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VIDEO: Expert discusses algorithmic approach to SFA intervention
HOLLYWOOD, Fla. — In this video, Gary M. Ansel, MD, interventional cardiologist at OhioHealth Heart and Vascular Physicians, presents a look at the interventions that are currently available for treatment of patients with superficial femoral artery disease and an algorithm that can help physicians determine which patient should receive which treatment.
Ansel said there are “good data” on treatment options for short to moderate lesions — including up to 5 years for drug-eluting stents and 2 years for drug-coated balloons — but a lack of data on longer lesions.
For patients with little calcification, he said his institution performs a predilation balloon angioplasty, and then uses DCB with a good result and DES with a bad one. If the patient has a long lesion, a stent graft may be considered.
For patients with more heavily calcified lesions, the available data conflict on whether DCB has increased efficacy, so the preferred method may be predilation to increase mean lumen diameter followed by implantation of a nitinol woven stent (Supera, Abbott Vascular), for which there are good 3-year data, he said.
Until there are more head-to-head studies of the technologies, “we have a pretty cost-effective algorithm that is data-based,” Ansel concluded.