Below-the-knee drug-eluting stents and drug-coated balloons

Area of Science:

• Vascular Surgery
• Interventional Cardiology
• Biomaterials Science

Background:

• Endovascular procedures are standard for infrapopliteal obstructive disease, particularly in critical limb ischemia patients.
• Standard balloon angioplasty has limitations including recoil, dissection, neointimal hyperplasia, and restenosis.
• Bare-metal stents also face challenges with progressive vascular restenosis.

Purpose of the Study:

• To review drug-eluting technologies for endovascular below-the-knee treatments.
• To summarize current clinical data on drug-eluting stents and drug-coated balloons.
• To critically appraise the current status and future of these endovascular interventions.

Main Methods:

• Literature review of drug-eluting properties of endovascular devices.
• Synthesis of available clinical data on drug-eluting stents and balloons.
• Critical appraisal of current evidence and future trends in below-the-knee interventions.

Main Results:

• Drug-eluting stents and drug-coated balloons aim to significantly inhibit vessel restenosis.
• These emerging technologies offer the potential for improved clinical outcomes compared to standard angioplasty.
• Current data suggests a promising role in managing complex infrapopliteal disease.

Conclusions:

• Drug-eluting technologies represent a significant advancement in endovascular below-the-knee revascularization.
• These innovations hold promise for reducing restenosis and enhancing patient outcomes in critical limb ischemia.
• The review provides insights into the current landscape and future directions for below-the-knee endovascular therapies.