Drug-Coated Balloon and Stent Therapies for Endovascular Treatment of Atherosclerotic Superficial Femoral Artery Disease

Abstract

Endovascular management of superficial femoral artery disease has historically been limited to percutaneous balloon angioplasty, atherectomy, and bare-metal stents. However, these therapies have been plagued by high restenosis and target lesion revascularization rates. More recent technologies such as drug-coated stents and balloons are designed to combat restenosis by locally delivering antiproliferative drugs. Several randomized controlled trials have directly compared these antiproliferative drug-delivering devices to their non-drug-coated counterparts. Additionally, trials are currently ongoing to compare use of drug-coated technologies in combination with traditional therapies in hope of synergistic effects. This review gathers data from currently published clinical trials, provides an overview of upcoming clinical studies utilizing drug-coated technology, and explores the possible impact these devices may have on clinical practice.

Efficacy and Safety Differences between Domestic Paclitaxel Drug‐Coated Balloons and Metal Bare Stents in the Treatment of ASO of Femoral‐Popliteal Arteries Type IIA–C

“…At 6 and 12 months after operation, there was no significant difference between the two groups, suggesting that domestic paclitaxel DCB is equivalent to BMS in improving Rutherford classification and ABI index. A previous study [ 12 ] analyzed the efficacy of DCB in the treatment of elderly patients with long-segment ASO lesions and found that the short-term and midterm efficacies of DCB in the treatment of long-segment ASO lesions were not inferior to that of BMS. It was considered that DCB could rapidly release the coating drug to the intima of the diseased vessel through balloon dilatation, which not only reduced the stimulation of foreign body implantation to the wall but also avoided the risk of restenosis after BMS.…”

Detection and characterization of early plaque formations by Raman probe spectroscopy and optical coherence tomography: an in vivo study on a rabbit model

“…Second-generation balloons for angioplasty and stents, which are coated with drugs to prevent early restenosis, are currently under development. [21][22][23] The efficiency of such drug-coated balloons and drug eluting stents can be investigated by directly monitoring the concentration and long-term release spectroscopically, as the active compounds also exhibit distinct spectroscopic properties. 24,25 The applied conditions of several seconds of nonfocused laser illumination at 100 mW within the artery did not lead to any noticeable alterations of the walls of the blood vessels, as confirmed by subsequent histopathological staining.…”

Endovascular Treatment with Drug-Coated Balloons in Femoropopliteal Artery Disease

“…The heavy calcification on the target lesion may reduce drug delivery to the vessel wall via DCB (7). Sub-intimal angioplasty in total occlusion and long lesions also reduces the effectiveness of DCB.…”

“…Furthermore, the mobility and length of the location of FAD facilitate the de- velopment of long stent fractures, restenosis and thrombosis after stent implantation. The most important advantages of DCB versus stents for the treatment of FAD are tied to having more homogeneous and anti-proliferative drug in high doses required per square millimeter, and no foreign substances that might trigger inflammatory processes (6,7).…”