This meta-analysis is an update on the role of drug-coated balloons in the treatment of infrapopliteal arterial disease, a difficult pathology for all strategies.

The primary endpoint of this meta-analysis was treated lower limb salvage at 12 months. The secondary endpoints included survival at 12 months, amputation free survival, restenosis, and target lesion repeat revascularization rate.

This analysis included 10 studies and a total of 1593 patients, even though study quality was moderate to low, according to the standards.

The treated limb salvage rate was 94% with drug-coated balloons vs. 95.7% with conventional angioplasty, which is not a significant difference.

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The survival rate at one year was 89.8% vs. 92.9%, which is not a significant difference either.

An analysis of the 4 most uniform studies showed a 32.9% rate of restenosis with drug-coated balloons vs. a 62% rate with conventional angioplasty. This difference seems significant, but there is great dispersion in the confidence interval (odds ratio [OR]: 2.87; 95% confidence interval [CI]: 0.83 to 9.92).

The amputation free survival rate was 82.5% with drug-coated balloons vs. 88.7% with conventional angioplasty (OR: 0.79; 95% CI: 0.23 to 2.75).

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There were no significant differences in any of the studied endpoints.

Conclusion

Based on this systematic review and meta-analysis, there are no significant differences in terms of lower limb salvage, survival, restenosis, target lesion revascularization, or amputation free survival between angioplasty with drug-coated balloons and conventional angioplasty in infrapopliteal arterial disease.

Original Title: Drug Coated Balloon Angioplasty vs. Standard Percutaneous Transluminal Angioplasty in Below the Knee Peripheral Arterial Disease: A Systematic Review and Meta-Analysis.

Reference: Jetty Ipema et al. Eur J Vasc Endovasc Surg, article in press.

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