Ren H, Liu J, Zhang J, et al. - In the AcoArt I trial, the five-year follow-up outcomes of the post-balloon angioplasty dissection indicated that drug-coated balloon (DCB) angioplasty is more trustworthy than percutaneous transluminal angioplasty (PTA), with a higher rate of freedom than clinically driven target lesion revascularization (CD-TLR) and sustained improvement in clinical symptoms. Nevertheless, after both DCB angioplasty and PTA, the all-cause mortality rate in patients with femoropopliteal lesions is similar.

• In comparison with patients who were treated by PTA, patients treated with DCB angioplasty showed an acceptable effect with a numerically higher but not statistically significant rate of freedom from CD-TLR over five years.

• The mean time from intervention to TLR in the DCB group was significantly prolonged in comparison with the PTA group among the patients who had undergone TLR.

• At five years, the stratified analysis demonstrated that the Rutherford classification played an interactive role in the relationship between the DCB angioplasty and the low CD-TLR rate.

• There was no significant difference in the all-cause mortality in the patients with post-balloon angioplasty dissection between the two treatment groups.