Drug-Eluting Balloons and Drug-Eluting Stents in the Treatment of Peripheral Vascular Disease

Lindquist, J.; Schramm, Kristofer

doi:10.1055/s-0038-1676360

Cited by 19 publications

(31 citation statements)

References 80 publications

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“…While the routine use of DEB in the femoropopliteal current path is based on a meaningful evidence situation with now 5 multicenter RCT studies from previous years, DES implantation is based on only one signi icantly positive RCT and registry study [34]. The long-term results of the 48-month Zilver PTX study [35,36] with a persistently signi icantly better patency rate than in the BMS group, even in long lesions, must be veri ied by a longer observation period.…”

Section: Discussionmentioning

confidence: 99%

Long-term results for post-interventional systemic heparinization following angioplasty of peripheral vessels

Mirzaie¹,

Guliyev²,

Dakna³

2020

J Cardiol Cardiovasc Med

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Objective: The long-term outcome of percutaneous transluminal angioplasties is mainly determined by restenoses, either by progression of the underlying disease or by intimal hyperplasia. Pharmacological substances on the one hand and the implantation of stents on the other have been developed with the intention of preventing precisely this complication. While patients are treated after PTA of peripheral vessels with diff erent low-molecular-weight heparins, the indication for stent implantation is determined individually rather by experience. The aim of this study was to determine gender-specifi c risk factors of long-term outcome after percutaneous transluminal angioplasty (PTA) of peripheral vessels with or without stentimplantation. Methods: In the present study, we examined the long-term results of percutaneous transluminal angioplasty (PTA) of peripheral vessels. Between 2007 and 2017, in total, 3,276 patients underwent PTA with or without stent implantation in our clinic. All patients were treated postinterventionally for 48 hours with 25,000 IU heparin (Unfractionated Heparin (UFH), heparinsodium-Braun, 25,000 I.E./5 ml, 2 ml/h) monitored by the partial thromboplastin time and subsequently underwent a control investigation every 6 months. The endpoint of the study was determination of symptomatic stenosis larger than 50% that required reintervention. Results: 239 (68.2% with mean age 68.02 years) male patients and 111 female patients (31.71% with mean age 62.92 years) were evaluated with complete follow-up. A total of 470 PTAs were performed on male patients and 213 on female patients in multiple interventions. The majority of patients at the time of treatment were in stage IIb according to the classifi cation of Fontaine (81.6% of male patients and 68% of females). In our sample, peripheral arterial disease stage III and IV according to Fontaine classifi cation occurred twice as frequently in female patients as in male patients (stage III in 12.6% in female versus 6.1% in male, and stage IV in 18% in female versus 8.9% in males). In both groups, the femoral superfi cialis artery was most frequently dilated (64 cases, 30% in female and 155 cases, 32.9% in male), followed by the iliacal communis artery (46 cases in female and 99 cases in male, both with 21.5%). A balloon angioplasty of the tibialis anterior and posterior arteries was performed twice as frequently in female patients as in male patients (28 cases with 13.1% of tibialis ant. artery in female versus 32 cases with 6.8% in male patients, and in 17 cases with 7.9% of tibialis post. artery in female versus 16 cases with 3.4% in male patients). In this study, without consideration of gender, patency rates of 79% after 2.5 years, 67% after 5 years, 49% after 7.5 years and 37% after 10 years were determined for PTA without stent implantation. Between the 7th and 10th year in follow-up, the cumulative patency rates for stent implantation was 49%, whereas it was 31% for PTA alone. The results of this study show that the stent assisted PTA`s of comm. art...

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Section: Discussionmentioning

confidence: 99%

Long-term results for post-interventional systemic heparinization following angioplasty of peripheral vessels

Mirzaie¹,

Guliyev²,

Dakna³

2020

J Cardiol Cardiovasc Med

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“…performing a double contraction with m i ⊗ m i , and remembering that I coll,i 2 , we obtain the following expression for _ l…”

Section: By Projecting Equation (215) Onto the Current Fibre Directionmentioning

confidence: 99%

“…Arterial smooth muscle cells (SMCs) in the media dedifferentiate into their synthetic phenotype, while becoming more proliferative and migratory, causing a significant thickening of the intima, called neointimal hyperplasia [1]. Reported restenosis rates range from less than 5% up to 50% in the first year, depending on the artery treated and the nature of the treatment [2]. The different treatment approaches include percutaneous transluminal angioplasty or the use of bare metal stents, drug-eluting stents or drug-eluting balloons.…”

Section: Introductionmentioning

confidence: 99%

“…The different treatment approaches include percutaneous transluminal angioplasty or the use of bare metal stents, drug-eluting stents or drug-eluting balloons. Drug-eluting stents show improved results [2,3]. Also the effectiveness of the use of drug-coated balloons has been shown, targeting a decreased cell proliferation, for example, in the treatment of femoropopliteal occlusive disease [4].…”

Section: Introductionmentioning

confidence: 99%

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A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty

Maes

Cloet

Fourneau

et al. 2021

J. R. Soc. Interface.

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Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model’s clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.

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“…They have been shown to reduce late lumen loss, binary restenosis, and target lesion revascularization (TLR) in the treatment of femoropopliteal disease, compared to conventional angioplasty (5). Majority of DCBs use a paclitaxel-based platform (PCB) and paclitaxel reduces late restenosis by exerting antiproliferative effects to inhibit NIH (6). However, during DCB application, more than 50% of the drug is lost downstream, a phenomenon termed particulate embolization (7).…”

Section: Introductionmentioning

confidence: 99%

Slow-flow phenomena following lower limb paclitaxel- and sirolimus-coated balloon angioplasty in the setting of chronic limb threatening ischaemia—a case series

Tang¹,

Sulaiman²,

Soon³

et al. 2022

Quant Imaging Med Surg

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Drug-Eluting Balloons and Drug-Eluting Stents in the Treatment of Peripheral Vascular Disease

Cited by 19 publications

References 80 publications

Long-term results for post-interventional systemic heparinization following angioplasty of peripheral vessels

Long-term results for post-interventional systemic heparinization following angioplasty of peripheral vessels

A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty

Slow-flow phenomena following lower limb paclitaxel- and sirolimus-coated balloon angioplasty in the setting of chronic limb threatening ischaemia—a case series

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