Original title: Drug-Coated Balloon Versus Standard Percutaneous Transluminal Angioplasty for the Treatment of Superficial Femoral and Popliteal Peripheral Artery Disease 12-Month Results From the IN.PACT SFA Randomized Trial. Reference: Gunnar Tepe et al. Circulation. 2015;131:495-502.

This interesting study randomly selected 331 patients with intermittent claudication or ischemic rest pain due to stenosis of the superficial femoral artery or popliteal for treatment with paclitaxel eluting balloon or balloon angioplasty.

Traditionally, conventional steel stents or drug eluting stents have been used for the treatment of stenosis in this area, however the dynamic forces applied to such prostheses can cause fractures in their rods and / or restenosis, particularly when long arterial segments are treated. After a follow-up period of 12 months, a significantly higher rate of primary patency (82% versus 52%, p <0.001) and a lower incidence of clinical need for target vessel revascularization (1.4% versus 3.7%) was observed in vessels whose patients were treated with drug-eluting balloon.

Furthermore, it was not required amputation of limbs and the occurrence of thrombosis was extremely low (1.4%). Significantly, these favorable results were obtained in a population of high-risk patients with extensive lesions (length of about 90 mm). These results are exciting because they suggest that the use of drug-eluting balloon as primary treatment may be associated with similar late patency rates (> 80%) than those obtained with post-stent implantation. Confirmation of these results can strengthen the drug-eluting balloon as the initial strategy of choice for the treatment of stenosis in the territories of the superficial femoral and popliteal, reserving stents for recurrent cases. 

Courtesy of Gilberto L. Nunes and Márcio Mossmann MDs (Brazil).

Dres Gilberto L. Nunes e Márcio Mossmann