A recent study presented at the American College of Cardiology’s Annual Scientific Session found that one-year success rates for angioplasty in patients with peripheral artery disease (PAD) were significantly higher when intravascular ultrasound (IVUS) was used alongside traditional angiography compared to angiography alone. The IVUS-DCB trial is the first randomized controlled study to highlight the clinical benefits of IVUS in treating PAD, which involves plaque buildup in the leg arteries and can lead to pain and mobility issues. IVUS provides detailed 3D images of the blood vessel walls, allowing for precise measurements and improved procedural accuracy. By using IVUS, doctors were able to achieve larger vessel lumen diameters, leading to better blood flow and potentially longer-lasting results.
The trial involved 237 patients undergoing angioplasty for femoropopliteal artery disease, where the femoropopliteal arteries become blocked. Patients were divided into two groups, with one group receiving both IVUS and angiography and the other receiving angiography alone. At the 12-month follow-up, 83.8% of patients in the IVUS group maintained primary patency, compared to 70.1% in the angiography-only group. The IVUS group also experienced fewer revascularization procedures and better sustained clinical outcomes. IVUS allowed operators to use larger pre-dilation balloons, higher pressures, and more frequent post-dilation adjustments, which contributed to more durable results.
Although the study demonstrates promising outcomes, researchers caution that it focused on complex, long lesions in the femoropopliteal arteries and used drug-coated balloons. The findings may not apply to shorter lesions or other types of devices like stents. The study was funded by Medtronic, Inc. and Korea United Pharm. Inc., with further research suggested to explore the benefits of IVUS in other peripheral arteries. Dr. Young-Guk Ko, the study’s lead author, will discuss the results in a press conference on April 8, 2024.
