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Calcium burden assessment and impact on drug-eluting balloons in peripheral arterial disease

F Fanelli1, A Cannavale, M Gazzetti

  • 1Vascular and Interventional Radiology Unit, Department of Radiologic Sciences, "Sapienza" University of Rome, 324 Viale Regina Elena, 00161, Rome, Italy, fabrizio.fanelli@uniroma1.it.

Cardiovascular and Interventional Radiology
|May 9, 2014
PubMed

Insights

Calcium in superficial femoral artery lesions hinders drug-eluting balloon (DEB) effectiveness, particularly with extensive circumferential calcification. This impacts revascularization outcomes and patency rates.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Superficial femoral artery (SFA) lesions often present with calcification, complicating endovascular treatment.
  • Drug-eluting balloons (DEBs) are used for SFA revascularization, but their efficacy may be influenced by lesion characteristics.

Purpose of the Study:

  • To evaluate the impact of arterial calcification on the efficacy of drug-eluting balloons (DEBs) in treating steno-obstructive SFA lesions.

Main Methods:

  • Sixty patients with SFA lesions underwent DEB treatment.
  • Calcium distribution and length were assessed using CT-angiography and digital-subtraction-angiography.
  • Outcomes including Ankle-brachial index (ABI), lumen loss, revascularization rates, patency, and adverse events were analyzed at 1-year follow-up.

Main Results:

  • Revascularization was universally successful.
  • Higher degrees of circumferential calcium (>270°) correlated with reduced DEB efficacy: lower ABI (0.71 vs. 0.92), increased lumen loss (0.75 vs. 0.45), decreased primary (50% vs. 100%) and secondary patency (50% vs. 100%), and higher target lesion revascularization (25% vs. 0%).

Conclusions:

  • Arterial calcification acts as a barrier to optimal drug absorption from DEBs.
  • The circumferential extent of calcium is a critical factor, with 360° calcification showing the most detrimental effect on treatment outcomes.
Abstract

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