During a late-breaking clinical trials session at the 2022 Vascular Interventional Advances (VIVA) conference (31 October–3 November, Las Vegas, USA), Mehdi Shishehbor (University Hospitals Harrington Heart & Vascular Institute, Cleveland, USA) presented a patient-level, propensity-adjusted comparison of drug-coated balloons (DCBs) versus bare metal stents in femoropopliteal lesions based on three-year results from four prospective, multicentre studies. In this interview with Vascular News filmed at the meeting, Shishehbor discusses the data and their significance.
Shishehbor explains that, prior to this study, he had become “frustrated” with the lack of available evidence on the topic of DCBs versus bare metal stents. “We have had a number of randomised clinical trials showing superiority of DCB versus angioplasty,” he says, noting however that around 20–30% of patients in the USA are still receiving angioplasty instead of DCB, and that a further 30% of patients receive stents. “What should I do?” he asks, highlighting the key clinical question when it comes to this group of patients. “Do I go with a stent, or do I go with DCB, given that we do not have randomised trials that have compared DCB to bare metal stent?”
In the present study, which assessed the safety and efficacy of DCB versus bare metal stent in femoropopliteal lesions that are amenable to both treatments—angioplasty or stenting—the researchers showed that DCBs were superior in terms of efficacy and safety out to three years. In light of these headline findings, Shishehbor comments on what is next for the study group, and whether there are any related areas of study that might elucidate the new findings.