Drug-Eluting Stents for Treatment of Peripheral Artery Disease

Abdullah, Kazeen; Dargham, Bassel Bou; Steinbrecher, Micah; Sun, Bo; Zhao, Hongxin; Khalili, Houman; Brilakis, Emmanouil S.; Banerjee, Subhash

doi:10.1007/s40256-018-0265-4

Cited by 7 publications

(5 citation statements)

References 29 publications

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“…Although the technology has not been applied in the venous system [8] , there is no doubt about its potential in treating venous diseases in the future. As endovascular restenosis can also be caused by peripheral blood thrombus formation, a heparincoated stent may be worth exploring as well [47,68] .…”

Section: Drug-eluting Stentsmentioning

confidence: 99%

“…In view of the limitations of the existing stents, a variety of self-expanding nitinol stents for the venous system have been developed, which would provide the best balance between strength, flexibility, and deployment precision [12] . Compared with Wallstents, self-expanding nitinol stents exhibit multiple advantages such as a shortened operation time, good flexibility, and great resistance [32,68] . In patients with symptomatic chronic iliac vein compression and a selfexpanding nitinol stent for endovascular treatment, most of them achieved a good patency rate and clinical improvement [22] .…”

Section: Future Of Venous Stentsmentioning

confidence: 99%

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Current Status and Prospect of Stent Placement for May-Thurner Syndrome

Liu

Lü

et al. 2021

CURR MED SCI

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Stent implantation has been proven to be safe and has become the first-line intervention for May-Thurner syndrome (MTS), with satisfactory mid-term patency rates and clinical outcomes. Recent research has demonstrated that catheter-directed thrombolysis is the preferred strategy when MTS is combined with deep vein thrombosis after self-expanding stent placement. However, the stent used for the venous system was developed based on the experience obtained in the treatment of arterial disease. Consequently, relatively common corresponding complications may come along later, which include stent displacement, deformation, and obstruction. Different measures such as adopting a stent with a larger diameter, improving stent flexibility, and increasing stent strength have been employed in order to prevent these complications. The ideal venous stent is presently being evaluated and will be introduced in detail in this review.

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Section: Drug-eluting Stentsmentioning

confidence: 99%

Section: Future Of Venous Stentsmentioning

confidence: 99%

Current Status and Prospect of Stent Placement for May-Thurner Syndrome

Liu

Lü

et al. 2021

CURR MED SCI

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“…The different treatment approaches include percutaneous transluminal angioplasty or the use of bare metal stents, drug-eluting stents or drug-eluting balloons. Drug-eluting stents show improved results [2,3]. Also the effectiveness of the use of drug-coated balloons has been shown, targeting a decreased cell proliferation, for example, in the treatment of femoropopliteal occlusive disease [4].…”

Section: Introductionmentioning

confidence: 99%

A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty

Maes

Cloet

Fourneau

et al. 2021

J. R. Soc. Interface.

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Restenosis is one of the main adverse effects of the treatment of atherosclerosis through balloon angioplasty or stenting. During the intervention, the arterial wall is overstretched, causing a cascade of cellular events and subsequent neointima formation. This mechanical stimulus and its mechanobiological effects can be reproduced in biomechanical simulations. The aim of these models is to predict the long-term outcome of these procedures, to help increase the understanding of restenosis formation and to allow for in silico optimization of the treatment. We propose a predictive finite-element model of restenosis, using the homogenized constrained mixture modelling framework designed to model growth and remodelling in soft tissues. We compare the results with clinical observations in human coronary arteries and experimental findings in non-human primate models. We also explore the model’s clinical relevance by testing its response to different balloon loads and to the use of drug-eluting balloons. The comparison of the results with experimental data shows the relevance of the model. We show its ability to predict both inward and outward remodelling as observed in vivo and we show the importance of an improved understanding of restenosis formation from a biomechanical point of view.

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“…The introduction of Zilver PTX (Cook Medical, Bloomington, IN, USA), a non-polymer-based paclitaxel-coated nitinol stent, represented a significant clinical innovation for endovascular therapies a decade ago, leading to improved patency rates and reduced rates of target lesion revascularisation (TLR) as compared to those with bare metal stents (BMS) and drug-coated balloons, respectively [ 1 , 2 ].…”

Section: Introductionmentioning

confidence: 99%

A Budget Impact Model for the use of Drug-Eluting Stents in Patients with Symptomatic Lower-Limb Peripheral Arterial Disease: An Australian Perspective

Altaf

Ariyaratne²,

Peacock³

et al. 2021

Cardiovasc Intervent Radiol

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Purpose Improvement in long-term outcomes through innovative, cost-effective medical technologies is a focus for endovascular procedures aimed at treating symptomatic lower-limb peripheral arterial disease (PAD). The advent of drug-eluting stents (DES) has improved symptomatic PAD treatment via a reduction in high rates of target lesion revascularisation (TLR). The present study aimed to compare the 5-year financial impact of treatment with Eluvia, a new paclitaxel-eluting stent, versus treatment with Zilver PTX, a drug-coated stent, among patients in Australia by developing a budget impact model (BIM). Methods A BIM was developed from an Australian public hospital payer perspective using Australian national cost weights (AUD), published literature, and public hospital audit data. Clinical outcomes, including clinically driven TLRs (CD-TLRs), adverse events, and length of stay, were based on the 2-year results of the IMPERIAL trial, which compared Eluvia DES to Zilver PTX. Results Assuming EVP eligibility rate of 80% and DES uses rate ranging from 10 to 28% (superficial femoral artery lesions only), the 5-year model forecasted a treatment population between 14,428 and 40,399 patients. The model estimated 1499–4198 fewer CD-TLRs and 16,515–46,243 fewer hospital days with Eluvia DES use. This translated to 5-year potential savings of $4.3–$12.1 million to the Australian public hospital payer attributable to reduced CD-TLRs for Eluvia DES and $33.1–$92.6 million to Australian public hospitals owing to reduced adverse events and hospital bed days. Conclusion Eluvia DES use as treatment for symptomatic lower-limb PAD could lead to potential savings for the Australian public healthcare system based on improved patient outcomes.

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Drug-Eluting Stents for Treatment of Peripheral Artery Disease

Cited by 7 publications

References 29 publications

Current Status and Prospect of Stent Placement for May-Thurner Syndrome

Current Status and Prospect of Stent Placement for May-Thurner Syndrome

A homogenized constrained mixture model of restenosis and vascular remodelling after balloon angioplasty

A Budget Impact Model for the use of Drug-Eluting Stents in Patients with Symptomatic Lower-Limb Peripheral Arterial Disease: An Australian Perspective

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