Drug-coated Balloon versus Bare Nitinol Stent in Femoropopliteal Artery: 12 Months Outcome from a Single Center in China

Abstract Object The study sought to compare the safety and effectiveness of drug-coated balloon(DCBs) with bare nitinol stent in patients with complex femoropopliteal(FP) lesions in real-world practice. Methods Patients with symptomatic (Rutherford stage 2 to 5) femoropopliteal lesions who underwent DCB or bare nitinol stent implantation at the Department of Cardiovascular Surgery of China-Japan Friendship Hospital from June 2016 to September 2017 were included. Demographics, angiographic and procedural variables were included. Freedom from target lesion revascularization (TLR), primary patency and major adverse events were obtained from follow-up results at 3,6 and12 months. Descriptive analysis was performed on all variables. Results A total of 90 eligible patients were enrolled, which included 51 DCB subjects (mean age, 63.1±13.2 years; 76.5% male) with 55 lesions and 39 nitinol stent subjects (mean age, 66.5±10.5 years; 61.5% male) with 42 lesions. Significant higher primary patency was observed in the DCB group compared with the stent group (74.5% versus 52.4%; log-rank test p=0.018; HR 0.335, 95%CI 0.124-0.903, p=0.031). The rates of freedom from TLR (f-TLR) were 78.2% and 59.5% (log-rank test p=0.032) for the DCB group and the stent group, respectively, at 12 months. CD-TLR rates were 18.2% versus 38.1% with a p-value of 0.023. Female sex (HR 6.122, 95%CI 1.880-19.934, p=0.003), lesion length over 20cm (HR 5.514, 95%CI 2.312-13.148, p Conclusion The result above demonstrates that DCB treatment has higher primary patency and lower TLR at 12 months than nitinol stent. These data confirm the safety and effectiveness of the DCB for patients with complex femoropopliteal lesions.