Objective To study the safety and efficacy of targeted plaque spatulectomy combined with drug-coated balloon angioplasty in the treatment of ischemic diabetic lower extremity lesions.Methods A retrospective analysis was performed on 30 patients with ischemic diabetic lower extremity lesions admitted to Guang'anmen Hospital of Chinese Academy of Traditional Chinese Medicine from May 2022 to May 2023.The mean age was(68.63±13.2)years old,the Rutherford grade was ≥3,and the mean length of lesions was(15.13± 9.56)mm.9 cases(30％)of chronic complete occlusive lesions were treated by directional plaque gyrotomy combined with drug-coated balloon angioplasty.The main outcome measures were primary patency rate and secondary patency rate.Secondary outcome measures included technical success rate,amputation rate,and target-free vascular remodeling(TLR).Results A total of 30 patients were enrolled,and the technical success rate was 100％.The average postoperative follow-up was 7-20(10.7±1.8)months.During the follow-up,2 patients underwent necrophalangic toe amputation due to toe end necrosis,and no major amputation or death occurred.The patency rate of the first stage was 80.0％(26/30)and that of the second stage was 93.3％(28/30).None of the patients underwent remedial stent implantation.Perioperative complications were observed in 5 cases,including vascular perforation in 3 cases(10.0％)and distal embolization in 2 cases(6.7％).Conclusion Targeted plaque spatulectomy combined with drug-coated balloon dilatation is safe and effective in the treatment of ischemic diabetic lower extremity lesions,which can avoid or reduce stent placement.
维普
万方数据