DCB Therapy Studied for Femoropopliteal Occlusive Disease

August 11, 2015—Gunnar Tepe, MD, et al published findings from an analysis of the association of patient, lesion, and procedure variables, including calcification, with late lumen loss (LLL) after drug-coated balloon (DCB) therapy in patients with femoropopliteal arterial disease. The study is available online ahead of print in the Journal of Endovascular Therapy (JEVT).

The investigators concluded that the severity of lesion calcification is associated with LLL after treatment with DCB. They advised that one possible approach to overcome this limitation might be plaque modification or removal before DCB usage; however, clinical data to support this hypothesis are currently lacking.

As summarized in the JEVT, the investigators retrospectively analyzed 91 patients (mean age 72 ± 8.62 years; 50 men) at 6 months after DCB treatment. Lesions were located in the superficial femoral artery (n = 68) and popliteal artery (n = 23). Lesion calcification was graded by a core laboratory using two published scoring indexes: the peripheral artery calcification scoring system and a grading system based on circumference (arc) and length of calcium. 

The median LLL after 6 months was 0.2 mm overall and varied significantly across lesions with differing severity of calcification. However, LLL did not differ based on calcium location (intimal, medial, or mixed) or calcium length. Additional predictors of LLL after DCB treatment included diabetes, coronary artery disease, and previous intervention. Notably, the severity of residual stenosis after the intervention did not have any impact on the LLL during follow-up (Spearman r = −.238), reported the investigators in JEVT.