Saucy François, Probst Hervé, Trunfio Rafael
Service of Vascular Surgery, Etablissement Hospitalier de la Côte, Morges, Switzerland.
Service of Vascular Surgery, Department Hear and Vessels, University Hospital, Lausanne, Switzerland.
Front Cardiovasc Med. 2020 Sep 23;7:558129. doi: 10.3389/fcvm.2020.558129. eCollection 2020.
Symptomatic peripheral arterial disease management involves medical treatment and interventional procedures. Intermittent claudication and critical limb threatened ischemia (CLTI) should be individually considered with specific outcomes and procedures. When intervention is required, an endovascular approach is usually the first-line option. Plain balloon angioplasty was previously used to dilate clinically significant femoropopliteal lesions with variable results. However, over recent years, the use of self-expanding nitinol stents has enabled treatment of long lesions, yielding significantly improved clinical results. Drug-eluting technology has also exhibited a capacity to limit in-stent restenosis and to drive target revascularization. Nevertheless, calcifications and elastic recoil of the arterial wall remain risk factors for early restenosis and failure. Therefore, vessel preparation using specific devices is required to modify vessel compliance and debulk obstructive calcification. In this short review, we provide an overview of the options for gaining lumen before stenting or dilation using drug-coated balloons.
有症状的外周动脉疾病管理包括药物治疗和介入手术。间歇性跛行和严重肢体缺血（CLTI）应根据具体结果和手术进行个体化考虑。当需要进行干预时，血管内治疗通常是一线选择。普通球囊血管成形术以前用于扩张具有不同结果的临床显著股腘病变。然而，近年来，自膨胀镍钛合金支架的使用使得能够治疗长病变，产生了显著改善的临床结果。药物洗脱技术也显示出限制支架内再狭窄和推动靶血管重建的能力。尽管如此，动脉壁的钙化和弹性回缩仍然是早期再狭窄和失败的危险因素。因此，需要使用特定装置进行血管预处理，以改变血管顺应性并减少阻塞性钙化。在这篇简短的综述中，我们概述了在使用药物涂层球囊进行支架置入或扩张之前获得管腔的选择。
