Evidence for treatment of lower limb in-stent restenosis with drug eluting balloons

Li, Brian H; Chan, Yiu Che; Cheng, Stephen W.K.

doi:10.23736/s0021-9509.20.07968-9

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…The new treatments for PAD have considerably simplified the post-operative course compared to the open surgery approach, but a significant increase in ISR has been observed in recent years and is forecasted in the next years considering the number of procedures performed in each center [ 2 , 4 , 5 , 26 , 60 , 61 ]. Despite reducing the impact for the patient, PTA is giving very poor results in terms of long-term patency and TLR, and DCB is a new technique which is performing adequately in ISR.…”

Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Circulating Biomarkers and Role of Drug-Coated Balloons for In-Stent Restenosis in Patients with Peripheral Arterial Disease

et al. 2022

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Peripheral arterial disease (PAD) is an increasingly pathological condition that commonly affects the femoropopliteal arteries. The current fashionable treatment is percutaneous transluminal angioplasty (PTA), often with stenting. However, the in-stent restenosis (ISR) rate after the stenting of the femoropopliteal (FP) district remains high. Many techniques have been proposed for the treatment of femoropopliteal ISR, such as intravascular brachytherapy, laser atherectomy, second stenting and drug-coated balloons angioplasty (DCB). DCB showed a significantly lower rate of restenosis and target lesions revascularization (TLR) compared to conventional PTA. However, further studies and multi-center RCTs with dedicated long-term follow-up are needed to verify the true efficiency of this approach. Nowadays, the correlation between PAD and inflammation biomarkers is well known. Multiple studies have shown that proinflammatory markers (such as C-reactive proteins) and the high plasma levels of microRNA could predict the outcomes after stent placement. In particular, circulating microRNA-320a, microRNA-3937, microRNA-642a-3p and microRNA-572 appear to hold promise in diagnosing ISR in patients with PAD, but also as predictors of stent patency. This narrative review intends to summarize the current knowledge on the value of circulating biomarkers as predictors of ISR and to foster the scientific debate on the advantages of using DCB in the treatment of ISR in the FP district.

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Section: Discussionmentioning

confidence: 99%

The Diagnostic Value of Circulating Biomarkers and Role of Drug-Coated Balloons for In-Stent Restenosis in Patients with Peripheral Arterial Disease

et al. 2022

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“…[7][8][9][10] Nonetheless, it is still controversial which endovascular treatment approach will contribute to the most efficient treatment outcome clinically. 11 Therefore, we performed a network meta-analysis (NWM) comparing the efficacy of treatment modalities…”

Section: Introductionmentioning

confidence: 99%

“…7–10 Nonetheless, it is still controversial which endovascular treatment approach will contribute to the most efficient treatment outcome clinically. 11 Therefore, we performed a network meta-analysis (NWM) comparing the efficacy of treatment modalities concerning primary patency, target lesion revascularization (TLR), technical success, and major amputations for femoropopliteal ISR disease.…”

Section: Introductionmentioning

confidence: 99%

The safety and efficacy of different endovascular treatments for in-stent restenosis of the femoropopliteal artery: A network meta-analysis

Wang

Lin

et al. 2022

Vasc Med

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Purpose: Femoropopliteal artery in-stent restenosis (ISR) remains a challenging treatment. We performed a network meta-analysis (NWM) for femoropopliteal artery ISR to explore the safety and efficacy of endovascular therapeutic strategies. Methods: The MEDLINE, Embase, Web of Science, and Cochrane databases were used as data sources. The network meta-analysis (NWM) approach used random-effects models based on the frequentist framework. We compared technical success rate, primary patency, target lesion revascularization (TLR), and major amputation at the 12-month follow-up for femoropopliteal artery ISR. Results: In total, 14 eligible studies (10 prospective and four retrospective; 1348 patients; and eight treatment modalities – standard balloon angioplasty (SBA), drug-coated balloon (DCB), peripheral cutting balloon angioplasty (PCBA), Viabahn endoprosthesis (VBE), directional atherectomy (DA), excimer laser atherectomy (ELA), and combinations – were included. The primary patency rates (at 6 months) were significantly higher for DCB and ELA+DCB than for SBA and ELA+SBA. ELA+DCB had higher primary patency rates (at 12 months) than ELA+SBA and SBA. The technical success rates were significantly lower for DCB and SBA than for VBE. The major amputation rates were significantly lower for ELA+DCB than for DCB. Based on the surface values under the cumulative ranking curve (SUCRA), ELA+DCB was considered the best treatment in terms of primary patency at 6 months (SUCRA = 91.1), primary patency at 12 months (SUCRA = 82.3), and TLR (SUCRA = 83.4). Conclusion: ELA+DCB showed positive encouraging results in primary patency (6, 12 months), TLR, and major amputation in femoropopliteal ISR. The efficacy and safety of ELA+DCB are worthy of further investigation. (PROSPERO Registration No.: CRD42021246674)

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Evidence for treatment of lower limb in-stent restenosis with drug eluting balloons

Cited by 2 publications

References 10 publications

The Diagnostic Value of Circulating Biomarkers and Role of Drug-Coated Balloons for In-Stent Restenosis in Patients with Peripheral Arterial Disease

The Diagnostic Value of Circulating Biomarkers and Role of Drug-Coated Balloons for In-Stent Restenosis in Patients with Peripheral Arterial Disease

The safety and efficacy of different endovascular treatments for in-stent restenosis of the femoropopliteal artery: A network meta-analysis

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