{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T23:03:22Z","timestamp":1776121402571,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T00:00:00Z","timestamp":1575849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2020,2,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Femoropopliteal (FP) artery is one of the most anatomically challenging areas for sustained stent patency. The incidence of FP in\u2010stent restenosis (ISR) is estimated at 50% at 24\u2009months. Prior studies have shown that lesion debulking with laser atherectomy (LA) combined with drug coated balloon (DCB) have superior outcomes compared to LA\u2009+\u2009balloon angioplasty (BA) ISR, but there have not been studies evaluating 2\u2010year outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a dual\u2010center retrospective cohort study that compared patients with FP\u2010ISR treated with LA\u2009+\u2009DCB versus LA\u2009+\u2009BA. Cox regression analysis was used to examine 2\u2010year outcomes of target lesion revascularization (TLR) and the composite outcome of TLR or restenosis. Multivariable analysis was performed for clinical and statistically significant (in the univariate analysis) variables.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred and seventeen consecutive patients with Tosaka II (<jats:italic>n<\/jats:italic> = 32) and III (<jats:italic>n<\/jats:italic> = 85) ISR were analyzed. Sixty\u2010six patients were treated with LA\u2009+\u2009DCB and 51 with LA\u2009+\u2009BA. The LA\u2009+\u2009DCB group had more lesions with moderate to severe calcification (58% vs. 13%; <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.0001). The LA\u2009+\u2009DCB group was more likely to be treated with the use of embolic protection devices (64% vs. 23%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and cutting balloons (61% vs. 6%, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Bail\u2010out stenting rates were lower in the LA\u2009+ DCB group (32% vs. 57%, <jats:italic>p<\/jats:italic> = .008). LA\u2009+\u2009DCB was superior (HR: 0.57; 95% CI: 0.34\u20130.9, <jats:italic>p<\/jats:italic> = .027) for the composite outcome of 2\u2010year TLR or restenosis. The 12\u2010month KM estimates for freedom from TLR or restenosis were 66% in the LA\u2009+ DCB group versus 46% in the LA\u2009+\u2009BA group. The 24\u2010month KM estimates were 45% in the LA\u2009+\u2009DCB group versus 24% in the LA\u2009+\u2009BA group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The combination of DCB\u2009+\u2009LA was associated with decreased rates of bail\u2010out stenting and improved 2\u2010year TLR or restenosis rates. Randomized clinical trials examining the DCB\u2009+\u2009LA combination for FP\u2010ISR are needed.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.28636","type":"journal-article","created":{"date-parts":[[2019,12,9]],"date-time":"2019-12-09T13:51:23Z","timestamp":1575899483000},"page":"439-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Laser atherectomy and drug\u2010coated balloons for the treatment of femoropopliteal in\u2010stent restenosis: 2\u2010Year outcomes"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1381-4754","authenticated-orcid":false,"given":"Damianos G.","family":"Kokkinidis","sequence":"first","affiliation":[{"name":"Division of Cardiology, Rocky Mountain Regional VA Medical Center University of Colorado  Denver 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Mountain Regional VA Medical Center University of Colorado  Denver Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9123-8038","authenticated-orcid":false,"given":"Gagan D.","family":"Singh","sequence":"additional","affiliation":[{"name":"Vascular Center and Division of Cardiovascular Medicine University of California  Davis Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John R.","family":"Laird","sequence":"additional","affiliation":[{"name":"Vascular Center and Division of Cardiovascular Medicine University of California  Davis Sacramento California"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier A.","family":"Valle","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Rocky Mountain Regional VA Medical Center University of Colorado  Denver 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