At present, the use of drug coated balloons (DCB) in femoropopliteal territory is more and more frequent. However, when it comes to treating moderate to severe calcification, the evidence is still limited. Using a peripheral artery calcification scoring system (PACSS) has been associated to clinical outcomes after DCB angioplasty for femoropopliteal lesions. The system categorizes…
Comparative Study of Two Drug Coated Balloons: Angiographic and Clinical Outcomes
The incidence of in-stent restenosis (ISR) requiring repeat revascularization ranges between 5% and 10% of PCI patients receiving new generation drug eluting stents (DES). This is why the current European guidelines on myocardial revascularization recommend treating ISR with drug coated balloons (DCB) with class I recommendation, level of evidence A. DCB are mostly coated with…
ISAR Score: Can We Predict the Need for Repeat PCI in DES Restenosis?
Score to predict the risk of repeat PCI in DES restenosis. With the use of drug eluting stents (DES) instent restenosis (ISR) has seen a significant reduction vs. bare metal stents (BMS) restenosis. The main cause of DES failure is ISR. This entity is difficult to manage because of its high recurrence and reintervention risk.…
Arterial Patency in Femoropopliteal Disease with Drug-Eluting Balloons
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…
Should We Use Drug Coated Balloons in Patients with Multivessel Disease?
Recent studies have shown that a drug coated balloons (DCB) based approach resulted non inferior when compared against drug eluting stents (DES) only approach in patients with instent restenosis and de novo lesions in small vessel disease. So far, two international consensuses have reported the use of DCB is feasible and safe to treat native…
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…
Left Main Coronary Artery PCI Using State-of-the-Art Zotarolimus-Eluting Stents
Percutaneous coronary intervention (PCI) to the left main coronary artery (LMCA) with drug-eluting stent implantation is currently a major challenge due to the size of the vessel, the compromise of a bifurcation lesion in important branches, and the potential risk of complications. Available information on LMCA PCI comes from studies where DES stents were implanted…
Can We Use DAPT for 3 Months in Acute Coronary Syndrome?
Current guidelines recommend 12-month dual antiplatelet therapy (DAPT) after DES stenting for acute coronary syndrome (ACS) because of elevated MACE risk. The development of more modern stents, with thin and ultrathin struts, compared against prior versions, has resulted in more effective devices in terms of stent thrombosis and restenosis. Prolonged DAPT has been associated with…