Highlighting New Developments in PVD Treatment
The past year has been full of exciting developments in peripheral vascular disease (PVD) treatment and management. From research on balloon angioplasty and drug trials, here are just some of the highlights of recent PVD research. In 2015, three major pivotal trials confirmed the safety and efficacy of paclitaxel-coated balloons in the endovascular treatment of femoropopliteal artery disease: the IN.PACT SFA trial, the LEVANT 2 trial, and the five-year follow-up of the THUNDER trial, writes Thosaphol Limpijankit, MD, FACC, in an expert analysis on ACC.org.
He explains that these trials demonstrated that while drug-coated balloons are generally safe and superior to standard balloon angioplasty, there are many unanswered questions. Future studies need to look at longer lesions, densely calcified lesions, or in-stent restenosis, and consider comparison with bare metal stents and drug-eluting stents. Additionally, appropriateness of these devices has yet to be determined. Trials are needed to determine which patients are good candidates for drug-coated balloons over standard balloons.
At ACC.16, new research, including the ACCELERATE trial, furthered our understanding of how best to treat patients with vascular disease. ACCELERATE, which was terminated early due to futility, found that evacetrapib is not superior to placebo in reducing cardiovascular outcomes in patients at high risk for vascular risk despite favorable effects on both high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C). This trial, along with negative results for torcetrapib and dalcetrapib, suggests that cholesterol ester transfer protein inhibition may not be a good strategy to reduce residual cardiovascular risk.
For the first time this year, the ACC Puerto Rico Chapter included a PVD educational track at its annual meeting, held April 29 – 30. Herbert Aronow, MD, FACC, chair of ACC’s Peripheral Vascular Disease Section, spoke during the session, addressing approaches to treating patients with peripheral artery disease as well as the challenges and opportunities of carotid artery stenting.
ACC’s PVD Section continues to develop new initiatives to enhance the experience of its members. The College’s patient resource website, CardioSmart.org, has launched a new condition center on PVD, aimed at helping patients understand their condition and providing them with the resources they need to maintain their heart health. Clinicians are encouraged to direct their patients to the condition center for information such as a patient-focused overview of peripheral arterial disease, questions to ask physicians and related fact sheets. Visit the PVD Condition Center at CardioSmart.org/PVD.
Learn more about the Peripheral Vascular Disease Section at ACC.org/PVDSection. Visit the Vascular Medicine Clinical Topic Collection on ACC.org for the latest clinical news, patient case quizzes and more.
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