI
change of ankle brachial index
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Time frame: 12 months
main amputation
rate of main amputation
Time frame: 12 months