Key result
LD-DCB matches HD-DCB for 1-year patency after Jetstream atherectomy in calcified femoropopliteal lesions.
Why the study?
Second-generation low-dose DCBs have shown efficacy comparable to high-dose DCBs for femoropopliteal artery lesions, but whether paclitaxel dose density remains clinically relevant after aggressive vessel preparation with atherectomy in severely calcified lesions was uncertain.
Does a second-generation low-dose drug-coated balloon provide comparable 1-year primary patency to a high-dose drug-coated balloon following Jetstream atherectomy in patients with severely calcified femoropopliteal artery lesions?
Cohort (n=262)
Yes
Does a second-generation low-dose drug-coated balloon provide comparable 1-year primary patency to a high-dose drug-coated balloon following Jetstream atherectomy in patients with severely calcified femoropopliteal artery lesions?
Following Jetstream atherectomy for severely calcified femoropopliteal lesions, second-generation low-dose DCBs achieve 1-year primary patency and clinical outcomes comparable to high-dose DCBs.
Answers are grounded in this paper and cite their sources.
Low-dose DCBs yield similar patency to high-dose after Jetstream atherectomy in calcified lesions; hypothesis-generating and should not yet change practice.
BACKGROUND: Second-generation low-dose drug-coated balloons (LD-DCBs) have shown clinical efficacy comparable to high-dose DCBs (HD-DCBs) for femoropopliteal artery (FPA) lesions. Whether paclitaxel dose density remains clinically relevant after aggressive vessel preparation with atherectomy in severely calcified FPA lesions remains uncertain. This study aimed to compare 1-year clinical outcomes of second-generation LD-DCB and HD-DCB following Jetstream atherectomy in patients with severely calcified FPA lesions. AIMS: This study aimed to compare 1-year clinical outcomes of second-generation LD-DCB and HD-DCB following Jetstream atherectomy in patients with severely calcified FPA lesions. METHODS: This multicenter retrospective study included 262 patients with severely calcified FPA lesions who underwent endovascular therapy with Jetstream atherectomy followed by second-generation LD-DCB (n = 175) or HD-DCB (n = 87). Propensity-score matching yielded 79 well-balanced pairs. The primary outcome was 1-year primary patency; secondary outcomes included freedom from clinically driven target-lesion revascularization (TLR), limb salvage, and overall survival. RESULTS: In the overall cohort before matching, 1-year primary patency was similar between second-generation LD-DCB and HD-DCB (86.8% vs. 83.1%, log-rank p = 0.578), with comparable freedom from TLR, limb salvage, and overall survival. After propensity score matching, primary patency remained similar between groups (88.5% vs. 84.9%, log-rank p = 0.588), as did freedom from TLR, limb salvage, and overall survival. Findings were consistent across calcification-related subgroups. In an exploratory Cox analysis, second-generation LD-DCB was not associated with an increased risk of restenosis compared with HD-DCB. CONCLUSIONS: After Jetstream atherectomy for severely calcified FPA lesions, second-generation LD-DCB and HD-DCB were associated with comparable 1-year clinical outcomes, suggesting that either strategy may be a reasonable treatment option.
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Ogata et al. (2026) conducted a cohort in Severely calcified femoropopliteal artery lesions (n=262). Second-generation low-dose paclitaxel drug-coated balloon (LD-DCB) following Jetstream atherectomy vs. High-dose paclitaxel drug-coated balloon (HD-DCB) following Jetstream atherectomy was evaluated on 1-year primary patency (p=0.578). Second-generation LD-DCB had similar 1-year primary patency to HD-DCB after Jetstream atherectomy in severely calcified femoropopliteal lesions.
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