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Download Drug-coated balloon: A new device for peripheral vascular interventions
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Drug-coated balloon: A new device for peripheral vascular interventions Ruchi Patel MD, Joanne Ilustre DO, Selvin Sudhakar MD, Gary Ledley MD Drexel University College of Medicine: Department of Medicine, Division of Cardiology, Section of Interventional Cardiology Introduction Figures Patency following lower extremity peripheral interventions remains a challenge. Patency rates following plain old balloon angioplasty (POBA), bare metal (BMS) and drug eluting stents (DES) are reported in the range are 40%, 65% and 75% respectively. (1-3) Restenosis in DES is caused by inflammation of the vessel wall secondary to material left behind. The drug-coated balloons (DCB) are new FDA approved technology that avoid inflammation by leaving no hardware behind at the lesion site. Case Report A 63 year old woman with coronary artery disease and peripheral arterial disease presented with worsening claudication. Three years earlier she received overlapping BMS (6.0mmx100mm and 6.0mmx150mm) in her left superficial femoral artery (SFA). Angiography this time revealed diffuse severe instent restenosis (ISR). The lesion was treated with DCB angioplasty with an excellent result. POSTER TEMPLATE BY: www.PosterPresentations.com Discussion DCB offers homogeneous drug delivery into the endothelium and avoids inflammation to the vessel. The balloon is coated with the drug paclitaxel, which inhibits cell division, cell growth, and intimal hyperplasia. The Lutonix drug-coated balloon is the first such FDA approved device. Anatomically difficult lesions can be treated without the fear of jailing the branch vessel or causing stent fracture. Studies have shown the superiority of DCB over POBA in treating lesions as well as ISR in femoral artery. In such studies the 1 year patency rates are comparable to patency rates of DES. (4) Comparison of DES and DCB are still lacking. Nonetheless, with comparable patency rates to DES, DCB offer a very valuable tool in challenging lesions such as in the case mentioned above. References Figure 1 ISR of left SFA Figure 2 Left SFA after DCB angioplasty 1. Deloose K., Lauwers K., Callaert J., et al: Drug-eluting technologies in femoral artery lesions. J Cardiovasc Surg (Torino) 2013; 54: pp. 217-224. 2. Deloose K., Lauwers K., Callaert J., et al: Drug-eluting technologies in femoral artery lesions. J Cardiovasc Surg (Torino) 2013; 54: pp. 217-224. 3. Dake M.D., Ansel G.M., Jaff M.R., et al: Paclitaxel-eluting stents show superiority to balloon angioplasty and bare metal stents in femoropopliteal disease: twelvemonth Zilver PTX randomized study results. 4. Liistro F, etal. Paclitaxel-Eluting Balloon vs Standard Angioplasty to Reduce Recurrent Restenosis in Diabetic Patients with In-Stent Restenosis of the Superficial Femoral and Proximal Popliteal Arteries: the DEBATE-ISR study. J Endovasc Ther .2014;21:1-8.
