Background:Treatment of ISR achieves high immediate procedural success, but durable long-term patency remains elusive. The aim of this work is to compare between plain balloon(PTA) and drug coated balloon (DCB) regarding patency rate and target lesion revascularization (TLR) and limb salvage in management of femoro-popliteal ISR lesions.

Methods:This prospective hospital based study was conducted on 25 patients presenting with femoropopliteal ISR presented with Rutherford category 4 and category 5 and adequate distal run- off vessels. Patients were randomized simply by flipping a coin into two groups: PTA group and DCB group.

Results: There was statistically significant difference between both groups regarding patency rate however no statistically significant difference was found regarding limb salvage. There was a statistically significant difference between both groups regarding mean degree of stenosis, mean ankle pressure and mean ankle brachial index after 3, 6, 9 and 12 months postoperatively. In addition there was a statistically significant difference between both groups in mean ankle pressure after 1 month and in mean ankle brachial index postoperatively. Wound healing was statistically significant lower in DCB compared to PTA. There was a statistically significant difference regarding TLR.There was no statistically significant difference between both groups regarding pre operative ankle pressure, however it was statistically significant higher in DCB group postoperatively. In addition, there was a statistically significant difference between pre and post operative ankle pressure in both groups.

Conclusions: DCB was superior to PTA results regarding patency rate, TLR and limb salvage rate.