Safety and efficacy of drug-coated balloon for peripheral artery revascularization-A systematic review and meta-analysis

Authors

Waqas Ullah, Department of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Mohammad Zghouzi, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Zeeshan Sattar, Department of Internal Medicine, SUNY Downstate Medical Center, Brooklyn, New York, USA.
Bachar Ahmad, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Salman Zahid, Rochester Regional HealthFollow
Abdul-Rahman M. Suleiman, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
Yasar Sattar, Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA.
Muhammad Zia Khan, Department of Cardiology, West Virginia University, Morgantown, West Virginia, USA.
Timir Paul, Department of Cardiology, The University of Tennessee, Nashville, Tennessee, USA.
Rodrigo Bagur, Department of Cardiology, London Health Science Centre Western University, London, Ontario, Canada.
Mohammad Imran Qureshi, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.
David L. Fischman, Department of Cardiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Subhash Banerjee, Department of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Anand Prasad, Department of Cardiology, UT Health San Antonio, San Antonio, Texas, USA.
M Chadi Alraies, Department of Cardiology, Detroit Medical Center, Heart Hospital, Detroit, Michigan, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Catheterization and Cardiovascular Interventions

Abstract

BACKGROUND: The relative merits of the drug-coated balloon (DCB) versus uncoated balloon (UCB) angioplasty in endovascular intervention for patients with symptomatic lower extremity peripheral arterial disease (PAD) remains controversial. METHODS: Online databases were queried with various combinations of keywords to identify relevant articles. Net adverse events (NAEs) and its components were compared using a random effect model to calculate unadjusted odds ratios (ORs). RESULTS: A total of 26 studies comprising 26,845 patients (UCB: 17,770 and DCB: 9075) were included. On pooled analysis, DCB was associated with significantly lower odds of NAE (OR: 0.47, 95% confidence interval [CI]: 0.36-0.61), vessel restenosis (OR: 0.46, 95% CI: 0.37-0.57), major amputation (OR: 0.68, 95% CI: 0.47-99), need for repeat target lesion (OR: 0.38, 95% CI: 0.31-0.47) and target vessel revascularization (OR: 0.62, 95% CI: 0.47-0.81) compared with UCB. Similarly, the primary patency rate was significantly higher in patients undergoing DCB angioplasty (OR: 1.44, 95% CI: 1.19-1.75), while the odds for all-cause mortality (OR: 0.96, 95% CI: 0.85-1.09) were not significantly different between the two groups. A subgroup analysis based on follow-up duration (6 months vs. 1 vs. 2 years) followed the findings of the pooled analysis with few exceptions. CONCLUSIONS: The use of DCB in lower extremity PAD intervention is associated with higher primary patency, lower restenosis, lower amputation rate, and decreased need for repeat revascularization with similar all-cause mortality as compared to UCB.

First Page

1319

Last Page

1326

DOI

10.1002/ccd.30074

Volume

99

Issue

4

Publication Date

3-1-2022

PubMed ID

35043555

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