A SELUTION to Paclitaxel DCB Complications in PAD? | JACC Baran

Could sirolimus-coated balloons change how we treat femoropopliteal peripheral artery disease? Host Mitsuaki Sawano, MD, welcomes Yoshimitsu Soga, MD, PhD (Kokura Memorial Hospital) to discuss the 3-year results of the SELUTION SFA Japan study, a prospective multicenter study of 134 patients with symptomatic femoropopliteal disease treated with a novel sirolimus-eluting balloon. Despite relatively complex lesions, the study showed encouraging long-term outcomes, with particularly few additional restenosis and target lesion revascularization events after the first year. We discuss why sirolimus may offer an alternative to paclitaxel, how sustained drug delivery makes a sirolimus-coated balloon possible, and what the recently published SIRONA randomized trial adds to the evolving evidence comparing sirolimus- and paclitaxel-coated balloons. Finally, we look ahead to whether sirolimus DCBs could reshape PAD intervention and what the peripheral experience might eventually teach us about coronary DCB therapy.