Introduction: Below-the-knee (BTK) arterial disease is associated with a high risk of limb loss, yet evidence supporting the use of paclitaxel-coated balloons (PCB) in routine clinical practice remains limited. Aim: This study aimed to evaluate the safety and clinical performance of Peripherics™ PCB catheter (Sahajanand Medical Technologies Limited, Surat, India) in the treatment of BTK arteries during routine clinical practice. Methods: This retrospective, observational, multicenter, single-arm, investigator-initiated, post-market study was conducted between September 2022 and September 2024 at four centers in India. All consecutive patients aged ≥18 years with Rutherford categories III-V, having de novo or non-stented restenotic lesions in one or two native arteries (below the tibial plateau and above the tibiotalar joint), and treated with at least one Peripherics™ PCB catheter were included. The primary safety endpoint was 30-day major adverse limb events (MALE) and perioperative all-cause death (POD). MALE comprised above-ankle amputation or major reintervention involving a BTK artery. Results: A total of 71 Peripherics™ PCB catheters were used in 70 patients (mean age: 63.3±11.9 years; n=58; 82.9% male) to treat 70 lesions in BTK arteries. Rutherford class V was observed in the majority of patients (n=44; 62.9%). Thrombus was present in 39 (55.7%) lesions, total occlusion in 25 (35.7%), and calcification in 28 (40%) lesions. Device success, technical success, and procedural success were 100% (n=71), 100% (n=70), and 97.1% (n=68), respectively. The mean ankle-brachial index improved from 0.51±0.15 at baseline to 0.79±0.16 at 30 days. At 30 days, the MALE with POD was observed in two (2.9%) patients, including one patient who required thrombolysis followed by major reintervention (1.4%) and one perioperative death (1.4%). Clinical improvement was evident in 60 (87%) patients who demonstrated improvement in at least one Rutherford class. Conclusion: The Peripherics™ PCB catheter demonstrated favorable safety and clinical performance in the treatment of BTK arteries, with low event rates and marked clinical improvement at 30 days.
Sarda et al. (Mon,) studied this question.