Author + information
- Sho Torii,
- Hiroyoshi Mori,
- Brandt Young,
- John Brumleve,
- Aloke Finn and
- Renu Virmani
Background: Drug eluting stent (DES) and drug coated balloon (DCB) angioplasty have each shown promising results for femoropopliteal peripheral artery disease (FPAD). Provisional stenting is utilized in 30–40% of patients undergoing DCB, mainly due to flow limiting dissection and refractory stenosis. However, the safety and efficacy of DES implantation following DCB has not been determined.
Methods: In a healthy swine (HS) model Zilver PTX DES (ZPTX) implantation following IN.PACT DCB or POBA (DCB/ZPTX or POBA/ZPTX) was assessed in the iliofemoral arteries of 12 HS, with sacrifice at 30 and 90 days. Histologic analysis of arterial wall and downstream skeletal muscle and coronary band was performed.
Results: No significant differences were observed in any of the measurements except for the presence of a slightly higher neointimal fibrin score at 90 days in DCB/ZPTX vs. POBA/ZPTX (0.9 [IQR 0.8–1.0] vs. 1.2 [IQR 1.0–1.5], p=0.02); however, % uncovered struts (see Table) were not significantly different. A percentage of sections and arterioles exhibiting paclitaxel-associated fibrinoid necrosis in downstream tissues were only observed in the DCB/ZPTX arm at 30 days [14.3% (0.0–32.2)] and 90 days [11.6% (0.0–15.4)]. Therefore, Zilver PTX safety following DCB usage has been established.
Conclusions: Provisional Zilver PTX stent implantation should be a safe and effective strategy if angiographic results are unsatisfactory following DCB usage for FPAD.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Head to Toe: Outcomes of Endovascular Interventions
Abstract Category: 18. Interventional Cardiology: Carotid and Endovascular Intervention
Presentation Number: 1112-122
- 2017 American College of Cardiology Foundation