# Early outcomes of drug-coated balloon angioplasty and stent placement for the treatment of iliac artery lesions

## TL;DR

This study compares drug-coated balloons and stents for treating iliac artery blockages, finding similar overall effectiveness but lower patency in specific artery segments with balloons.

## Contribution

The study provides early evidence on the comparative effectiveness of drug-coated balloons versus stents for iliac artery lesions.

## Key findings

- Drug-coated balloons and stents showed similar primary patency rates at 6 and 12 months.
- Patency in the common iliac artery segment was significantly lower with drug-coated balloons.
- No significant factors were found to influence long-term patency in either group.

## Abstract

The efficacy and safety of drug-coated balloons (DCBs) in the treatment of aortoiliac artery stenosis or occlusion remains poorly explored.

A single-center retrospective cohort study of patients diagnosed with iliac artery stenosis or occlusion who received either iliac artery DCB angioplasty or stent implantation was conducted at our institution. The patients were followed up 6 and 12 months postoperatively. Lower limb computed tomography angiography was performed during the follow-up period. The primary endpoint of the study was the primary patency at 6 and 12 months. Both the clinical and follow-up data were analyzed.

50 patients underwent DCB angioplasty, while 71 received stent implantation. Demographic and lesion characteristics were comparable between the two groups (P > 0.05). However, the balloon diameter used in the DCB group was significantly smaller (6.42 ± 0.80 mm vs. 7.39 ± 0.97 mm, P < 0.001). The primary patency values 6 and 12 months postoperatively were 84.2% and 80.7% for the DCB group and 96.1% and 89.6% for the stent group, respectively with no significant difference between the two groups (P = 0.124). However, the 12-month patency in the common iliac artery segment for the DCB group was significantly lower than that for the stent group (75.0% vs. 97.3%, P = 0.006). Univariate and multivariate logistic analyses did not identify any factors associated with long-term patency.

Same as stents, DCBs maintained a favorable but lower patency rate across various calcification levels and different TASC Ⅱ classification in patients with aortoiliac artery stenosis or occlusion.