Angiographic Outcomes of Drug-Coated Balloon versus Percutaneous Transluminal Angioplasty for Revascularization of Infrapopliteal Arteries: A Meta-Analysis of Randomized Controlled Trial

Purpose: The aim of this review was to perform a meta-analysis of randomized controlled trials investigating the angiographic and wound healing outcomes of patients undergoing percutaneous revascularization with drug-coated balloon (DCB) versus percutaneous transluminal angioplasty (PTA) of infrapopliteal arteries.

Materials and Methods: A systematic review of scientific databases was searched for randomized controlled trials of DCB vs PTA for revascularization of atherosclerotic infrapopliteal arteries. Two authors independently performed searches, study selection, and methodologic data extraction. Study quality and heterogeneity were assessed. Mantel Haenszel relative risks (RRs) were calculated using random effect models.

Results: Ten studies (1532 patients) met the inclusion criteria. DCB use significantly decreased TLR (RR, 0.56; 95% confidence interval [CI], 0.39–0.80; P = 0.009), LLL (MD, -0.52; 95% CI, -0.84, -0.20; P = 0.001), restenosis or occlusion (RR, 0.67; 95% CI, 0.46, 0.97; P = 0.03), and time to healing (MD ,-1.41; 95% CI, -2.48, -0.34; P = 0.01). No significant difference in complete healing (RR, 1.13; 95% CI, 0.99–1.29; P = 0.06) between DCB and PTA was noted.

Conclusions: In patients undergoing revascularization of infrapopliteal arteries, DCB is associated with reduced restenosis or occlusion and LLL with increase complete healing at a shorter interval.