Peripheral artery disease (PAD) refers to the narrowing or blockage of arteries other than those that supply the heart and brain. The most common symptom of PAD is leg pain or cramping. A promising new treatment called drug-eluting balloons (DEBs) is showing effectiveness for PAD. DEBs work by delivering medication directly to the artery walls during an angioplasty procedure to prevent renarrowing.
How DEBs Work
In a typical angioplasty, or percutaneous transluminal angioplasty (PTA), a small deflated balloon is threaded through the artery to the site of narrowing or blockage. The balloon is then inflated to compress the plaque and widen the artery. However, renarrowing often occurs within months as the body tries to repair damage caused by the procedure. Drug Eluting Balloon aim to address this problem by delivering medication directly to the artery walls.
The balloon carries a coating of an anti-proliferative drug such as paclitaxel that is absorbed into the artery during the procedure. By delivering medication site-specifically, higher concentrations can be achieved compared to oral or intravenous administration. This helps prevent smooth muscle cell proliferation that causes renarrowing. Clinical trials show DEBs lead to significantly less renarrowing compared to uncoated angioplasty balloons.
Expanding Role in Drug Eluting Balloon Treatment
Originally developed for treatment of in-stent restenosis in coronary arteries, DEBs are now increasingly used for infrainguinal PAD treatment. One of the first DEBs approved was the IN.PACT Admiral paclitaxel-coated balloon for use in superficial femoral and popliteal arteries above the knee. Long-term data from the IN.PACT SFA trial shows DEBs led to improvement in patency rates and reduced need for target lesion revascularization compared to uncoated balloon angioplasty.
Other DEBs that have gained approval include Lutonix and Izoel. Multiple randomized controlled trials support their efficacy compared to standard PTA alone in the above-knee femoropopliteal segment. DEBs are now considered the preferred option for revascularization of these arteries by leading clinical guidelines. Ongoing trials are also exploring the potential for DEBs in treating below-the-knee PAD.
Potential for Improved Patient Outcomes
By addressing renarrowing more effectively, DEBs could significantly improve long-term patency rates compared to uncoated balloon angioplasty or bare metal stenting. This translates to better symptom relief and quality of life for PAD patients. DEBs may also reduce the high target lesion revascularization rates seen with standard PTA alone.
Less renarrowing means fewer repeat procedures that are physically and financially taxing on patients. DEBs have the potential to cut healthcare costs by reducing reintervention rates. While high upfront costs may be a limitation, studies find DEBs produce favorable long-term cost-effectiveness compared to competitor therapies when factoring in reduced revascularization needs. Widespread adoption of DEBs could thus benefit both patients and the overall healthcare system.
Ongoing Advancements
Manufacturers continue optimizing DEB technologies through drug and balloon design innovations. Newer DEBs feature drug layers engineered for even drug elution. Balloons are being designed for enhanced deliverability and conformability in tortuous anatomy. Combination DEB and stent approaches are also being explored for particularly complex lesions.
In over a decade of research shows percutaneous transluminal angioplastys provide an effective option for many angioplasty cases, particularly those involving complex lesions, small vessels, or perioperative patients where stenting poses greater risks. They allow targeted drug delivery without a permanent implant and avoid long-term antiplatelet medications. Ongoing research continues to explore applications in new vessel territories and refinement of drug coatings.
Gets More Insights on, Drug Eluting Balloon
About Author:
Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
