World J Cardiol. Nov 26, 2018; 10(11): 196-200 Published online Nov 26, 2018. doi: 10.4330/wjc.v10.i11.196
Revisiting endovascular treatment in below-the-knee disease. Are drug-eluting stents the best option?
Stavros Spiliopoulos, Panagiotis M Kitrou, Elias N Brountzos
Stavros Spiliopoulos, Elias N Brountzos, 2nd Radiology Department, Interventional Radiology Unit, University of Athens, Attikon University General Hospital, Athens 12461, Greece
Panagiotis M Kitrou, Department of Interventional Radiology, Patras University Hospital, Patras 26500, Greece
Author contributions: Spiliopoulos S conceived the study and made critical revisions to its content; Kitrou PM drafted the manuscript and made critical revisions to its content; Brountzos EN drafted the manuscript and made critical revisions to its content; All authors approved the final version of the article.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
Corresponding author to: Stavros Spiliopoulos, MD, PhD, Assistant Professor, 2nd Department of Radiology, Division of Interventional Radiology, National and Kapodistrian University of Athens, School of Medicine, Attikon University General Hospital, Athens 12461, Greece. stavspiliop@med.uoa.gr
Telephone: +30-693-7403468
Received: July 12, 2018 Peer-review started: July 12, 2018 First decision: August 2, 2018 Revised: August 14, 2018 Accepted: October 11, 2018 Article in press: October 12, 2018 Published online: November 26, 2018 Processing time: 137 Days and 8.2 Hours
Core Tip
Core tip: The use of infrapopliteal drug-eluting stents (DES) remains limited in clinical practice mainly due to concerns regarding the deployment of a permanent metallic scaffold and the possibility of valid future therapeutic perspectives. However, these concerns are not scientifically justified. Large-scale, multicenter randomized controlled trials investigating a significantly larger number of patients would consolidate the use of infrapopliteal DES in critical limb ischemia patients. Moreover, there is still little evidence on whether this technology can be as effective for longer lesions, where a considerable number of DES is required. The development and investigation of longer balloon-expanding or self-expanding DES could solve this problem.
