Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis

The optimal endovascular therapy for vein graft stenosis (VGS) following infrainguinal arterial bypass is yet to be established. Drug-coated balloons (DCB) have rapidly improved the inferior patency outcomes of angioplasty using a conventional plain balloon (PB). This study compares the efficacy of...

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Main Authors: Toshihiko Isaji, Yutaka Hosoi, Kota Kogure, Yohei Ichikawa, Keisuke Fujimaki, Toru Ikezoe, Masao Nunokawa, Hiroshi Kubota
Format: Article
Language:English
Published: MDPI AG 2022-12-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/12/1/87
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author Toshihiko Isaji
Yutaka Hosoi
Kota Kogure
Yohei Ichikawa
Keisuke Fujimaki
Toru Ikezoe
Masao Nunokawa
Hiroshi Kubota
author_facet Toshihiko Isaji
Yutaka Hosoi
Kota Kogure
Yohei Ichikawa
Keisuke Fujimaki
Toru Ikezoe
Masao Nunokawa
Hiroshi Kubota
author_sort Toshihiko Isaji
collection DOAJ
description The optimal endovascular therapy for vein graft stenosis (VGS) following infrainguinal arterial bypass is yet to be established. Drug-coated balloons (DCB) have rapidly improved the inferior patency outcomes of angioplasty using a conventional plain balloon (PB). This study compares the efficacy of DCBs and PBs for the treatment of infrainguinal VGS. This systematic review and meta-analysis was performed according to the PRISMA statement. Multiple electronic searches were conducted in consultation with a health science librarian in September 2022. Studies describing the comparative outcomes of angioplasty using DCBs and PBs in the treatment of infrainguinal VGS were eligible. Datasets from one randomized controlled trial and two cohort studies with a total of 179 patients were identified. The results indicated no significant difference in target lesion revascularization between DCBs and PBs (OR, 0.64; 95% CI, 0.32–1.28; <i>p</i> = 0.21), with no significant heterogeneity between studies. Additionally, differences in primary patency, assisted primary patency, secondary patency, and graft occlusion were not significant. Subgroup analysis showed similar effects for different DCB devices. In conclusion, DCBs showed no significant benefit in the treatment of VGS compared to PBs. Given the small population size of this meta-analysis, future trials with a larger population are desired.
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spelling doaj.art-085f91f7028b4cf0baba61b8cdfc29142023-11-16T15:41:10ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-011218710.3390/jcm12010087Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-AnalysisToshihiko Isaji0Yutaka Hosoi1Kota Kogure2Yohei Ichikawa3Keisuke Fujimaki4Toru Ikezoe5Masao Nunokawa6Hiroshi Kubota7Department of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanDepartment of Cardiocascular surgery, Kyorin University, 6-20-2, Shinkawa, Mitaka 181-8611, Tokyo, JapanThe optimal endovascular therapy for vein graft stenosis (VGS) following infrainguinal arterial bypass is yet to be established. Drug-coated balloons (DCB) have rapidly improved the inferior patency outcomes of angioplasty using a conventional plain balloon (PB). This study compares the efficacy of DCBs and PBs for the treatment of infrainguinal VGS. This systematic review and meta-analysis was performed according to the PRISMA statement. Multiple electronic searches were conducted in consultation with a health science librarian in September 2022. Studies describing the comparative outcomes of angioplasty using DCBs and PBs in the treatment of infrainguinal VGS were eligible. Datasets from one randomized controlled trial and two cohort studies with a total of 179 patients were identified. The results indicated no significant difference in target lesion revascularization between DCBs and PBs (OR, 0.64; 95% CI, 0.32–1.28; <i>p</i> = 0.21), with no significant heterogeneity between studies. Additionally, differences in primary patency, assisted primary patency, secondary patency, and graft occlusion were not significant. Subgroup analysis showed similar effects for different DCB devices. In conclusion, DCBs showed no significant benefit in the treatment of VGS compared to PBs. Given the small population size of this meta-analysis, future trials with a larger population are desired.https://www.mdpi.com/2077-0383/12/1/87drug-coated ballooninfrainguinal artery bypassbypass stenosis
spellingShingle Toshihiko Isaji
Yutaka Hosoi
Kota Kogure
Yohei Ichikawa
Keisuke Fujimaki
Toru Ikezoe
Masao Nunokawa
Hiroshi Kubota
Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
Journal of Clinical Medicine
drug-coated balloon
infrainguinal artery bypass
bypass stenosis
title Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
title_full Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
title_fullStr Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
title_full_unstemmed Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
title_short Drug-Coated Balloon versus Plain Balloon Angioplasty in the Treatment of Infrainguinal Vein Bypass Stenosis: A Systematic Review and Meta-Analysis
title_sort drug coated balloon versus plain balloon angioplasty in the treatment of infrainguinal vein bypass stenosis a systematic review and meta analysis
topic drug-coated balloon
infrainguinal artery bypass
bypass stenosis
url https://www.mdpi.com/2077-0383/12/1/87
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