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DCBs effective in popliteal arteries
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Drug-coated balloon angioplasty in popliteal arteries produced results that were “acceptable compared with previous studies,” researchers reported.
“Compared with the superficial femoral artery (SFA), the [popliteal artery] is under particularly pronounced mechanical stress, including shortening and lengthening, compression, bending, and torsion, making it susceptible to increased rates of stent fracture and reocclusion,” Tomoharu Dohi, MD, from the department of cardiovascular medicine at Osaka University Graduate School of Medicine, Suita, Japan, and colleagues wrote in the study background. “Several pivotal studies using DCBs have supported their use for treating atherosclerotic lesions of the femoropopliteal arteries. All these studies, however, focused on the SFA and on shorter diseased segments. The efficacy of DCB angioplasty in longer segments with popliteal involvement and in isolated popliteal lesions has not been definitively established.”
Dohi and colleagues conducted a retrospective analysis of 266 patients (mean age, 72 years; 62% men) who had 281 de novo lesions including the popliteal artery (median length, 270 mm) treated with a DCB at a single center between December 2011 and January 2015. DCBs used included IN.PACT Admiral and IN.PACT Pacific (Medtronic), Lutonix (C.R. Bard) and Freeway (Eurocor).
Outcomes of interest were primary patency and predictors of restenosis.
At a median follow-up of 12.2 months, primary patency was 77.4% (95% CI, 71.4-83.9), according to the researchers. Estimated freedom from target lesion revascularization was 84.1% (95% CI, 79.4-89.1).
The researchers identified the following variables as independent predictors of restenosis:
- Baseline Rutherford category (HR = 1.36; 95% CI, 1.05-1.77);
- Reference vessel diameter (HR = 0.77; 95% CI, 0.63-0.95);
- Dissection (HR = 1.69; 95% CI, 1.02-2.79); and
- Standard nitinol stent use (HR = 2.08; 95% CI, 1.14-3.79).
“This retrospective study demonstrated that DCB angioplasty for patients with lesions including or confined to the [popliteal artery] provided favorable outcomes,” Dohi and colleagues wrote. “The role of some specific factors including the optimal strategy for flow-limiting dissections and choice of stents after DCB angioplasty need to be examined in future studies.” – by Erik Swain
Disclosure: Dohi reports no relevant financial disclosures. Please see the study for a list of the other authors’ relevant financial disclosures.
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