Drug-Eluting Balloons for the Treatment of the Superficial Femoral Artery In-Stent Restenosis

Virga, Vittorio; Stabile, Eugenio; Biamino, Giancarlo; Salemme, Luigi; Cioppa, Angelo; Giugliano, Giuseppe; Tesorio, Tullio; Cota, Linda; Popusoi, Grigore; Pucciarelli, Armando; Esposito, Giovanni; Trimarco, Bruno; Rubino, Paolo

doi:10.1016/j.jcin.2013.11.020

Cited by 73 publications

(44 citation statements)

References 12 publications

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“…First results were published from a small prospective registry of 39 consecutive patients treated with the In.Pact DCB for femoral in stent stenosis. Primary patency was 92.1 % and 70.3 % after one and two years, respectively [28,29]. Similar results have been presented for the In.Pact Global study with 113 patients treated with the In.Pact DCB for in stent stenosis (Table III).…”

Section: Drug-coated Balloons For the Treatment Of In-stent Stenosissupporting

confidence: 82%

Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease

Werner

2016

Vasa

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Restenosis is considered a local manifestation of the biologic response to vascular injury, characterised by infl ammation and cell proliferation [12]. In-stent restenosis is entirely caused by smooth muscle cell proliferation. After migration from the media into the intima, smooth muscle cells form the neointima, causing arterial reobstruction. Mechanisms responsible for restenosis after PTA are mainly the negative remodelling of the vessel (increased colla- Review Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease Martin WernerHanusch-Krankenhaus, Vienna, Austria Summary: Restenosis or re-occlusion after femoropopliteal angioplasty or stent implantation is the main limitation of endovascular treatment strategies for peripheral artery disease. Within the last years, balloon catheters with anti-proliferative drug coating on the balloon surface have shown to be associated with higher patency rates compared to plain balloon angioplasty. Thus, drug-coated balloons were gradually adopted in many interventional centres for the treatment of femoropopliteal obstructions. The current review summarises the existing evidence for drugcoated balloons in the infrainguinal vessels and their indication in special lesion cohorts.

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Section: Drug-coated Balloons For the Treatment Of In-stent Stenosissupporting

confidence: 82%

Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease

Werner

2016

Vasa

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“…The majority of previously assessed data on SFA ISR treatment have not been convincing. Results have been derived from single-arm observations (DCBA 12,13 ), historical comparisons (DCBA versus POBA 14 ), subgroup analyses (drug-eluting stent 18 ), studies on specific lesions (chronic total occluded ISR 19 ), and initial experiments (cutting balloon versus POBA 17 ). In some cases, high rates of bailout stenting (10% 13 and 15.9% 14 ) or additional laser mediated debulking (10% 13 ) weaken the significance of the findings.…”

Section: Discussionmentioning

confidence: 99%

“…11 However, for superficial femoral artery (SFA) ISR, currently available data are poor. In a small, prospective registry of DCBA for SFA ISR, 12,13 recurrent restenosis rates were 7.9% (4 of 39) and 29.7% (11 of 37) at 12 and 24 months, respectively. For diabetic patients, Liistro et al 14 reported significantly lower recurrent ISR rates at 12 months after DCBA compared with a historical POBA group (19.5% [8 of 41] …”

Section: Editorial See P 2198 Clinical Perspective On P 2236mentioning

confidence: 99%

Drug-Coated Balloon Versus Standard Balloon for Superficial Femoral Artery In-Stent Restenosis

et al. 2015

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Background-Drug-coated balloon angioplasty (DCBA) was shown to be superior to standard balloon angioplasty (POBA) in terms of restenosis prevention for de novo superficial femoral artery disease. For in-stent restenosis, the benefit of DCBA over POBA remains uncertain. Methods and Results-One hundred nineteen patients with superficial femoral artery in-stent restenosis and chronic limb ischemia were recruited over 34 months at 5 German clinical sites and prospectively randomized to either DCBA (n=62) or POBA (n=57

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“…62 A similar catch-up phenomenon has also been described after DCB angioplasty to treat ISR after SFA stenting. 63 Cautious optimism is needed to temper the enthusiasm associated with this technology. Potentially revolutionary, DCB could greatly extend the spectrum of disease treatable by increasing endovascular options for disease over joints, bifurcations, or long segments of disease in small vessels.…”

Section: Drug-coated Balloonsmentioning

confidence: 99%

Endovascular Intervention for Peripheral Artery Disease

Thukkani

Kinlay

2015

Circulation Research

215

158

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Advances in endovascular therapies during the past decade have broadened the options for treating peripheral vascular disease percutaneously. Endovascular treatment offers a lower risk alternative to open surgery in many patients with multiple comorbidities. Noninvasive physiological tests and arterial imaging precede an endovascular intervention and help localize the disease and plan the procedure. The timing and need for revascularization are broadly related to the 3 main clinical presentations of claudication, critical limb ischemia, and acute limb ischemia. Many patients with claudication can be treated by exercise and medical therapy. Endovascular procedures are considered when these fail to improve quality of life and function. In contrast, critical limb ischemia and acute limb ischemia threaten the limb and require more urgent revascularization. In general, endovascular treatments have greater long-term durability for aortoiliac disease than femoral popliteal disease. Infrapopliteal revascularization is generally reserved for critical and acute limb ischemia. Balloon angioplasty and stenting are the mainstays of endovascular therapy. New well-tested innovations include drug-eluting stents and drug-coated balloons. Adjunctive devices for crossing chronic total occlusions or debulking plaque with atherectomy are less rigorously studied and have niche roles. Patients receiving endovascular procedures need a structured surveillance plan for follow-up care. This includes intensive treatment of cardiovascular risk factors to prevent myocardial infarction and stroke, which are the main causes of death. Limb surveillance aims to identify restenosis and new disease beyond the intervened segments, both of which may jeopardize patency and lead to recurrent symptoms, functional impairment, or a threatened limb.

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Drug-Eluting Balloons for the Treatment of the Superficial Femoral Artery In-Stent Restenosis

Abstract: The data suggest that adjunctive use of DEBs for the treatment of SFA ISR is a safe and effective therapeutic strategy up to 2 years of follow-up.

Cited by 73 publications

References 12 publications

Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease

Angioplasty with drug coated balloons for the treatment of infrainguinal peripheral artery disease

Drug-Coated Balloon Versus Standard Balloon for Superficial Femoral Artery In-Stent Restenosis

Endovascular Intervention for Peripheral Artery Disease

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