The Value Of Drug-Eluting Stents For Infrapopliteal Artery Lesions: A New Horizon, But Large Scale Randomized Trials Are Recommended

Main Category: Cardiovascular / Cardiology
Also Included In: Medical Devices / Diagnostics
Article Date: 24 Nov 2008 - 6:00 PST

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Recanalization of infrapopliteal arteries is important in patients with chronic limb ischemia to decrease limb-loss. Dr. Konstantinos Katsanos, of the Department of Radiology, Patras University Hospital School of Medicine, Patras, Greece, reviewed published data that highlighted the promising long-term limb salvage rates of below-the-knee angioplasty.

But, he noted re-occlusion following infrapopliteal angioplasty and stenting is identified in more than 50% of cases by 1 year thereby resulting in a high frequency of repeat procedures.

Drug-eluting stents (DES) have emerged as a potential solution to prevent restenosis from occurring. Dr. Katsanos reviewed studies that reported superior 6-month and 1-year angiographic and clinical performance of sirolimus-eluting stents (SES) versus bare metal stents (BMS) in terms of significantly reduced neointimal hyperplasia, higher angiographic primary patency and lower clinically driven re-intervention procedures.

He concluded that infrapopliteal SES for CLI significantly improve primary patency and reduce infrapopliteal vascular restenosis thereby lessening the rate of clinically driven repeat procedures. Dr. Katsanos cautions, however, that large-scale multicenter randomized trials are required to further investigate the role of infrapopliteal SES in CLI treatment prior to widespread adoption of this technology.

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Source
Pauline T. Mayer
www.ptmhcm.com