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...
The technological development of drug eluting stents has allowed us to treat increasingly complex patients, with around 10% stenosis and using more, and longer stents. This situation generates a great challenge: keep using stents or use paclitaxel coated balloons (PCB). At present, there are sirolimus drug coated balloons (SCB), but we do not have enough...
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...
Lecture by Dr. Hector García García – LM-PCI: IVUS and FFR/IFR? Dr. Hector García delivered an excellent presentation on whether we should use intravascular ultrasound (IVUS) or fractional flow reserve (FFR)/instantaneous wave-free ratio (iFR) in the left main coronary artery (LMCA) to consider severe obstruction, since there is significant interobserver variability with angiography. Although the...
In the first session of SOLACI-SOCIME 2022 on “Complex angioplasty guided by intravascular imaging”, Dr. Alejandro Diaz (MEX) reviewed the evidence on intravascular ultrasound (IVUS) in complex angioplasties. A meta-analysis indicated its use is associated with a significant decrease in the risk of death, acute myocardial infarction (AMI), and new target lesion revascularization (TLR) in...
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...
Second generation drug-eluting stents have lower frequency of thrombotic complications and in-stent restenosis. While clinical results have significantly improved, having a 2-3% annual rate of these complications within the first year after angioplasty is still worrisome. This resulted in the development of stents with struts <70 µm (ultrathin), with bioresorbable polymer and abluminal cover. Stents...
For lesions in the common femoral artery, guidelines recommend surgical endarterectomy (TEA) as the gold standard. However, endovascular therapy (EVT) is an alternative option for these lesions. In 2017 the first randomized study comparing TEA vs EVT was carried out, showing that EVT presents clinical benefits, though it does not replace surgical treatment as first...
We all know the benefits of ultravascular ultrasound (IVUS) in the development of percutaneous coronary intervention, such as more accurate vessel measurement, improved stent expansion and apposition, and complication identification. This is why the use of IVUS is a class IIa recommendation in AHA and ESC guidelines. The aim of this retrospective study was to...
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...