Comparison of IVUS-Guided vs. Angiography-Guided Angioplasty for the Outcomes of Drug-Coated Balloon in the Treatment of Femoropopliteal Artery Disease - IVUS-DCB

Contribution To Literature:

The IVUS-DCB trial showed that IVUS-guided drug-coated balloon angioplasty improves primary patency.

Description:

The goal of the trial was to evaluate intravascular ultrasound (IVUS)-guided drug-coated balloon angioplasty compared with angiography-guided drug-coated balloon angioplasty among patients with femoropopliteal artery disease.

Study Design

  • Randomized
  • Parallel
  • Blinded

Patients with symptomatic femoropopliteal artery disease were randomized to IVUS-guided drug-coated balloon angioplasty (n = 119) vs. angiography-guided drug-coated balloon angioplasty (n = 118).

  • Total number of enrollees: 237
  • Duration of follow-up: 12 months
  • Mean patient age: 69 years
  • Percentage female: 14%
  • Percentage with diabetes: 60%

Inclusion criteria:

  • Symptomatic femoropopliteal artery disease
  • Rutherford category 2-5

Principal Findings:

The primary outcome (primary patency) at 12 months was 83.8% in the IVUS-guided group vs. 70.1% in the angiography-guided group (p = 0.01). Among TASC A/B lesions, there was no difference between treatment strategies (p = 0.52); however, in TASC C/D lesions, there was a significant benefit favoring IVUS-guided drug-coated balloon angioplasty (p = 0.002).

Interpretation:

Among patients with symptomatic femoropopliteal artery disease, IVUS-guided drug-coated balloon angioplasty was associated with an improvement in primary patency compared with angiography-guided drug-coated balloon angioplasty. Benefit was especially evident among complex lesions.

References:

Presented by Dr. Young-Guk Ko at the American College of Cardiology Annual Scientific Session (ACC.24), Atlanta, GA, April 8, 2024.

Clinical Topics: Vascular Medicine

Keywords: ACC24, ACC Annual Scientific Session, Vascular Diseases


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