{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T11:16:01Z","timestamp":1784200561327,"version":"3.55.0"},"reference-count":14,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T00:00:00Z","timestamp":1743465600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Endovasc Ther"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate and compare the efficacy and safety of drug-coated balloon angioplasty (DEB) versus rotational atherectomy combined with DEB (RA\u2009+\u2009DEB) in patients with in-stent restenosis (ISR) in the femoropopliteal territory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Retrospective multicenter observational study based on data from a prospective registry of patients with femoropopliteal stents treated between January 2017 and March 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      One hundred and six patients were included (53 in each group) with 3\u2009years median follow-up. At 2\u2009years, freedom from clinically driven target lesion revascularization (CD-TLR) was 87.1\u2009\u00b1\u20093.9% in the RA\u2009+\u2009DEB group compared to 75.5\u2009\u00b1\u20098.7% in the DEB group. At 5\u2009years, the CD-TLR rates were 64.0\u2009\u00b1\u20099.4% in RA\u2009+\u2009DEB and 30.5\u2009\u00b1\u200910.6% in DEB (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.036). Additionally, 5-year thrombosis-free survival was significantly higher in RA\u2009+\u2009DEB (74.6\u2009\u00b1\u20097.6%) compared to DEB (37.2\u2009\u00b1\u200910.5%,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.026). There were no statistically significant differences in MALE between the treatment groups. In multivariable analysis, RA\u2009+\u2009DEB reduced TLR risk and improved assisted primary patency, while Tosaka 3 and lesion length predicted worse outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>RA combined with DEB offers advantages over DEB alone in femoropopliteal ISR, reducing reinterventions, enhancing assisted primary patency, and lowering thrombosis rates without increasing MALE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Impact<\/jats:title>\n                    <jats:p>This study addresses the current lack of long-term evidence on the treatment of femoropopliteal in-stent restenosis (ISR) using drug-coated balloons (DEB) alone versus DEB combined with rotational atherectomy (RA). Clinically, RA+DEB significantly reduces reinterventions and thrombosis, and improves assisted primary patency without increasing complications. For clinicians, this supports a more effective and durable option for complex ISR, particularly in occlusive or long lesions. The innovation lies in demonstrating the added value of vessel preparation with RA, offering a lesion-specific strategy in the absence of clear guideline recommendations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/15266028251329757","type":"journal-article","created":{"date-parts":[[2025,4,1]],"date-time":"2025-04-01T23:07:17Z","timestamp":1743548837000},"page":"2102-2111","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparative Long-Term Outcomes of Drug-Coated Balloons Alone Versus Combined Treatment with Rotational Atherectomy in the Treatment of Femoropopliteal Artery In-Stent Restenosis"],"prefix":"10.1177","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9191-5043","authenticated-orcid":false,"given":"Vicente","family":"Molina N\u00e1cher","sequence":"first","affiliation":[{"name":"La Fe University and Polytechnic Hospital, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 C.","family":"Rosell\u00f3 Paredes","sequence":"additional","affiliation":[{"name":"La Fe University and Polytechnic Hospital, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura G\u00e1lvez","family":"N\u00fa\u00f1ez","sequence":"additional","affiliation":[{"name":"La Fe University and Polytechnic Hospital, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Picazo Pineda","sequence":"additional","affiliation":[{"name":"Doctor Peset University Hospital, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Olmos","family":"S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Doctor Peset University Hospital, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4687-3574","authenticated-orcid":false,"given":"Bader Al-Raies","family":"Bola\u00f1os","sequence":"additional","affiliation":[{"name":"Hospital de Manises, Angiology and Vascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8836-6987","authenticated-orcid":false,"given":"Francisco J.","family":"G\u00f3mez Palon\u00e9s","sequence":"additional","affiliation":[{"name":"Hospital Universitario Doctor Peset, Angiology, Vascular and Endovascular Surgery, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prof. Manuel Miralles","family":"Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"University of Valencia, Departament of Surgery, Faculty of Medicine, Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,1]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/5935039"},{"key":"e_1_3_2_3_2","article-title":"Outcomes and comparative analysis of the initial results of standard balloon angioplasty versus drug-coated balloons alone versus in association with laser-excimer atherectomy in the treatment of femoropopliteal artery in-stent restenosis (INTACT)","author":"Ducasse E","unstructured":"Ducasse E, Sapoval M, Brunet J, et al Outcomes and comparative analysis of the initial results of standard balloon angioplasty versus drug-coated balloons alone versus in association with laser-excimer atherectomy in the treatment of femoropopliteal artery in-stent restenosis (INTACT). J Endovasc Ther. Epub ahead of print 24 April 2024. 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Cir Cir. 2022;90(S2):29-35.","journal-title":"Cir Cir"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.avsg.2019.02.018"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/15266028231161246"},{"issue":"1","key":"e_1_3_2_15_2","first-page":"166","article-title":"Debulking plus drug-coated balloon angioplasty versus drug-coated balloon angioplasty alone for femoropopliteal Tosaka III in-stent restenosis lesions","volume":"18","author":"Li L","year":"2023","unstructured":"Li L, Tong Z, Cui S, et al Debulking plus drug-coated balloon angioplasty versus drug-coated balloon angioplasty alone for femoropopliteal Tosaka III in-stent restenosis lesions. 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