Combination of scaffold and drug in BTK intervention “without question” the right way forward

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Sahil Parikh (New York, USA) talks to Brian DeRubertis (Los Angeles, USA) at VEITHsymposium 2019 (19–23 November, New York, USA) about the future of below-the-knee (BTK) interventions, with the latter noting that there is “a lot of excitement” around the number of devices currently available.

DeRubertis adds that there is “a buzz” around the prospect of bioresorbable technology which he believes will be helpful in providing structural support and may not have “the downsides of some of the permanent implants”.

The pair also discuss the role of drug-elution below the knee, particularly in the wake of the paclitaxel controversy. DeRubertis says it is “complicated” and that although “not all of us believe there is a true mortality risk…we cannot ignore this concern”. Drug elution is “always going to be part of our best therapies going forward” and the combination with structural support is “the right magic bullet” to achieve long-term patency, he adds.

Parikh and DeRubertis conclude by touching upon a number of recent and upcoming trials including the SAVAL trial and the LIFE-BTK trial. “Without question” notes DeRubertis regarding prior drug-eluting stent trials, “all of these trials have shown a superiority for the combination of scaffold and drug”, and he suspects that the forthcoming results from these contemporary trials will show positive results and may become the new standard of care.

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