Intravascular Lithotripsy vs Atherectomy in the Treatment of Calcified Common Femoral Artery Disease

BackgroundCommon femoral artery (CFA) disease is often heavily calcified and prone to low patency rates with endovascular treatment compared surgical endarterectomy. Recent data suggest promising short-term outcomes the adjunct use of intravascular lithotripsy; however, on its midterm effectiveness are lacking. We clinically driven target lesion revascularization (CD-TLR) between patients receiving drug-coated balloon angioplasty lithotripsy (IVL-DCB) vs atherectomy (Ath-DCB) for CFA disease.MethodsIn a single-center retrospective cohort study, IVL-DCB Ath-DCB symptomatic from January 2015 March 2020 were included. The primary outcome was cumulative CD-TLR angiographic restenosis ≥50%, estimated by Kaplan-Meier analysis during 18-month follow-up log-rank test.ResultsTotal 68 lesions (Ath-DCB, 35; IVL-DCB, 33) Patients had mean age (standard deviation) 72 (8) years predominantly male (63.3%) White (92%). Mean baseline stenosis 78% (11) in group 70% (10) (P = .002). Technical success 100% both groups. One flow-limiting dissection occurred requiring stent placement, whereas 2 bailout stentings performed group. Cumulative freedom 91.2% (95% CI, 81.6%-100%) 79.4% 64.6%-94.2%) (Log-rank P .167).ConclusionsThe safety comparable those follow-up. Further studies required verify these findings.