Full-Coverage Drug-Eluting Stent Vs Drug-Coated Balloon in De Novo Femoropopliteal Lesions: Three-Year TASC II-Stratified Outcomes

Full-coverage DCB and DES yielded favorable outcomes in TASC II A/B lesions, supporting a stentless strategy in selected cases. For TASC II C/D lesions, DES provided superior long-term patency and lower reintervention rates, highlighting the importance of lesion complexity-based device selection.Clinical ImpactThis study demonstrates that lesion complexity, as defined by the TASC II classification, is a decisive factor in device selection for femoropopliteal interventions. In de novo TASC II A/B lesions, full-coverage drug-coated balloon angioplasty and drug-eluting stent implantation achieved comparable 3-year outcomes, supporting a stentless approach in suitable cases. In contrast, the drug-eluting stent strategy provided superior long-term patency in complex TASC II C/D lesions, emphasizing the value of full-lesion coverage and optimized lumen expansion. These findings offer lesion-specific guidance that may refine treatment algorithms, improve durability of revascularization, and support individualized therapy in peripheral artery disease.