Promising outcomes for DEB in long femoropopliteal artery lesions

Courtesy of Dr. Carlos Fava.

For type A and B femoropopliteal artery lesions, percutaneous transluminal angioplasty (PTA) with balloon has proven beneficial; however, drug-eluting balloons (DEB) have shown superiority as regards restenosis.

Some studies have reported favorable outcomes for DEB in type C and D lesions, but its real benefit is still unclear.

This study prospectively enrolled 105 patients who underwent PTA with DEB (IN.PACT Admiral Medtronic, Frauenfeld, Switzerland) for femoropopliteal lesions.

The mean age was 68; most patients were male, and all of them presented Rutherford class 2 to 4 intermittent claudication. Lesion length was 251 ± 71 mm and 49.5% were total occlusions.

The 24-month follow-up data were available in 98 patients. The primary patency rate was 70.4%, the secondary patency rate was 79.6%, and the target-lesion revascularization (TLR) rate was 15.3%. The unrelated mortality rate was 5.1%. No patients presented related death or amputation.

There was no difference in primary patency between patients with and without diabetes.

All patients presented class improvement at 24 months: half of the subjects were asymptomatic.

Conclusion

PTA with DEB provides benefits related to primary patency and TVR at 24 months for asymptomatic patients with femoropopliteal disease.

Editorial Comment

This study shows that, in patients with long femoropopliteal lesions without critical ischemia, DEB would offer very good outcomes.

This allows physicians to adopt a different approach on this issue, leaving aside stent implantation whenever angiographic results are inadequate.

Further investigation is necessary for the adoption of definitive measures.

Courtesy of Dr. Carlos Fava.

Original title: 2-Year Results of Paclitaxel-Coated Balloons for Long Femoropopliteal Artery Disease: Evidence from the SFA-Long Study

Reference: Antonio Micari. J Am. Coll Cardiol Intv 2017;10:728-34.

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