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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
INTERVENTIONAL VASCULAR PROCEDURES
Italian Journal of Vascular and Endovascular Surgery 2012 March;19(1):9-20
Drug eluting balloons and stents: the solution to prevent and treat re-stenosis in peripheral artery disease
Bausback Y., Schmidt A., Scheinert D.
Centre of Vascular Medicine, Angiology and Vascular Surgery, Park Hospital Leipzig, Leipzig, Germany
Endovascular therapy has become the first line treatment in many cases of symptomatic peripheral occlusive artery disease (PAOD) as defined in the TASC II document consented by international vascular societies in 2007. Although highly successful, it still lacks sufficient long term outcome and is associated with a high rate of re-stenosis. Intensive attempts were undertaken to overcome this burden, like alternative balloon-technologies (cutting- and scoring balloons), atherectomy and the development of different stent-designs. Currently the most promising new technology seems to be local drug delivery with drug-eluting stents or drug-eluting balloons and a similar breakthrough seems possible as has been seen for coronary artery revascularization, where the use of drug-eluting stents has been implemented to actual guidelines. Several technologies are on the shelf, which are Paclitaxel-eluting balloons for all infrainguinal arteries, Paclitaxel-eluting stents for femoropopliteal arteries and Sirolimus- or Everolimus-eluting stents for infrapopliteal arteries. This review aims to describe the current drug eluting technologies which are available for treatment of infrainguinal PAOD, to summarize currently published trials and illustrate ongoing studies.