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A Rat Carotid Artery Pressure-Controlled Segmental Balloon Injury with Periadventitial Therapeutic Application
Published on: July 9, 2020
Drug-coated balloons in below-the-knee arteries
Felicitas Stoll1, Reyhan Uslu1, Erwin Blessing2
1Department of Cardiology, Angiology, Pneumology, Heidelberg University Hospital, Heidelberg, Germany.
Insights
Drug-coated balloons (DCB) show promise for treating infrapopliteal peripheral artery disease, improving limb outcomes and reducing revascularization needs. This real-world data supports DCB use in below-the-knee interventions.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Peripheral Artery Disease Management
Background:
- Optimal interventional strategies for infrapopliteal peripheral artery disease (PAD) are actively sought.
- The efficacy and safety of drug-coated balloons (DCB) in crural interventions remain debated due to conflicting study results.
Purpose of the Study:
- To evaluate the real-world outcomes of drug-coated balloon (DCB) interventions in patients with infrapopliteal peripheral artery disease (PAD).
- To assess the safety and effectiveness of DCB in below-the-knee interventions for Rutherford categories 3-6 PAD.
Main Methods:
- Retrospective analysis of 75 infrapopliteal DCB interventions in 68 patients with PAD (Rutherford category 3-6).
- Evaluation of clinical outcomes including freedom from target lesion revascularization (TLR), ulcer healing, and freedom from major amputation and death at 365 days.
Main Results:
- 68% freedom from clinically driven target lesion revascularization (TLR) at 365 days.
- 78% ulcer healing or significant improvement at six months.
- 82% freedom from major amputation and death at 365 days.
- A significant difference in freedom from major amputation and death was observed between patients with (76.2%) and without (91.5%) diabetes mellitus (p=0.049).
Conclusions:
- Real-world data suggests favorable outcomes for DCB treatment in below-the-knee interventions for PAD.
- DCB interventions demonstrate potential for improving limb salvage and reducing revascularization needs in complex infrapopliteal lesions.
- Further research is warranted to solidify the role of DCB in PAD treatment strategies.
Abstract:
Background: The search for an optimal interventional treatment strategy in infrapopliteal peripheral artery disease remains in the focus of interest. Whether drug-coated balloons (DCB) might enhance interventional outcomes after crural interventions is a matter of debate, as studies yielded conflicting results on DCB safety and efficacy. Patients and methods: We analyzed a retrospective cohort of 75 infrapopliteal DCB interventions performed at our institution in 68 patients with peripheral artery disease in Rutherford category 3 to 6. Results: Despite a high rate of long complex lesions and multi-vessel disease, freedom from clinically driven target lesions revascularization (TLR) after 365 days was 68%. After six months, healing or significant improvement of the ischemic ulcer was observed in 78% of cases. Accordingly, freedom from major amputation and death after 365 days was 82%. Freedom from major amputation and death was 76.2% of cases in patients with diabetes mellitus as opposed to 91.5% in patients without diabetes mellitus (p=0.049). Conclusions: With this real-world analysis we would like to contribute to the ongoing discussion on the benefit and safety of DCB treatment in below-the-knee interventions.
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