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Drug-Coated Balloons for Native Femoro-popliteal Disease

  • Dario Pellegrini
  • Bernardo Cortese
Chapter

Abstract

Lower extremity artery disease (LEAD) has a high prevalence in general population worldwide and carries a high burden in terms of mortality, morbidity and quality of life. However, this disease is frequently underdiagnosed and undertreated. Revascularization improves symptoms and functional status and has potential to impact on prognosis. Surgical revascularization used to be the only available strategy, but in recent years, endovascular strategies have become first-line treatment, due to low complication rates, faster recovery and good long-term results. Historically, critical drawbacks of percutaneous therapies for peripheral artery disease used to be higher restenosis rates and low long-term patency rates. Bare-metal stents first, and then drug-eluting stents, were introduced to reduce restenosis, similarly to percutaneous coronary interventions. However, LEAD usually involves long vessel segments, and it frequently crosses joints, which are risk factors for restenosis and even strut rupture. Drug-coated balloon (DCB) resolved this issue, allowing better long-term patency rates and lower incidence of complications.

This chapter will review current supporting evidence, indications and technique for DCB angioplasty in femoro-popliteal lesions. Use in below-the-knee disease and in-stent restenosis (ISR), even in the femoral territory, is not discussed in this section but in dedicated, stand-alone chapters.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Dario Pellegrini
    • 1
  • Bernardo Cortese
    • 2
  1. 1.San Luca ClinicMilanoItaly
  2. 2.Cardiac DepartmentSan Carlo ClinicMilanoItaly

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