Speaker: Masahiko Fujihara, MD

Hospital: Kishiwada Tokushukai Hospital, Osaka, Japan

Abstract

This study analyzed real-world outcomes of paclitaxel DES in complex femoropopliteal lesions. While DES showed superior patency (72.7% at 3 years), concerns about aneurysmal degeneration (16.8% at 1 year) and reintervention complexity limit its adoption.

Introduction

Despite trial success, real-world DES use faces challenges. CAPSICUM registry data and case studies highlight the balance between efficacy and complications.

Case Studies

Aneurysmal Degeneration

IVUS-guided oversizing (MLA>28 mm²) correlated with 16.8% aneurysm risk.

Drug-with-Drug (DWD) Strategy

DES+DCB achieved 85.3% 1-year patency, with diffuse restenosis (67%).

Conclusion

1.DES remains effective for long lesions but requires cautious deployment.

2.DWD may reduce occlusive restenosis and simplify reinterventions.

3.Technical refinements and post-procedural monitoring are critical.