Sumaira Macdonald, Freeman Hospital, Newcastle, UK, in a presentation at the British Society of Interventional Radiology’s (BSIR) Annual Meeting (14–16 November, Bournemouth, UK) told delegates that drug-eluting stents ease severe pain when walking in patients with peripheral vascular disease.
The speaker said that balloon angioplasty was the most common treatment and was safe and effective. However, balloons, according to the speaker, were not a durable, long-term solution to intermittent claudication and patients suffered restenosis within one year after treatment.
MacDonald presented the data from five randomised trials and said that future trials for drug-eluting stent systems should have clinically meaningful end points such as restenosis, patency, and lesion revascularisation
Macdonald summarised the findings of a trial that compared the everolimus-eluting stent (Xience V, Abbott) against a bare-metal stent, and the data came out in favour of the everolimus-eluting stent. The trial data showed promising restenosis rate for the drug-eluting devices and were presented in comparison with balloon angioplasty at six months and with favourable one year patency.
She also said that the trials were conducted on long lesions and therefore they more accurately reflected real world practice.
As an alternative to balloon angioplasty, the speaker said, drug-eluting stents are an option as there is evidence to suggest that drug-eluting stents are more favourable to bare-metal stents and balloon angioplasty.
“There is a growing body of evidence to show that there are clear benefits of drug elution, in that they provide a more durable response to the treatment of intermittent claudication compared with standard therapies and may offer an improved quality of life to thousands of patients adversely affected in the UK,” MacDonald said.
“While drug-eluting technology does currently carry a higher initial cost per patient, commissioners should understand that by reducing the risk of a recurrent re-narrowing of the arteries, there is a strong cost effectiveness argument, with patients less likely to need further treatment freeing up an already stretched NHS hospital capacity,” she concluded.