The role of drug coating balloons for artery restenosis

Despite technological developments in the percutaneous trasluminal angioplasty (PTA) of peripheral artery disease (PAD), restenosis remains one of the most important critical issue. The vascular injury determined by balloon-induced barotrauma has been proven to cause restenosis through four processes: 1) acute elastic recoil; 2) negative vascular remodeling; 3) thrombus formation; 4) inflammatory response leading to smooth muscle cells proliferation. Drug-eluting balloons (DEBs), also known as drug-coated balloons, represent the next step in the evolution of effective treatment strategies for atherosclerotic vascular disease. Stent technology, particularly the drug-eluting stents, solved much of the problems, and their use in coronary angioplasty has cemented over the years. However, development of late restenosis and neointimal hyperplasia coupled with the need for effective long-term antiplatelet therapy for preventing stent thrombosis meant that further evolution of technologies was needed to develop an effective therapy for extracardiac atherosclerotic vascular disease.