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Lesion calcification severity linked to late lumen loss after DEB therapy
After treatment with a drug-eluting balloon, severe lesion classification independently predicted late lumen loss at 6 months.
A retrospective study was performed to determine the association between patient, lesion and procedure variables, such as calcification, with late lumen loss (LLL) after DEB therapy in patients with femoropopliteal arterial disease. Ninety-one patients (mean age, 72 ± 8.62 years; 54.9% men) were enrolled and evaluated 6 months after DEB treatment.
Researchers reported lesions in the superficial femoral artery (n = 68) and popliteal artery (n = 23).
A core laboratory graded lesion calcification using two published scoring indices: the peripheral artery calcification scoring system and a calcium circumference and length grading system.
At 6 months, the median LLL was 0.2 mm (interquartile range, −0.5 to 1.14), which varied significantly across lesions with differing calcification severity (P = .042). However, calcium location — intimal, medial or mixed — or calcium length did not significantly affect LLL.
Additional data revealed the following predictors of LLL after DEB treatment: diabetes (P = .034); CAD (P = .024); and previous intervention of the target lesion (P = .013). Furthermore, after intervention, the severity of residual stenosis did not influence LLL during follow-up.
A possible approach to overcome the association between lesion calcification severity and LLL, the researchers wrote, might be plaque modification or removal before DEB usage.
“Nevertheless, clinical data that support this hypothesis are currently lacking,” they wrote. – by Brian Ellis
Disclosure: Two of the researchers report consulting and/or advisory board roles with Abbott, Biotronik, Boston Scientific, C.R. Bard, Cardiovascular Systems, Cook, Covidien, Johnson & Johnson Cordis, Medtronic, Medrad, Straub Medical and W.L. Gore & Associates.