Meta-Analysis Supports Use of Drug-Eluting Technologies to Treat Infrainguinal PAD

April 1, 2015—Findings from a meta-analysis of randomized controlled trials (RCTs) of drug-eluting balloon (DEB) angioplasty and drug-eluting stents (DESs) for infrainguinal peripheral arterial disease (PAD) were published by Mark Otto Baerlocher, MD, in the Journal of Vascular and Interventional Radiology (JVIR; 2015;26:459–473). Systematic searches were performed for all relevant RCTs.

The investigators found that DEB angioplasty and DESs demonstrated superior outcomes compared to percutaneous transluminal angioplasty and bare-metal stents (BMSs), with no difference in amputation or mortality.

As summarized in JVIR, eight RCTs for DEB angioplasty and 12 RCTs for DES treatment in PAD were identified. The meta-analysis demonstrated statistically significant superiority of DEB over plain balloon angioplasty of femoral-popliteal disease for late lumen loss, restenosis, and target lesion revascularization, with no benefit in major amputation or mortality.

Statistically significant superiority of DEB over percutaneous transluminal angioplasty was demonstrated for infrapopliteal disease for restenosis and target lesion revascularization. DESs showed statistically significant superiority over BMSs to treat femoral-popliteal disease for late lumen loss and restenosis, with no benefit in mortality or amputation.

Additionally, DESs showed statistically significant superiority over BMSs of infrapopliteal disease restenosis and target lesion revascularization, with no benefit in amputation or mortality, reported the investigators in JVIR.