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Review
. 2024 Sep 16;20(18):e1136-e1153.
doi: 10.4244/EIJ-D-23-01080.

Drug-eluting devices for lower limb peripheral arterial disease

Yann Gouëffic  1 , Marianne Brodmann  2 , Koen Deloose  3 , Maxime Dubosq-Lebaz  4 , Joakim Nordanstig  5   6
Affiliations
Review

Drug-eluting devices for lower limb peripheral arterial disease

Yann Gouëffic et al. EuroIntervention. .

Abstract

Peripheral arterial disease is the third leading cause of cardiovascular morbidity after coronary artery disease and stroke. Lower limb peripheral arterial disease commonly involves infrainguinal arteries, may impair walking ability (intermittent claudication) and may confer a significant risk of limb loss (chronic limb-threatening ischaemia), depending on the severity of ischaemia. Endovascular treatment has become the mainstay revascularisation option in both the femoropopliteal and the below-the-knee arterial segments. After crossing and preparing the lesion, treatment results in these arterial segments can be enhanced by using drug-coated devices (drug-eluting stents and drug-coated balloons) that mitigate the occurrence of restenosis. As for other medical devices, the use of drug-eluting devices is based on their demonstrated safety and efficacy profiles when applied in the distinct segments of the lower limb vasculature. In this state-of-the-art narrative review we provide an overview of the safety and efficacy of drug-coated devices when used in the femoropopliteal and below-the-knee arterial segments.

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Conflict of interest statement

Y. Gouëffic reports research funding from PrediSurge, Biotronik, W. L. Gore & Associates, and GE HealthCare; and honoraria for consulting, medical advisory board, educational course, or speaking from Abbott, BD, Bentley, Biotronik, Boston Scientific, Cook, Eclevar Medtech, GE HealthCare, iVascular, Medtronic, Penumbra, Sensome, Shockwave Medical, and W. L. Gore & Associates. K. Deloose reports consulting fees from Terumo, BD, Biotronik, iVascular and honoraria and speaker fees from Boston Scientific, Abbott, Biotronik, Terumo, BD and iVascular. J. Nordanstig is an advisory board member for AstraZeneca and iThera Medical; he has previously received honoraria for educational activities arranged by Medtronic, BD, and Bayer Medical. The other authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1. Primary patency and freedom from target lesion revascularisation rates in randomised controlled trials testing drug-eluting devices for femoropopliteal endovascular interventions.
NA: not applicable; SES: sirolimus-eluting stent
Figure 2
Figure 2. Major amputation and freedom from target lesion revascularisation rates in randomised controlled trials testing drug-eluting scaffolds for below-the-knee endovascular interventions.
Figure 3
Figure 3. Major amputation and freedom from target lesion revascularisation rates in randomised controlled trials testing drug-eluting balloons for below-the-knee endovascular interventions.
NA: not available
Central illustration
Central illustration. Main head-to-head comparisons for femoropopliteal and below-the-knee artery endovascular procedures.
See this image and copyright information in PMC

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