[Endovascular therapy for peripheral arterial disease].
Deutsche Medizinische Wochenschrift (1946)
|September 27, 2023
Summary
Peripheral arterial disease treatment includes endovascular and surgical revascularization. Endovascular approaches are preferred for most segments, with specific devices recommended for iliac and femoropopliteal lesions, while infrapopliteal angioplasty remains standard.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Endovascular Therapy
Context:
- Peripheral arterial disease (PAD) management involves conservative, endovascular, and open surgical revascularization.
- Endovascular techniques have advanced significantly, becoming the primary choice for many vascular segments.
- Device selection is crucial and varies by vessel segment.
Purpose:
- To review current endovascular and surgical revascularization strategies for peripheral arterial disease.
- To highlight the efficacy of different devices and techniques in specific arterial segments.
- To discuss emerging therapies and the need for further research.
Summary:
- Primary stent angioplasty is superior to balloon angioplasty for iliac lesions.
- Paclitaxel-eluting balloon angioplasty is recommended for femoropopliteal disease, with no confirmed mortality signal.
- Directional atherectomy and intravascular lithotripsy offer plaque modification options; sirolimus requires further investigation.
- Infrapopliteal balloon angioplasty is the standard treatment, with regular follow-up essential post-intervention.
Impact:
- Provides an overview of current best practices in PAD revascularization.
- Informs clinical decision-making regarding device selection for different PAD locations.
- Identifies areas for future research in PAD treatment, including novel antirestenotic agents.
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