Conventional balloon angioplasty versus peripheral cutting balloon angioplasty for treatment of femoropopliteal artery in-stent restenosis: initial experience.
OBJECTIVE
To prospectively determine whether cutting balloon angioplasty, when compared with conventional balloon angioplasty (CBA), improves morphologic and clinical outcome in patients with femoropopliteal in-stent restenosis.


METHODS
Patients with symptomatic femoropopliteal in-stent restenosis were randomly assigned to undergo CBA or peripheral cutting balloon angioplasty (PCBA) for treatment of lesions up to 20 cm in length. Patients were followed up clinically and with duplex ultrasonography (US) at 1, 3, and 6 months for occurrence of a restenosis of 50% or higher. The Fisher exact test and Mann Whitney U test were used for statistical analyses.


RESULTS
Forty patients were enrolled; one patient was lost to follow-up. In the remaining patients, CBA was performed in 22 patients; PCBA was used in 17 patients. Average lesion length was 80 mm +/- 68 (standard deviation). Restenosis rates at 6 months were 65% (11 of 17; 95% confidence interval: 42%, 88%) after PCBA versus 73% (16 of 22; 95% confidence interval: 54%, 92%) after CBA (P = .73). Ankle brachial index (0.83 vs 0.75, P = .26) and maximum walking capacity on the treadmill (117 m vs 103 m, P = .97) at 6 months were also not significantly different between the two groups.


CONCLUSIONS
PCBA failed to prove superiority compared with CBA for treatment of femoropopliteal in-stent restenosis in this pilot study. In restenotic lesions with an average length of approximately 8 cm, both treatment modalities yielded disappointing 6-month patency rates.
Department of Internal Medicine II, Division of Angiology, Vienna General Hospital, Medical School, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Petra
P
Dick
Schila
S
Sabeti
Wolfgang
W
Mlekusch
Oliver
O
Schlager
Jasmin
J
Amighi
Markus
M
Haumer
Manfred
M
Cejna
Erich
E
Minar
Martin
M
Schillinger
D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects*; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011150:Popliteal Artery / Q000601:surgery*; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome