{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:35:12Z","timestamp":1791999312135,"version":"4.4.0"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T00:00:00Z","timestamp":1700179200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Whether drug\u2010coated balloon (DCB) angioplasty would be effective in spiral dissection (SD) lesions with no flow impairment has been thoroughly investigated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>The present study sought to assess the clinical outcomes of non\u2010flow\u2010limiting SD after DCB angioplasty for de novo femoropopliteal lesions in patients with symptomatic lower extremity artery disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>This single\u2010center retrospective study enrolled 497 patients with non\u2010flow\u2010limiting SD (<jats:italic>n<\/jats:italic>\u2009=\u200992) or non\u2010SD (<jats:italic>n<\/jats:italic>\u2009=\u2009405) without bailout stenting. The primary endpoint was 1\u2010year primary patency, with the secondary endpoints including freedom from target lesion revascularization (TLR), major adverse limb event (MALE), all\u2010cause death, and 30\u2010day restenosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The 1\u2010year primary patency and freedom from TLR were significantly lower in the SD group than in the non\u2010SD group (69.8% vs. 83.3%, <jats:italic>p<\/jats:italic>\u2009=\u20090.004; 78.7% vs. 93.0%, <jats:italic>p<\/jats:italic>\u2009=\u20090.007, respectively). The SD group had a higher incidence of MALE and 30\u2010day restenosis than the non\u2010SD group (24.6% vs. 11.9%, <jats:italic>p<\/jats:italic>\u2009=\u20090.001; 4.3% vs. 0.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.002, respectively). All\u2010cause death was comparable. One\u2010year restenosis after SD was associated with chronic limb\u2010threatening ischemia (CLTI) (hazard ratio, 3.36 [95% confidence interval, 1.21\u20139.36]; <jats:italic>p<\/jats:italic>\u2009=\u20090.020), TASC \u2161 D (hazard ratio, 3.97 [95% confidence interval, 1.02\u201315.52]; <jats:italic>p<\/jats:italic>\u2009=\u20090.047), and residual stenosis \u226550% (hazard ratio, 4.92 [95% confidence interval, 1.01\u201323.94]; <jats:italic>p<\/jats:italic>\u2009=\u20090.048). The incidence of restenosis after SD increased with the number of these risk factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite normal antegrade flow, the 1\u2010year primary patency rate after DCB angioplasty for de novo femoropopliteal lesions was significantly lower in lesions with SD than those without SD. CLTI, TASC II D, and residual stenosis \u226550% were risk factors associated with 1\u2010year restenosis after DCB angioplasty for non\u2010flow\u2010limiting SD lesions.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30911","type":"journal-article","created":{"date-parts":[[2023,11,17]],"date-time":"2023-11-17T09:28:32Z","timestamp":1700213312000},"page":"97-105","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Outcomes of non\u2010flow\u2010limiting spiral dissection after drug\u2010coated balloon angioplasty for de novo femoropopliteal lesions"],"prefix":"10.1002","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2116-2178","authenticated-orcid":false,"given":"Takuya","family":"Haraguchi","sequence":"first","affiliation":[{"name":"Department of Cardiology Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic Sapporo 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katsuhiko","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic Sapporo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsutomu","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Cardiology Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic Sapporo 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