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A percutaneous transluminal angioplasty is a relatively new medical technology used in angioplasty procedures to treat blocked arteries. Traditional angioplasty uses a standard balloon to open narrowed or blocked arteries. However, percutaneous transluminal angioplastys have a coating that releases a low dose of medication to prevent arteries from renarrowing. This article will discuss the development of percutaneous transluminal angioplastys, how they work, benefits over other treatments, and research on their effectiveness.
How Drug Eluting Balloon Work
Standard angioplasty balloons are inflated to compress plaque and widen the artery at the site of narrowing or blockage. However, studies show that in many cases the artery renarrows within months, requiring another procedure. With percutaneous transluminal angioplastys, a hydrophobic polymer coating on the balloon surface carries a therapeutic drug, usually paclitaxel. Drug Eluting Balloon Upon inflation, the drug is transferred to the artery walls. As the balloon is deflated and removed, the drug remains embedded in the arterial plaque and innermost vessel layers. This helps prevent renarrowing by inhibiting cell proliferation in the blood vessel wall.
The goal of percutaneous transluminal angioplastys is to deliver medication directly to the site of injury caused by angioplasty. This allows a higher concentration of drug to be delivered locally while avoiding systemic distribution and side effects seen with drug eluting stents. Less drug is needed compared to drug eluting stents as well. The medication is not permanently implanted either.
Benefits Over Other Treatments
Studies comparing percutaneous transluminal angioplastys to standard balloons have found they significantly reduce the risk of restenosis and the need for repeat procedures over the long term. They also compare favorably to drug eluting stents in many cases. Some key benefits include:
- No need to implant a permanent stent, avoiding long-term risks like late stent thrombosis. Percutaneous transluminal angioplastys leave nothing behind after treating the blockage.
- Ability to treat diffuse long lesions and small vessel diseases where getting full stent coverage can be difficult.
- Lower risk of artery damage than scoring balloons that are used prior to stenting to induce controlled injuries to the vessel wall.
- Avoidance of lifelong dual antiplatelet drugs required with stenting. Percutaneous transluminal angioplastys only require short-term use of antiplatelet medications.
- Potentially lower cost than stenting procedures without loss of efficacy.
Research on Effectiveness
Numerous randomized control trials and registry studies have evaluated percutaneous transluminal angioplastys for treating coronary and peripheral artery disease. In coronary applications, they have shown equivalent outcomes to drug eluting stents for treating simple lesions but with fewer safety issues long term. Head-to-head trials found percutaneous transluminal angioplastys non-inferior to plain balloon angioplasty plusdrug-coated stents for reducing restenosis at nine months.
Studies of percutaneous transluminal angioplastys for treating blocked leg arteries found significantly less renarrowing versus plain balloon angioplasty or drug eluting stents at 12 months. Other trials confirmed reduced target lesion revascularization rates versus plain balloons or bare metal stents at two years. No safety issues were observed.
Treating Specific Conditions
Below are some examples of how percutaneous transluminal angioplastys are being used off-label or evaluated in clinical trials for specific conditions:
In-Stent Restenosis - When tissue grows back inside a previously placed coronary artery stent, causing renarrowing, percutaneous transluminal angioplastys can effectively treat it without requiring a stent-in-stent.
Peripheral Artery Disease - Studies demonstrate improved patency rates versus uncoated balloons or bare metal stenting for blocked leg arteries above and below the knee.
Coronary Bifurcation Lesions - Early research suggests comparable outcomes to complex stenting techniques but without double stenting. Larger studies are still evaluating this application.
Small Vessel Disease - The ability to treat diffuse lesions and accurately deliver medication makes percutaneous transluminal angioplastys an appealing option when standard stents may undersize vessels or inadequately cover diseased segments.
Vein Grafts - Initial case series and trials show promise for reducing renarrowing of artery bypass grafts prone to accelerated atherosclerosis, but more data is still needed from larger studies.
In as percutaneous transluminal angioplasty technology continues to evolve, it shows potential for safely and effectively treating an expanding set of vascular conditions. Ongoing research aims to further optimize drug coatings and balloon designs.
Over the past decade, percutaneous transluminal angioplastys have emerged as a viable minimally invasive treatment for coronary and peripheral artery blockages. Later generation balloons have refined drug coatings that allow targeted drug delivery right where it is needed to prevent vessel renarrowing. Extensive clinical testing demonstrates equivalent efficacy to other standard revascularization procedures like bare metal or drug eluting stents, but with a reduced risk profile over the long term. As research continues, percutaneous transluminal angioplastys show promise for new applications in vessel territories like vein grafts or treatment of in-stent restenosis. Overall, they represent an important advancement for safely and effectively opening narrowed arteries.
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About Author:
Ravina Pandya, Content Writer, has a strong foothold in the market research industry. She specializes in writing well-researched articles from different industries, including food and beverages, information and technology, healthcare, chemical and materials, etc. (https://www.linkedin.com/in/ravina-pandya-1a3984191)
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