Drug-eluting balloon for treatment of superficial femoral artery in-stent restenosis

Eugenio Stabile, Vittorio Virga, Luigi Salemme, Angelo Cioppa, Vittorio Ambrosini, Giovanni Sorropago, Tullio Tesorio, Linda Cota, Grigore Popusoi, Armando Pucciarelli, Giancarlo Biamino, Paolo Rubino, Eugenio Stabile, Vittorio Virga, Luigi Salemme, Angelo Cioppa, Vittorio Ambrosini, Giovanni Sorropago, Tullio Tesorio, Linda Cota, Grigore Popusoi, Armando Pucciarelli, Giancarlo Biamino, Paolo Rubino

Abstract

Objectives: The purpose of this prospective registry was to evaluate the safety and efficacy, at 1 year, of the use of drug-eluting balloons (DEB) for the treatment of superficial femoral artery (SFA) in-stent restenosis (ISR).

Background: The use of the self-expanding nitinol stent has improved the patency rate of SFA after percutaneous transluminal angioplasty (PTA). As the population with SFA stenting continues to increase, occurrence of ISR has become a serious problem. The use of DEB has showed promising results in reducing restenosis recurrence in coronary stents.

Methods: From December 2009 to December 2010, 39 consecutive patients underwent PTA of SFA-ISR in our institution. All patients underwent conventional SFA PTA and final post-dilation with paclitaxel-eluting balloons (IN.PACT, Medtronic, Minneapolis, Minnesota). Patients were evaluated up to 12 months.

Results: Technical and procedural success was achieved in every patient. No in-hospital major adverse cardiac and cerebrovascular events occurred. At 1 year, 1 patient died due to heart failure. Primary endpoint, primary patency rate at 12 months, was obtained in 92.1% (35 patients). At 1 year, patients were asymptomatic for claudication, and duplex assessment demonstrated lack of recurrent restenosis (100% rate of Secondary patency). The presence of an occlusive restenosis at the time of treatment was not associated with an increased restenosis rate, when compared with non-occlusive restenosis, at 1 year.

Conclusions: The data suggest that adjunctive use of DEB for the treatment of SFA-ISR represents a potentially safe and effective therapeutic strategy. These data should be considered hypothesis-generating to design a randomized trial.

Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Source: PubMed

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