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Online ISSN 1827-1847
INNOVATIONS IN BTK TREATMENT
Palena L. M. 1, Granada J. F. 2, Manzi M. 1
1 Interventional Radiology Unit, Foot and Ankle Clinic Policlinico Abano Terme, Abano Terme, Padua, Italy;
2 Skirball Research Center Cardiovascular Research Foundation Columbia University Medical Center,New York, NY, USA
Diabetes is a major risk factor for the development of lower limb arterial occlusive disease and diabetic patients are more likely to progress to critical limb ischemia (CLI) leading to major amputations. CLI is a major worldwide cause of limb amputation, leading to severe disabilities and representing an emerging health issue. Limb amputations are usually associated with a significant increase in mortality risk, and every effort should be pursued to minimize amputations and ensure limb salvage. Arterial revascularization is the first-line of treatment in CLI patients to relieve clinical symptoms and improve wound healing. Despite advances in endovascular techniques, the success of these revascularization procedures is limited by neointimal hyperplasia and subsequent restenosis or occlusion, causing delay in ulcer healing or clinical deterioration. In addition, outcomes in the diabetic subpopulation are even worse, with a higher risk of amputation, re-interventions, and failed procedures in critical limb ischemia. Drug Coated Balloons (DCB’s), which deliver antiproliferative drug release into the vessel wall at the site of endovascular intervention, display promising results in the infrainguinal arteries, reducing restenosis and target lesion revascularization rate in long lesions and may be of particular advantage among diabetics presenting with CLI.