Comparison of Primary Patency Rates and Influencing Factors Between Drug-Coated Balloons and Drug-Eluting Stents in the Endovascular Treatment of Lower Extremity Arteriosclerosis Obliterans

AIM: To compare the 1-year patency rates of drug-coated balloon (DCB) and drug-eluting stent (DES) in the treatment of lower extremity arteriosclerosis obliterans (LEASO), and to systematically analyze the factors influencing post-treatment patency.METHODS: This retrospective study included 302 patients with LEASO who received treatment at Fuyang People’s Hospital between January 2021 and December 2024. Based on the treatment modality, patients were divided into a DCB group (n = 152) and a DES group (n = 150). Comprehensive baseline demographic, clinical, and procedural data were collected. The 1-year primary patency rates of the two groups were compared using imaging assessment, primarily based on ultrasonography. Independent risk factors affecting patency were identified using a multivariate Cox proportional hazards regression model.RESULTS: The 1-year primary patency rate was 87.5% (133/152) in the DCB group and 89.3% (134/150) in the DES group. No statistically significant difference in the 1-year primary patency rates was observed between the two groups (p > 0.05). Multivariate Cox regression analysis demonstrated that diabetes mellitus, lesion length, and severe calcification were independent risk factors affecting patency after endovascular treatment (all p < 0.05).CONCLUSIONS: The 1-year patency rates did not differ significantly between the DCB and DES groups. Diabetes mellitus, long lesion length, and severe calcification were identified as key factors associated with reduced patency rates. Clinical management should emphasize individualized intervention strategies and postoperative management for these high-risk patients.