Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA 94143, USA.
Division of Angiology, Medical University Graz, 8036 Graz, Austria.
Rev Cardiovasc Med. 2021 Sep 24;22(3):585-595. doi: 10.31083/j.rcm2203070.
Infrapopliteal atherosclerotic disease continues to present the greatest conundrum for effective endovascular therapies. To date, conventional angioplasty has been fraught with early restenosis and recoil in these complex, long, calcified, and occlusive lesions. The success of metallic drug-eluting stents in coronary arteries has not carried over to below-the-knee arteries. Initial promise in paclitaxel-coated balloons has not been demonstrated in large randomized clinical trials. Furthermore, the potential association between paclitaxel and mortality continues to generate tremendous controversy. The goal of this review article is to discuss the evolution and challenges of drug-coated balloon (DCB) science, present the clinical results of currently available tibial DCBs, and introduce new horizons in DCB technology.
腘动脉以下动脉粥样硬化性疾病仍然是血管内治疗的最大难题。迄今为止，传统的血管成形术在这些复杂、长段、钙化和闭塞病变中，早期再狭窄和回缩的问题仍然存在。金属药物洗脱支架在冠状动脉中的成功并不能转化到膝下动脉。紫杉醇涂层球囊在大型随机临床试验中也没有显示出最初的疗效。此外，紫杉醇与死亡率之间的潜在关联仍存在巨大争议。本文旨在讨论药物涂层球囊（DCB）技术的发展和挑战，介绍目前可用的胫骨 DCB 的临床结果，并介绍 DCB 技术的新进展。
