Balloon angioplasty
Pro Research Analysisby 
Searched over 200M research papers for "balloon angioplasty"
Consensus Meter
Balloon Angioplasty: Efficacy, Comparisons, and Clinical Outcomes
Introduction to Balloon Angioplasty
Balloon angioplasty, also known as percutaneous transluminal angioplasty (PTA), is a minimally invasive procedure used to open narrowed or blocked blood vessels. This technique is widely used in the treatment of coronary artery disease, peripheral artery disease, and for maintaining vascular access in dialysis patients. This article synthesizes findings from multiple studies to provide a comprehensive overview of the efficacy, comparisons, and clinical outcomes of balloon angioplasty.
Coronary Artery Disease: Stent vs. Balloon Angioplasty
Procedural Success and Restenosis Rates
Studies comparing coronary stent placement with standard balloon angioplasty have shown that stent placement generally results in higher procedural success rates and lower restenosis rates. For instance, one study found that stent placement had a procedural success rate of 96.1% compared to 89.6% for balloon angioplasty, with a significantly larger immediate increase in luminal diameter. Another study reported that stent implantation led to better clinical and angiographic outcomes over seven months, although it was associated with a higher risk of vascular complications and longer hospital stays.
Long-term Outcomes
At six months, patients with stented lesions had a larger luminal diameter and a lower rate of restenosis (31.6% vs. 42.1%) compared to those treated with balloon angioplasty. Similarly, another study found that the need for a second coronary angioplasty was significantly reduced in the stent group.
Peripheral Artery Disease: Drug-Coated vs. Conventional Balloon Angioplasty
Efficacy and Safety
Drug-coated balloon (DCB) angioplasty has shown superior efficacy over conventional balloon angioplasty in treating femoropopliteal lesions. A study demonstrated that at two years, primary patency was achieved in 90.2% of DCB angioplasty cases compared to 62.7% for conventional balloon angioplasty. Another trial found that DCB angioplasty resulted in a higher rate of primary patency at 12 months (65.2% vs. 52.6%) and was noninferior in terms of safety.
Clinical Improvements
DCB angioplasty also led to sustained clinical and hemodynamic improvements without an increased risk of mortality. These findings suggest that DCB angioplasty is a more effective and safer option for long-term vessel patency in peripheral artery disease.
Dialysis Access: Drug-Eluting vs. Plain Balloon Angioplasty
Patency and Cost-Effectiveness
In the context of failing dialysis access, drug-eluting balloon (DEB) angioplasty has been found to significantly improve primary patency compared to plain balloon angioplasty. One study reported a cumulative target lesion primary patency of 35% for DEB angioplasty versus 5% for plain balloon angioplasty at one year. Additionally, DEB angioplasty was found to be a cost-effective option, with an incremental cost-effectiveness ratio of 2198 Euros per primary patency year gained.
Short-term and Long-term Outcomes
While DEB angioplasty showed a modest improvement in primary patency at six months, this benefit was not durable to one year, indicating the need for reinterventions. Another study found that DEB angioplasty did not meet the primary effectiveness endpoint at 180 days but was noninferior in terms of safety.
Hypertensive Patients with Renal Artery Stenosis
Blood Pressure Reduction
Balloon angioplasty has been shown to be more effective than medical therapy in reducing blood pressure in hypertensive patients with atherosclerotic renal artery stenosis. A meta-analysis found that balloon angioplasty significantly reduced both systolic and diastolic blood pressure compared to medical therapy.
Renal Function and Artery Patency
Although balloon angioplasty did not consistently improve renal function, it was more likely to result in patent renal arteries after 12 months and required fewer antihypertensive medications.
Conclusion
Balloon angioplasty, whether conventional or drug-coated, remains a cornerstone in the treatment of various vascular conditions. While stent placement often provides better immediate and long-term outcomes in coronary artery disease, drug-coated balloons offer superior efficacy in peripheral artery disease and dialysis access. However, the benefits of these advanced techniques must be weighed against their costs and potential complications. Further large-scale studies are warranted to optimize treatment protocols and improve patient outcomes.
Sources and full results
Most relevant research papers on this topic