Follow-up of drug-coated balloon angioplasty in femoropopliteal disease in a real-world population. Using drug-releasing devices has decreased the rate of restenosis in obstructive femoropopliteal lesions compared with conventional balloons or conventional stents (bare-nitinol stent, BNS). Both in the placement of BNS and of drug-eluting stents (DES) there is a mechanical risk of stent fracture or…
Stent Revascularization in Femoropopliteal Disease: An Analysis of Clustered Randomized Trials
A study compared pooled data of claudication and critical ischemia patients treated with stenting vs. by-pass surgery in femoropopliteal disease. The main objective of revascularization in femoropopliteal disease is to improve the quality of life and functional capacity of claudication patients who did not respond to medical treatment, and to save the affected limb in…
What Is the Best Strategy for Moderately Complex Femoropopliteal Lesions?
At present, PCI is the preferred treatment for femoropopliteal lesions and drug coated balloons (DCB) have shown good performance. However, they have not yet been shown superior to bare-metal stents (BMS). This study compared randomized trials IN.PACT SFA I/II and IN.PACT JAPAN including 288 patients vs. the prospective Complete SE and DURABILITY II with 483…
IN.PACT Study | Should We Start Using DCBs More Frequently in Cases of Femoropopliteal Disease?
With the new devices (drug-eluting balloons [DEB], drug-eluting stents [DES], and atherotomes) percutaneous treatment is becoming the first line of approach for femoropopliteal disease, especially when dealing with not very long total occlusions. Randomized studies and registries on the use of drug-coated balloons (DCB) in femoropopliteal disease are currently available, but their evolution beyond 2…
Safety of Atherectomy in Femoropopliteal Disease
Peripheral artery disease hinders patient quality of life extensively. In advanced stages, such as critical lower limbs ischemia (CLLI), it could yield an increased risk in major cardiovascular events, as well as limb-related events (amputation or repeat revascularization), making treatment with revascularization paramount in these cases. Calcification is a predictor of revascularization failure, which is…
Drug Coated Balloons in Femoropopliteal Territory: Predictors of Failed Patency
Endovascular treatment in femoropopliteal territory has become the strategy of choice over time, with diverse devices; among others, drug coated balloons (DCB). DBS are meant to provide the antiproliferation effect of drugs while reducing exposure of a specific artery segment to a strange body. Even though the number of studies on DCB effectiveness has been…
EMINENT Trial | Stent Eluvia vs BMS in Femoropopliteal Territory
Endovascular therapy in femoropopliteal territory has become the standard, mainly with self-expanding stents, aimed at preventing early vascular recoil and late constrictive remodeling. Randomized studies have shown that the use of Paclitaxel drug eluting stents (DES) reduces the number of new revascularizations (even though these studies compared mostly against conventional balloons, which is why we…
Results of the COMPARE Study After 2 Years: Low Dose vs. High Dose Paclitaxel-Coated Balloons
The development of new devices and techniques has expanded the range of patients who benefit from endovascular treatment of femoropopliteal lesions. Paclitaxel-eluting devices have improved clinical results and treated-vessel patency at follow-up compared with conventional angioplasty. Currently, devices with different doses of paclitaxel are available in the market. The COMPARE (Compare I Pilot Study for…
Clinical Results of IVUS-Guided Drug-Eluting Stent Implantation in Femoropopliteal Disease
Endovascular treatment of femoropopliteal lesions has become the first-line treatment due to the development of devices that decrease the restenosis rate. Recently, the IMPERIAL study showed greater patency at 1 year and greater freedom from clinically guided revascularization at 2 years in favor of the ELUVIA stent (paclitaxel-eluting fluoropolymer, FP-DES) compared with the ZILVER PTX…
DISRUPT-PAD III: Followup of IVL Treatment in Femoropopliteal Territory
Femoropopliteal segment calcification can generate complications for both preparation and execution of endovascular therapies for patients with peripheral artery disease. It can produce suboptimal vessel expansion associated to higher risk of dissection or perforation. These adverse effects can affect procedure durability in the long term. Studies on the use of drug coated balloons to treat…
Intermittent Claudication: Invasive Treatment Superior to Pharmacological Treatment?
Peripheral vascular disease is strongly associated to cardiovascular events and a negative impact on health status and quality of life. However, researchers are yet to determine the benefit of early intervention in patients presenting intermittent claudication, and whether it improves quality of life. At present, there is little information in this regard (CLEVER trial), and…