Drug-coated balloon versus drug-eluting stent in patients with femoropopliteal artery disease: a systematic review and meta-analysis

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Vasc Endovascular Surgery. February 2022 28:15385744211051491. doi: 10.1177/15385744211051491. Online ahead of print.


OBJECTIVE: In this systematic review and meta-analysis, we sought to compare drug-coated balloon (DCB) versus drug-eluting stent (DES) in patients with femoropopliteal lesions in terms of restenosis, revascularization of the target lesion (TLR) and mortality.

Methods: An exhaustive literature search was performed in the PubMed, Scopus and Embase databases. The intervention group consisted of patients receiving percutaneous balloon angioplasty using the DCB. The control group consisted of patients receiving percutaneous intervention using DES. The primary endpoint was restenosis and the secondary endpoints were TLR and mortality.

RESULTS: There were 4 studies comprising 812 patients (906 lesions) included in this systematic review and meta-analysis. The restenosis rate was 0.19 [.13, .26] in BCD and .24 [.20, .28] diced. There was a downward trend in the rate of restenosis (OR .73 [.52, 1.03], P = 0.074; I2: 46.3%) for the use of DCB compared to the use of DES. The TLR rate was 0.11 [.08, .14] in DCB and .17 [.14, .21] diced. The TLR was lower (OR .61 [.41, .92], P = 0.017; I2: 1.2%) in the DCB group compared to the DES group. There were no significant differences in mortality (OR 1.38 [.78, 2.44], P = 0.268; I2: 0%) between the two groups. Meta-regression analysis showed that the rate of restenosis in DCB in this pooled analysis was affected by gender (reference: male, coefficient -.004, P = .009), smoking (coefficient: .003, P = .010), and total occlusion (coefficient: .008, P = 0.004).

CONCLUSION: DCB use in patients with femoropopliteal lesion was associated with a similar rate of restenosis, lower TLR, and similar mortality rate compared to DES use.

PMID:35225707 | DO I:10.1177/15385744211051491