Aortic & peripheral vascular disease
Intravascular Ultrasound-Guided vs Angiography-Guided Drug-Coated Balloon Angioplasty in Patients With Complex Femoropopliteal Artery Disease
Corrected 23 Oct 2026: Measure wording clarified; no values changed.
Authors' conclusion
In endovascular treatment of FPA using DCB, IVUS guidance was significantly associated with improved 12-month clinical outcomes, particularly in patients with complex FPA lesions.
Study context
- Population
- Patients with femoropopliteal artery disease undergoing DCB angioplasty, by complex (TASC II C/D) or noncomplex (TASC II A/B) lesions158 complex, 79 noncomplex
- Participants
- 237 patients
- Comparison
- Intravascular ultrasound (IVUS)-guided vs angiography-guided DCB angioplasty
- Primary endpoint
- Primary patency
- Follow-up
- 12 months
Methodological detailsprespecified subgroup analysis
- Prespecified subgroup analysis
Primary result
As reported in the abstract
Primary patency, by lesion complexity (subgroups)
IVUS vs AngiographyEstimate (95% CI)P value
Complex FPA: 82.1%vs 60.3%; HR for loss of primary patency
HR for loss of primary patency 0.34(0.16–0.70)
P = 0.002Noncomplex FPA: 87.5% vs 88.2%
HR 1.84 (0.39–8.60), event not clearly stated
P = 0.44Secondary outcomes
Freedom from CD-TLR (complex FPA)
HR 0.31 (0.13–0.75) · P = 0.01
Sustained clinical and hemodynamic improvement (complex femoropopliteal artery (FPA))
- Significantly higher with IVUS vs angiography guidance
Secondary endpoints (noncomplex FPA)
- No significant difference between IVUS and angiography guidance
Original publication
Intravascular Ultrasound-Guided vs Angiography-Guided Drug-Coated Balloon Angioplasty in Patients With Complex Femoropopliteal Artery Disease. JACC Cardiovasc Interv. Published 22 January 2025. doi:10.
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