In recent years, the effectiveness of non-stenting treatment using drug-coated balloons (DCB) has been demonstrated in patients with peripheral arterial disease, particularly in areas where stenting is not indicated, such as the common femoral artery and popliteal artery. However, vessel preparation is essential in order to achieve adequate balloon expansion in calcified lesions. Dr. Hirokazu Konishi and his colleagues of Toyohashi Heart Center reported the effectiveness of a new technique for such lesions called ARCADIA in the online edition of the Journal of Endovascular Therapy.
The Practicality of the ARCADIA Technique
TCROSS NEWS interviewed Dr. Hirokazu Konishi about this technique.
The ARCADIA technique is a method of penetrating a wire through a heavily calcified lesion and dilatating it with a high-pressure balloon catheter. This technique has been performed at the Toyohashi Heart Center for approximately ten years. Since the patient background of such lesions is a population often with poor treatment outcomes, mainly dialysis patients, it is difficult to generate significant developments in that area. Until now, no effective treatment strategy has not been established.
However, with the advent of DCB, the importance of reviewing preparations prior to dilatation has been reaffirmed, and we have investigated lesions where the ARCADIA technique is particularly useful. The No stenting zone described in this paper is a typical example of such a lesion.
The ARCADIA technique may also be useful for preparations before Supera stent placement as well as for using debulking devices introduced in the future. 3D images using IVUS and angiography and careful wire manipulation are required for this technique. Although the process is somewhat time-consuming, it is a point that Japanese interventionists should certainly focus on, and I think it was very important that we were able to publish this paper. We will conduct a multicenter study involved in several hospitals to confirm our findings in the near future.
※コンテンツには、国内で未承認、適応外の医療機器、医薬品、または効能・効果/用法・用量の情報を含む場合がありますが、未承認、適応外の使用を推奨するものではありません。
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