Aortic & peripheral vascular diseaseCohort study

3-Year Outcomes of Low-Dose vs High-Dose Drug-Coated Balloons in Femoropopliteal Artery Disease

JACC AdvPublished

  • prospective, multicenter, study
  • propensity score matching

Authors' conclusion

In a real-world population with complex FPA disease, second-generation LD-DCB demonstrated 3-year clinical outcomes comparable to those of first-generation HD-DCB. These findings support the use of second-generation LD-DCB as a reasonable treatment option and suggest that comparable efficacy may be achieved despite substantially lower paclitaxel exposure.

Study context

Population
Patients undergoing endovascular therapy for symptomatic femoropopliteal artery (FPA) diseasematched: 358 low-dose drug-coated balloon (LD-DCB) and 163 high-dose drug-coated balloon (HD-DCB) · LD-DCB 370 · HD-DCB 211
Participants
581 patients
Exposure
LD-DCB vs HD-DCB
  • LD-DCBn = 370
  • HD-DCBn = 211reference
Outcome
Primary patency and freedom from clinically driven target lesion revascularization
Follow-up
3 years

Main finding

As reported in the abstract

LD-DCB

60.1% [95% CI: 53.1%-67.9%]

Primary patency · Freedom from clinically driven target lesion revascularization 71.0% [64.7%-77.9%]

HD-DCB

48.4% [39.3%-59.7%]

Primary patency · Freedom from clinically driven target lesion revascularization 59.9% [50.8%-70.7%]

LD-DCB vs HD-DCBHazard ratio (CI)P value
primary patency
1.02(0.60–1.73)
P = 0.93
freedom from clinically driven target lesion revascularization
1.02(0.58–1.81)
P = 0.94

Observational data: associations, not effects.

Secondary outcomes

Secondary outcomes (major adverse limb events, limb salvage, overall survival)

Secondary outcomes were comparable

Interaction of baseline characteristics with 3-year restenosis

No baseline characteristics showed a significant interaction with 3-year restenosis

Follow-up

months

Median follow-up
19.9 (IQR: 9.4-37.7)
Median follow-up among matched participants
19.9 (9.2-37.9)

Original publication

3-Year Outcomes of Low-Dose vs High-Dose Drug-Coated Balloons in Femoropopliteal Artery Disease. JACC Adv. Published 14 August 2026. doi:10.1016/j.jacadv.2026.103133

Summarised from the published abstract; every number is checked against it