title: Drug-eluting stents and balloons in peripheral arterial disease: evidence so far.
abstract: Restenosis by myointimal hyperplasia after peripheral arterial angioplasty or stenting is a major problem limiting its long-term efficiency and patency, and may lead to recurrent symptoms. Drug-eluting devices which inhibit the proliferation of neo-intimal growth of vascular smooth muscle cells may prevent restenosis. The aim of this article is to examine the evidence in published literature on the use of drug-eluting devices in the treatment of peripheral arterial diseases. A systematic literature review was undertaken of all published literature on this subject using Medline and cross-referenced. All published relevant articles on the use of drug-eluting stents and balloons in peripheral arterial disease were used. Cochrane Central Register of Controlled Trials and electronic databases were also searched for on-going studies. Published results from randomised studies such as the SIROCCO I and II Trials and the THUNDER study, together with single cohort studies, are now available. There are on-going studies comparing drug-eluting and non-drug-eluting devices. Evidence from the published literature suggests that drug-eluting stents and balloons are safe and effective in preventing restenosis after peripheral angioplasty. However, drug-eluting devices are more expensive and many are limited to single-use only. It is anticipated that results from all the on-going studies may allow a meta-analysis to show whether these preliminary data can translate into a clinically applicable cost-effective strategy in combating restenosis after peripheral angioplasty or stenting.
authors.affiliation: Division of Vascular & Endovascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong. ycchan88@ hkucc.hku.hk
authors.forename: Y C
authors.initials: YC
authors.lastname: Chan
authors.forename: S W
authors.initials: SW
authors.lastname: Cheng
mesh_terms: D000800:Angioplasty, Balloon / Q000379:methods*; D050197:Atherosclerosis / Q000628:therapy; D054855:Drug-Eluting Stents; D019317:Evidence-Based Medicine; D006801:Humans; D007511:Ischemia / Q000628:therapy; D007866:Leg / Q000098:blood supply; D058729:Peripheral Arterial Disease / Q000628:therapy*; D012008:Recurrence