{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:37:33Z","timestamp":1786700253662,"version":"build-2736575974"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T00:00:00Z","timestamp":1786665600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cardiovasc. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare one-year vessel patency, limb perfusion and function, and direct and indirect costs between combined balloon angioplasty with rotational atherectomy versus balloon angioplasty with drug-eluting stent placement in patients with lower-limb peripheral arterial disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Single-center retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients treated between January 2020 and December 2023 with atherectomy plus balloon angioplasty (AB group) were propensity-score-matched 1:1 to patients treated with balloon angioplasty plus a paclitaxel-eluting nitinol stent (BS group). The matched cohort included 160 patients per group. The primary outcome was 12-month primary vessel patency. Secondary outcomes were target vessel re-occlusion, ankle-brachial index (ABI), six-minute walk distance, Rutherford classification, disease-specific quality of life (Peripheral Artery Questionnaire, PAQ), major adverse cardiovascular events, and direct and indirect costs at one year.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the matched cohort, 12-month primary patency was similarly high in both groups. Re-occlusion rates were comparable. The adjusted between-group ABI difference at 12 months was 0.010 (95% confidence interval \u22120.000 to 0.019;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.060). The mean 6-minute walk distance improved by 121.1\u2005m (AB) versus 122.5\u2005m (BS) (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.867). Rutherford category and PAQ score improved similarly in both groups (PAQ increase 25.6 vs. 26.2,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.593). Major adverse cardiovascular events were rare [2 patients (1.3%) in each group by 3 months, none thereafter]. Mean total cost over one year was significantly lower in the AB group (93,189 CNY) than in the BS group (119,702 CNY;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001), driven by lower device\/implant costs (27,574 vs. 54,536 CNY;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Atherectomy plus angioplasty was associated with 12-month patency and functional outcomes for which no significant difference from balloon angioplasty with drug-eluting stenting was detected, at significantly lower one-year cost. Because the design was powered for superiority rather than non-inferiority, these findings indicate absence of evidence of a difference rather than proven equivalence. The cost difference was driven almost entirely by the lower device price of the atherectomy-based strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>Therapeutic, Level III (retrospective matched cohort).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcvm.2026.1785484","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T09:10:23Z","timestamp":1786698623000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and costs of combined balloon dilation plus atherectomy versus combined balloon dilation plus stent for lower-limb peripheral arterial disease: a single-center propensity-matched retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Haisheng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Vascular Surgery, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manrong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Endocrinology, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruixin","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Fudan University","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"Shen","sequence":"additional","affiliation":[{"name":"Division of Population and Public Health Science, Pennington Biomedical Research Center","place":["Baton Rouge, LA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengdi","family":"Lu","sequence":"additional","affiliation":[{"name":"Division of Population and Public Health Science, Pennington Biomedical Research Center","place":["Baton Rouge, LA, United States"]},{"name":"Department of Orthopaedics, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ye","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Vascular Surgery, Shanghai Sixth People\u2019s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"e1020","DOI":"10.1016\/S2214-109X(19)30255-4","article-title":"Global, 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