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Clinical Outcomes in Patients with Repeat Drug-Coated Balloon Angioplasty for a Femoropopliteal Occlusive Lesion

Shogo Emura1, Taira Kobayashi2, Takanobu Okazaki2

  • 1Department of Cardiovascular Surgery, National Hospital Organization Higashihiroshima Medical Center, Higashihiroshima-shi, Hiroshima, Japan.

Annals of Vascular Surgery
|November 15, 2025
PubMed

Insights

Repeat drug-coated balloon (DCB) angioplasty offers acceptable 18-month durability for femoropopliteal lesions. Longer lesion length and chronic total occlusion are risk factors for restenosis after repeat DCB angioplasty.

Area of Science:

  • Vascular Surgery
  • Interventional Cardiology
  • Medical Devices

Background:

  • Drug-coated balloon (DCB) angioplasty is a common treatment for femoropopliteal lesions.
  • Long-term outcomes of repeat DCB angioplasty for these lesions are not well-established.
  • Identifying risk factors for restenosis is crucial for optimizing patient care.

Purpose of the Study:

  • To evaluate the outcomes of repeat DCB angioplasty in patients with femoropopliteal occlusive lesions.
  • To identify predictors of recurrent restenosis after repeat DCB angioplasty.

Main Methods:

  • Retrospective review of 116 patients (127 limbs) undergoing repeat DCB angioplasty across 10 centers (2018-2023).
  • Primary endpoints included freedom from recurrent restenosis and freedom from re-target lesion revascularization (re-TLR).
  • Multivariate analysis was used to identify risk factors for restenosis.

Main Results:

  • Technical success rate was 94% with no bailout stenting.
  • 18-month freedom from restenosis and re-TLR were 66% and 74%, respectively.
  • Longer lesion length (>15 cm) and chronic total occlusion (CTO) were associated with recurrent restenosis.

Conclusions:

  • Repeat DCB angioplasty demonstrates acceptable durability at 18 months.
  • This approach is suitable as a first-line treatment for restenosis following initial DCB angioplasty.
  • Longer lesions and CTO are significant risk factors for restenosis.
Abstract

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