Recent trials indicate cryoplasty does not offer outcomes superior to balloon angioplasty
Unfavorable cost-benefit
Possibly higher restenosis rates
Drug-eluting balloon angioplasty: Balloon coated with medication (e.g., paclitaxel)
Delivers antiproliferative drug to vessel surface
Local drug application to vessel surface to prevent restenosis without placing stent
High drug concentration reduces neointimal proliferation even with short time exposure
Investigational device with ongoing trials
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
Naghi J et al: New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease. Med Devices (Auckl). 9:161-74, 2016
Diehm NA et al: Drug eluting balloons. Tech Vasc Interv Radiol. 13(1):59-63, 2010
Banerjee S et al: Atheroemboli during peripheral arterial interventions. J Invasive Cardiol. 21(12):632-3, 2009
Bosiers M et al: Use of the AngioSculpt scoring balloon for infrapopliteal lesions in patients with critical limb ischemia: 1-year outcome. Vascular. 17(1):29-35, 2009
Conrad MF et al: Infrapopliteal balloon angioplasty for the treatment of chronic occlusive disease. J Vasc Surg. 50(4):799-805, 2009
Das TS et al: Primary cryoplasty therapy provides durable support for limb salvage in critical limb ischemia patients with infrapopliteal lesions: 12-month follow-up results from the BTK Chill Trial. J Endovasc Ther. 16(2 Suppl 2):II19-30, 2009
Laird JR et al: The role for cryoplasty in the treatment of infrainguinal artery disease: case studies. J Endovasc Ther. 16(2 Suppl 2):II116-28, 2009
Shammas NW: Restenosis after lower extremity interventions: current status and future directions. J Endovasc Ther. 16 Suppl 1:I170-82, 2009
Siablis D: Atheroembolization and peripheral vascular interventions: the evidence is mounting. J Endovasc Ther. 16(2):203-5, 2009
Wilson AM et al: Randomized controlled trial of aspirin and clopidogrel versus aspirin and placebo on markers of smooth muscle proliferation before and after peripheral angioplasty. J Vasc Surg. 50(4):861-9, 2009
Bosiers M et al: Present and future of endovascular SFA treatment: stents, stent-grafts, drug coated balloons and drug coated stents. J Cardiovasc Surg (Torino). 49(2):159-65, 2008
Fonseca A et al: Intravascular ultrasound assessment of the novel AngioSculpt scoring balloon catheter for the treatment of complex coronary lesions. J Invasive Cardiol. 20(1):21-7, 2008
Werk M et al: Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008 Sep 23;118(13):1358-65. Epub 2008 Sep 8. Erratum in: Circulation. 118(16):e670, 2008
Scheinert D et al: Results of the multicenter first-in-man study of a novel scoring balloon catheter for the treatment of infra-popliteal peripheral arterial disease. Catheter Cardiovasc Interv. 70(7):1034-9, 2007
Laird JR et al: Cryoplasty for the treatment of femoropopliteal arterial disease: extended follow-up results. J Endovasc Ther. 13 Suppl 2:II52-9, 2006
Related Anatomy
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Related Differential Diagnoses
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References
Tables
Tables
KEY FACTS
Terminology
Procedure
Post Procedure
Outcomes
TERMINOLOGY
Definitions
Percutaneous transluminal angioplasty (PTA): Inflation of catheter-mounted balloon within narrowed vascular structure to enlarge luminal diameter, improve flow hemodynamics
Arterial angioplasty: Primary mechanism is controlled fracture of obstructing atherosclerotic plaque
Desquamation of endothelial cells
Causes fissures in plaque/intima; stretches media
Virtually no compression of plaque itself
Venous angioplasty: PTA of stenotic venous lumen
Stretches entire vein wall, usually without fissures
Often requires high-pressure balloon
Stent associated: PTA often performed in conjunction with stenting
Predilation PTA of stenosis, allowing stent advancement into position
Recent trials indicate cryoplasty does not offer outcomes superior to balloon angioplasty
Unfavorable cost-benefit
Possibly higher restenosis rates
Drug-eluting balloon angioplasty: Balloon coated with medication (e.g., paclitaxel)
Delivers antiproliferative drug to vessel surface
Local drug application to vessel surface to prevent restenosis without placing stent
High drug concentration reduces neointimal proliferation even with short time exposure
Investigational device with ongoing trials
PREPROCEDURE
Indications
Contraindications
Getting Started
PROCEDURE
Patient Position/Location
Equipment Preparation
Procedure Steps
Alternative Procedures/Therapies
POST PROCEDURE
Things to Do
OUTCOMES
Complications
Expected Outcomes
Selected References
Naghi J et al: New developments in the clinical use of drug-coated balloon catheters in peripheral arterial disease. Med Devices (Auckl). 9:161-74, 2016
Diehm NA et al: Drug eluting balloons. Tech Vasc Interv Radiol. 13(1):59-63, 2010
Banerjee S et al: Atheroemboli during peripheral arterial interventions. J Invasive Cardiol. 21(12):632-3, 2009
Bosiers M et al: Use of the AngioSculpt scoring balloon for infrapopliteal lesions in patients with critical limb ischemia: 1-year outcome. Vascular. 17(1):29-35, 2009
Conrad MF et al: Infrapopliteal balloon angioplasty for the treatment of chronic occlusive disease. J Vasc Surg. 50(4):799-805, 2009
Das TS et al: Primary cryoplasty therapy provides durable support for limb salvage in critical limb ischemia patients with infrapopliteal lesions: 12-month follow-up results from the BTK Chill Trial. J Endovasc Ther. 16(2 Suppl 2):II19-30, 2009
Laird JR et al: The role for cryoplasty in the treatment of infrainguinal artery disease: case studies. J Endovasc Ther. 16(2 Suppl 2):II116-28, 2009
Shammas NW: Restenosis after lower extremity interventions: current status and future directions. J Endovasc Ther. 16 Suppl 1:I170-82, 2009
Siablis D: Atheroembolization and peripheral vascular interventions: the evidence is mounting. J Endovasc Ther. 16(2):203-5, 2009
Wilson AM et al: Randomized controlled trial of aspirin and clopidogrel versus aspirin and placebo on markers of smooth muscle proliferation before and after peripheral angioplasty. J Vasc Surg. 50(4):861-9, 2009
Bosiers M et al: Present and future of endovascular SFA treatment: stents, stent-grafts, drug coated balloons and drug coated stents. J Cardiovasc Surg (Torino). 49(2):159-65, 2008
Fonseca A et al: Intravascular ultrasound assessment of the novel AngioSculpt scoring balloon catheter for the treatment of complex coronary lesions. J Invasive Cardiol. 20(1):21-7, 2008
Werk M et al: Inhibition of restenosis in femoropopliteal arteries: paclitaxel-coated versus uncoated balloon: femoral paclitaxel randomized pilot trial. Circulation. 2008 Sep 23;118(13):1358-65. Epub 2008 Sep 8. Erratum in: Circulation. 118(16):e670, 2008
Scheinert D et al: Results of the multicenter first-in-man study of a novel scoring balloon catheter for the treatment of infra-popliteal peripheral arterial disease. Catheter Cardiovasc Interv. 70(7):1034-9, 2007
Laird JR et al: Cryoplasty for the treatment of femoropopliteal arterial disease: extended follow-up results. J Endovasc Ther. 13 Suppl 2:II52-9, 2006
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