Drug coated balloons (DCB) emerged as an innovative treatment approximately 10 years ago. Since then, numerous randomized studies have shown their effectiveness and benefit in femoropopliteal territory, and even though the use of paclitaxel coated balloons has been called into question, a retrospective study including 168,553 patients was able to show paclitaxel coated balloons were…
Should We Start Stenting with DES in Femoropopliteal Territory?
Percutaneous intervention of femoropopliteal lesions have been the standard strategy these past two decades. The development of drug eluting stents (DES) or drug eluting balloons (DEB) has improved patency rate compared against conventional balloon angioplasty. The ILLUMINA -a multicenter study- looked into the polymer free self-expanding stent NiTiDES, which showed at 1 year an 87%…
IVUS in Femoropopliteal PCI: Should We Start Using It?
For approximately two decades now, PCI has been the treatment of choice in femoropopliteal territory, and even though technological developments and increasing operator experience have indeed improved outcomes, IVUS (which has showed great benefits in PCI, even reducing left main mortality) is hardly used in this territory. This was a prospective randomized controlled study including…
Discrepancy between Angina and Ischemia Repeats in Peripheral Artery Disease
Three randomized studies showed exercising significantly improves 6-minute walk outcomes in patients with peripheral artery disease (PAD). However, many participants randomized to exercise did not perceive changes, and sometimes even got worse. These findings suggest a significant discrepancy between objective and perceived change in walking ability among PAD patients. 400 patients with peripheral artery disease…
ELUVIA: DES in Complex Femoropopliteal Lesions
Paclitaxel-eluting stent Eluvia showed promising results after two years with a revascularization freedom rate of 80% despite the fact that these were complex femoropopliteal lesions. As the safety of paclitaxel-eluting devices becomes more consistent, more studies on its efficacy are being published. Back in 2018, the safety of paclitaxel-eluting balloons and stents was under scrutiny…
ACC 2021 | SAFE-PAD: Paclitaxel-Eluting Devices in Peripheral Disease
This work was conducted alongside the US Food and Drug Administration (FDA) to investigate the association between all-cause mortality and paclitaxel-eluting devices in peripheral vascular disease. According to data from SAFE-PAD, presented at the American College of Cardiology (ACC) 2021 Congress and simultaneously published in JAMA, there is no increase in mortality compared with conventional…
SOLACI PERIPHERAL | 6th Clinical Case: Common, Superficial and Deep Femoral Artery Recanalization
Here is a new SOLACI PERIPHERAL Case! In this opportunity, Dr. Ana Paula Mollón (Arg.) presents “Common, Superficial and Deep Femoral Artery Recanalization”. This is the 6th clinical case presented by SOLACI Peripheral. The purpose of this space is to encourage and further the exchange of experiences and opinions, to keep advancing our knowledge in…
Optimal Medical Treatment Under-used in Vascular Peripheral Disease
Less than half of patients undergoing endovascular revascularization for peripheral artery disease to their lower limbs are discharged with optimal medical treatment. Their traditional risk factors are predictors of a more comprehensive treatment; however, women, patients with higher risk of thrombosis, and those more likely to lose a lower limb, are far from being treated…
Diabetes and Peripheral Vascular Disease: Old Drugs, New Evidence
This paper, recently published in JAHA, showed that patients with type 2 diabetes mellitus exhibiting lower-limb vascular disease benefit from combining cilostazol and clopidogrel. Treatment for at least 6 months with clopidogrel (75 mg/QD) plus cilostazol (100 mg/BID) significantly reduces ischemic events—including stroke, infarction, and death from vascular causes—compared with clopidogrel monotherapy. Adding cilostazol reduces ischemic events, but that…
The Key We Are Overlooking in Peripheral Vascular Disease
To change the prognosis of peripheral vascular disease patients, a referral for supervised exercise is paramount. This should be a cultural change, not only an individual recommendation. A physically active lifestyle reduces the risk of cardiovascular events and functional impairment in patients with peripheral vascular disease. The novelty of this work (forthcoming in Eur J…
ESC 2020 | Rivaroxaban Might Reduce Cardiac Cerebral and Peripheral Events
Adding rivaroxaban to the standard treatment might reduce events incidence in lower limbs, heart, and brain, in patients with peripheral vascular disease undergoing revascularization. These new data resulted from the analysis of the VOYAGER PAD subgroups and were presented at the virtual ESC 2020. The COMPASS study had reached similar conclusions using 2.5 mg rivaroxaban…