Use of Vessel Preparation in Endovascular Peripheral Arterial Disease (PAD) Interventions: A Global Qualitative Analysis - PubMed
4 days ago
- #vessel preparation
- #peripheral arterial disease
- #endovascular
- Peripheral arterial disease (PAD) is a major global health issue requiring endovascular interventions.
- Complex lesion morphologies like calcification or long occlusions limit procedural success.
- Vessel preparation (VP) techniques, including atherectomy and intravascular lithotripsy, are increasingly used but lack consensus on definition and clinical role.
- A modified Delphi process involved 103 international experts to define VP and its aims.
- VP was defined as the initial step to modify lesion characteristics for facilitating subsequent interventions (93% agreement).
- Six core aims of VP: luminal gain, improved vessel compliance, plaque/calcification reduction, enhanced drug delivery, reduced complications, and improved technical success.
- Barriers to VP adoption include high device costs and insufficient evidence.
- High-level agreement supports VP use in femoropopliteal and popliteal segments, with intravascular lithotripsy preferred for calcified lesions.
- Imaging recommendations and modality-specific VP guidance were developed.
- This consensus provides the first international definition and structured aims of VP in PAD, aiding standardization in clinical practice and research.