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Effectiveness of Nitinol-Constrained Balloon Angioplasty for Treating Postangioplasty Dissections in Chronic Total Occlusions of the Femoropopliteal Segment

Title: Effectiveness of Nitinol-Constrained Balloon Angioplasty for Treating Postangioplasty Dissections in Chronic Total Occlusions of the Femoropopliteal Segment
Authors: Mirabella D.; Bruno S.; La Marca M.; Dinoto E.; Setacci C.; Pecoraro F.
Contributors: Mirabella, D.; Bruno, S.; La Marca, M.; Dinoto, E.; Setacci, C.; Pecoraro, F.
Publisher Information: ELSEVIER SCIENCE INC
Publication Year: 2026
Collection: IRIS Università degli Studi di Palermo
Subject Terms: nitinol-constrained balloon; percutaneous transluminal angioplasty; postangioplasty dissection; chronic total occlusion; emoropopliteal segment; Settore MEDS-13/B - Chirurgia vascolare
Description: Purpose: To assess the effectiveness of nitinol-constrained balloon (NCB; Chocolate; Medtronic, Dublin, Ireland) percutaneous transluminal angioplasty (PTA) for treating Diameter reduction, Spiral shape, Flow impairment, or adverse Morphology (DISFORM) III postangioplasty dissections in chronic total occlusions (CTOs) of the femoropopliteal segment. Materials and Methods: The CHOCOlate-STABilization (CHOCO-STAB) study was conducted from February 2019 to February 2022. It included patients with peripheral arterial disease affected by chronic limb-threatening ischemia. This study specifically included patients with DISFORM III postangioplasty dissections who were treated using NCB angioplasty after initial PTA. The main outcomes assessed in this study were technical success and the occurrence of major adverse events. Results: This study included 68 patients with a mean age of 72 years (SD +/- 10), of whom 39% had diabetes. The initially treated CTOs had a mean length of 10.32 mm (SD +/- 5; interquartile range, 5-15 mm), with moderate or severe calcification in 28%. Forty-seven (69%) patients received initial treatment with drug-coated balloons (DCBs). NCB angioplasty was feasible in all patients, achieving technical success in 62 (91%). Stent placement was required in the remaining 6 (9%) cases. Three-year estimated overall survival was 98.5%, primary patency was 88.2%, freedom from major amputation was 94.1%, and freedom from clinical target lesion revascularization was 94.1%. Conclusions: Postangioplasty dissections represent a relevant adverse event that necessitates scaffolding in moderate and severe grades. The CHOCO-STAB study demonstrated the safety and potential of NCB angioplasty to reduce stent placement in patients treated with DCB and plain old balloon angioplasty who present with postangioplasty dissections.
Document Type: article in journal/newspaper
Language: English
Relation: info:eu-repo/semantics/altIdentifier/pmid/41207533; info:eu-repo/semantics/altIdentifier/wos/WOS:001676860200001; volume:37; issue:4; firstpage:1; lastpage:11; numberofpages:11; journal:JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY; https://hdl.handle.net/10447/699689
DOI: 10.1016/j.jvir.2025.107912
Availability: https://hdl.handle.net/10447/699689; https://doi.org/10.1016/j.jvir.2025.107912
Rights: info:eu-repo/semantics/closedAccess
Accession Number: edsbas.CF914A32
Database: BASE