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ITALIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
Rivista di Chirurgia Vascolare ed Endovascolare
PERIPHERAL ARTERIAL DISEASES
Italian Journal of Vascular and Endovascular Surgery 2014 Dicembre;21(4):163-72
Technologies delivering antirestenotic drugs in peripheral arterial disease
Cassese S., Fusaro M.
Deutsches Herzzentrum, Technische Universität München, Munich, Germany
Percutaneous interventions for peripheral artery disease (PAD) have evolved from balloon angioplasty for simple focal lesions to multimodality techniques that enable treatment of severe arterial insufficiency in iliac, femoral as well as below-the-knee setting. The advancement in interventions tools has expanded the opportunity for treating even more complex lesions, such as high-grade, long stenoses, chronic-total, and acute arterial occlusions. However, as the widespread adoption of endovascular therapies for severe PAD increases, unsatisfactory clinical outcomes have to be overcome by the development of new devices. Current portfolio of endovascular techniques includes angioplasty with uncoated balloon and/or balloons coated with antiproliferative drugs, balloon-expandable and self-expandable stents (with or without the delivery of antirestenotic drugs), and plaque-debulking systems (atherectomy, cryoplasty, excimer laser). In this article, we undertake a critical review of the evidence accumulated from randomized controlled trials investigating technologies delivering antirestenotic drugs for the treatment of PAD.