The Journal of cardiovascular surgery · 2012
Standard balloon angioplasty versus angioplasty with paclitaxel-eluting balloons for femoropopliteal artery stenosis.
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Ju M H, Rodríguez H E
Аннотация
AIM: The aim of this article was to review the available literature on the use of drug-coated balloons (DCB) for endovascular treatment of femoropopliteal arterial stenosis.
METHODS: Manual searches of articles, presentations, and clinical trials were performed. Selected references were reviewed and summarized.
RESULTS: Due to the high morbidity associated with femoropopliteal bypass, endovascular approaches, such as balloon angioplasty and stent placement, have become the first line of therapy for isolated, de novo femoral atherosclerosis. However, percutaneous interventions have been limited by restenosis. In an effort to overcome this obstacle, the use of antiproproliferative drugs to inhibit hyperplasia has been attempted. The success of drug-eluting stents (DES) in the coronary circulation has not been reproduced in the femoropopliteal segment. Animal and human experiments have shown prolonged inhibition of intimal hyperplasia with single delivery of large doses of paclitaxel during balloon angioplasty. Recent randomized trials have shown significant advantages at 12 and 24 month angiographic follow-up with the use of DCB when compared to standard balloon angioplasty.
CONCLUSION: Several clinical trials have demonstrated promising early results with the use of DCB in treating femoropopliteal stenosis. However, long term results, exact indications, and optimal applications are yet to be determined.
METHODS: Manual searches of articles, presentations, and clinical trials were performed. Selected references were reviewed and summarized.
RESULTS: Due to the high morbidity associated with femoropopliteal bypass, endovascular approaches, such as balloon angioplasty and stent placement, have become the first line of therapy for isolated, de novo femoral atherosclerosis. However, percutaneous interventions have been limited by restenosis. In an effort to overcome this obstacle, the use of antiproproliferative drugs to inhibit hyperplasia has been attempted. The success of drug-eluting stents (DES) in the coronary circulation has not been reproduced in the femoropopliteal segment. Animal and human experiments have shown prolonged inhibition of intimal hyperplasia with single delivery of large doses of paclitaxel during balloon angioplasty. Recent randomized trials have shown significant advantages at 12 and 24 month angiographic follow-up with the use of DCB when compared to standard balloon angioplasty.
CONCLUSION: Several clinical trials have demonstrated promising early results with the use of DCB in treating femoropopliteal stenosis. However, long term results, exact indications, and optimal applications are yet to be determined.