Drug coated balloon angioplasty in the treatment of peripheral artery disease

Introduction: Conventional therapies for transcatheter treatment of patients with obstructive peripheral artery disease of the lower limb remain compromised by high restenosis rates. Drug-coated balloons (DCB) offer a novel therapeutic alternative for such patients, providing local delivery of antirestenotic drug to the vessel wall, targeting the source of neo-intimal hyperplasia, without the need for a permanent endovascular mechanical scaffold and their inherent limitations.

Areas covered: In this article, we present an up-to-date review of the clinical trial literature relating to DCB therapy of infrainguinal obstructive peripheral artery disease as well as a summary of ongoing trials and future directions. Expert commentary: At present, convincing data exists to support the use of DCB in femoropopliteal disease but the role of DCB in the treatment of tibialpedal disease remains less well defined. More randomized data are needed to clarify this, including comparative effectiveness studies against treatment modalities other than PTA, as well as evaluation of their role in combination with adjunctive therapies.