Midterm results of catheter-directed thrombolysis combined with drug-coated balloon dilatation in the treatment of femoral-popliteal thromboangiitis obliterans

Objectives To investigate the effect of catheter-directed thrombolysis (CDT) combined with drug-coated balloon (DCB) dilatation in the treatment of femoral-popliteal thromboangiitis obliterans (TAO). Materials and Methods The clinical data of 26 patients with femoral-popliteal TAO who underwent CDT combined with DCB dilatation were collected from April 2020 to November 2023. The clinical efficacy at different time points (preoperative, 24 hours postoperatively. and every 6-month intervals after the procedure) in terms of the pain score, Rutherford classification, and ankle-brachial index (ABI) was compared. The primary patency was assessed at 6 months and 1 year postoperatively. Amputation-free survival and limb salvage rate were also evaluated. Result The femoral-popliteal artery occlusions were successfully recanalized in all 26 patients. No complications such as thrombosis, rupture of vessel, and distal embolism occurred during the operation. Thrombolytic-related hemorrhage occurred in one patient. The pain score and Rutherford grade were lower and ABI was higher at 24 hours, 6 months, and 1 year postoperatively ( p < .05). The primary patency rate was 88.5% (23/26) at 6 months and 65.3% (17/26) at 1 year postoperatively. Amputation-free survival and limb salvage rate were both 92.3% at 1 year. Conclusion The efficacy of CDT therapy combined with DCB dilatation for femoral-popliteal thromboangiitis obliterans is acceptable at 6 months and 1 year, and the long-term effects need to be further observed.