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THE JOURNAL OF CARDIOVASCULAR SURGERY

A Journal on Cardiac, Vascular and Thoracic Surgery


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The Journal of Cardiovascular Surgery 2017 Apr 14

DOI: 10.23736/S0021-9509.17.09977-3

Copyright © 2017 EDIZIONI MINERVA MEDICA

language: English

Combination therapy for complex peripheral artery disease: the evidence for combining mechanical revascularisation with anti-restenotic drug delivery systems

Ramon L. VARCOE 1, 2, 3

1 Department of Surgery, Prince of Wales Hospital, Sydney, Australia; 2 University of New South Wales, Sydney, Australia; 3 The Vascular Institute, Prince of Wales, Sydney, Australia


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The management of complex, lower-extremity peripheral artery disease remains a difficult challenge, with ample room for improvement in the results seen with current generation devices. Therapies which use a combination of multiple devices for their mechanical and anti-restenotic properties may be advantageous, and offer an opportunity to improve the durability of revascularization through optimizing and individualizing care. Combination therapy typically utilizes drug delivery devices in addition to stents and atherectomy to achieve improved results. However, there is a paucity of high-level evidence with which to direct treatment, with many different forms of combination therapy under investigation and little clinical research coordination. Herein we seek to describe and evaluate the growing number of options for combination treatment in this challenging disease.


KEY WORDS: Peripheral artery disease - Arterial occlusive disease - Femoral artery - Popliteal artery - Tibial arteries - Ischemia - Angioplasty - Stents - Atherectomy - Paclitaxel - Drug-eluting stents

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r.varcoe@unsw.edu.au