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| Turkish Society of Cardiology Young Cardiologists Bulletin Year: 7 Number: 1 / 2024 |
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Name of the Study: Comparison of IVUS-Guided vs. Angiography-Guided Angioplasty for the Outcomes of Drug-Coated Balloon in the Treatment of Femoropopliteal Artery Disease - IVUS-DCB Published in Congress: ACC 2024 Link: "Comparison of Intravascular Ultrasound-guided versus Angiography-guided Angioplasty for the Outcomes of Drug-coated Balloon in the Treatment of Femoropopliteal Artery Disease," on Monday, April 8, 2024, at 11:00 a.m. ET / 15:00 UTC in the Hall B-1 Main Tent. Full text has not been published yet. Objective:The IVUS-DCB study compares intravascular ultrasound (IVUS)-guided drug-coated balloon angioplasty with angiography-guided drug-coated balloon angioplasty in patients with femoropopliteal artery disease. Methods:Multicenter, randomized (1:1), parallel and blind study, 237 patients with symptomatic (Rutherford category 2-5) femoropopliteal artery disease were randomized IVUS-guided drug-coated balloon angioplasty (n = 119) and angiography-guided drug-coated balloon angioplasty (n = 118). Follow-up period: 12 months, average patient age was 69 years, female sex ratio was 14%, and diabetes mellitus patients were 60%. The primary outcome of the study was determined as the persistence of primary patency or absence of restenosis in the femoropopliteal artery in imaging methods (DUS, CT, angiography) at the end of 12 months. Results:Primary patency at 12 months was 83.8% with IVUS guided and 70.1% with angiography guidance (HR 0.46, CI 0.25-0.85, p = 0.01). There was no difference between treatment strategies among TASC A/B lesions (p = 0.52); however, there was a significant benefit in favor of IVUS-guided drug-coated balloon angioplasty in TASC C/D lesions (p = 0.002). Technical and procedural success was significantly higher in the IVUS group (p<0.05). Post-procedural ABI values were significantly higher in the IVUS group (0.99 vs. 0.93, p<0.01). Conclusion:Among patients with symptomatic femoropopliteal artery disease, IVUS-guided drug-coated balloon angioplasty was associated with a significant benefit in primary patency compared with angiography-guided drug-coated balloon angioplasty. This significant benefit was especially evident in complex lesions. Interpretations :IVUS-DCB study results showed that; The use of IVUS in angioplasty procedures performed on patients with symptomatic femoropopliteal artery disease may provide more accurate results than angiography in measuring vessel dimensions, facilitates reaching adequate vessel lumen diameter, and helps evaluate the treatment response of the target lesion. In this patient group, IVUS-guided angioplasty procedure may benefit patients by improving treatment outcomes (providing a high primary patency rate).
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