Drug-Eluting Stents: New Tools for the Armamentarium Against Peripheral Arterial Disease

With the growing epidemic of diabetes and hyperlipidemia, there is an ever-increasing prevalence of peripheral arterial disease (PAD) of the lower extremities. The complications of PAD can be devastating and can increase the economic burden on the healthcare system. Traditionally, open revascularization procedures have been the mainstay of treatment for lower extremity PAD. Cardiac comorbidities are common among patients with PAD and as such may prohibit open revascularization. With the advent of minimally invasive endovascular procedures, the threshold for revascularization opportunities has increased. Despite promising early results of percutaneous transluminal angioplasty (PTA), atherectomy, and stenting, long-term outcomes are hindered by neointimal hyperplasia, which accounts for high restenosis and thrombosis rates. The utility and efficacy of drug-eluting stents in decreasing restenosis rates has been well demonstrated for coronary artery disease. This article will present a review of the current literature available on the use of drug-eluting (polymer-free) and drug-coated (polymer) stents for lower extremity PAD.