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RATIONALE: Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery "de novo" lesions. METHODS: A retrospective analysis was performed and included all consecutive patients who underwent endovascular treatment for CLI in our centers between January 2011 and March 2013. Inclusion criteria were (1) "de novo" tibial artery stenosis and (2) Rutherford class >4. Lesions were further divided by TransAtlantic Inter-Societal Consensus (TASC) classification into groups A, B, C, and D. RESULTS: Between January 2010 and March 2013, a total of 138 patients underwent simple PTA or DEB for CLI, and the groups were clinically and demographically homogenous. We decided to use DEBs in 70 cases. An improvement in the Rutherford Scale in cumulative and single TASC lesions classification was better in the DEB group (74% vs 51%; P = .024) at 24 months than in the PTA group. In the DEB group, the increase in ankle-brachial index was significantly higher than in the PTA group (P = .039). CONCLUSIONS: Our experience in addition to the existing literature supports the use of DEB in patients with CLI Rutherford class >3.

Original publication

DOI

10.1177/1538574416647500

Type

Journal article

Journal

Vasc Endovascular Surg

Publication Date

07/2016

Volume

50

Pages

304 - 308

Keywords

drug-eluting balloon, intimal hyperplasia, restenosis, Aged, Amputation, Angioplasty, Balloon, Ankle Brachial Index, Cardiovascular Agents, Coated Materials, Biocompatible, Equipment Design, Europe, Female, Humans, Hyperplasia, Ischemia, Limb Salvage, Lower Extremity, Male, Middle Aged, Neointima, Peripheral Arterial Disease, Recurrence, Retrospective Studies, Tibial Arteries, Time Factors, Treatment Outcome, Vascular Access Devices