Objective:

The aim of this study was to compare the long-term outcomes of below the knee revascularization with percutaneous atherectomy followed by drug-coated balloon and revascularization with drug-coated balloon alone for symptomatic diabetic patients with peripheral arterial disease.

Patients and methods:

Between April 2015 and January 2020, total of 128 patients and 228 below the knee procedures were enrolled into this retrospective study. Sixty-five patients were treated with atherectomy followed by drug-coated balloon and 63 patients were treated solely with drug-coated balloon.

Results:

Technical success rates were similar in the AT+DCB group and DCB group. Target lesion revascularization (TLR) was found similar in both groups at 6-month follow-up. Clinically, driven repeat endovascular and surgical limb revascularization rates were also significantly lower at 12 and 24 months.

Conclusion:

Combined usage of rotational atherectomy and drug-coated balloons for the treatment of diabetic patients with below-the knee arterial lesions and critical limb ischemia is associated with reduced long-term TLR rates and improved the long-term outcomes.