Durability of Infra Popliteal Arteries Angioplasty: Paclitaxel- Coated Balloons Versus Percutaneous Transluminal | ||||
| The Egyptian Journal of Surgery | ||||
| Volume 44, Issue 2, April 2025, Page 631-637 PDF (511.39 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2024.328524.1238 | ||||
 View on SCiNiTO | ||||
| Author | ||||
Mohamed A. Elbahat 
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| Department of Vascular and Endovascular, Shebin Elkoom Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Menofia, Egypt | ||||
| Abstract | ||||
| Background: Chronic limb-threatening ischemia affects below-the-knee (BTK) arteries, with endovascular procedures like percutaneous transluminal angioplasty (PTA) being preferred due to high surgical risks. Paclitaxel drug-coated balloons (DCBs) usage for BTK lesions is expanding, although concerns about their long-term safety and effectiveness persist. Objective: Comparing paclitaxel-coated balloons durability versus conventional PTA in infrapopliteal angioplasty, focusing on clinical outcomes, patency rates, and the incidence of restenosis over an extended follow-up period. Patients and Methods: Patients with critical limb ischemia (Rutherford class 4 to 6) and chronic total occlusions in the BTK arteries were enrolled. They were divided into two groups: DCB angioplasty and standard PTA. Follow-ups at 1, 6, 9, and 12 months assessed primary effectiveness by late lumen loss at 9 months. Results: A study comprising 50 participants, evenly split between DCB and PTA groups (25 each), revealed several significant findings. The DCB group indicated significantly reduced late lumen loss compared with the PTA group (0.7820.675± vs. 1.4500.610± mm, P=0.003). Additionally, the DCB group exhibited superior minimum lumen diameter (1.0620.810± vs. 0.6120.568± mm, P=0.030) and greater acute lumen gain (1.9200.510± vs. 1.5300.470± mm, P=0.045). Primary patency rates were significantly greater in the DCB group at 80.0 versus 60.0% in the PTA group (P=0.048). While the composite safety endpoint was achieved in 92.0% of DCB patients compared with 88.0% of PTA patients (P=0.754), there were no significant differences in major adverse events between the two groups. Conclusion: Paclitaxel-coated balloons in infrapopliteal angioplasty yield better primary patency and reduced late lumen loss compared with conventional PTA, with comparable safety outcomes. The results endorse the DCBs usage as an effective treatment option for patients with intricate BTK lesions. | ||||
| Keywords | ||||
| Angioplasty; below-the-knee (BTK); chronic limb-threatening ischemia (CLTI); drug-coated balloons (DCBs); endovascular procedures | ||||
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