Drug-coated balloons and in-stent restenosis: a new tale of an old story

Multiple studies have shown that nitinol stents improve patency and relieve symptoms more effectively when treating femoral and popliteal obstructions than percutaneous transluminal angioplasty (PTA) alone. However, it is now well known that stents in the superficial femoral artery (SFA) and popliteal arteries are subject to external forces such as bending, twisting, elongation, foreshortening, and external compression1. As a consequence, in-stent restenosis (ISR) has been reported to occur in up to 40% of femoropopliteal lesions treated with metallic stents within one year2,3, with the risk of ISR increasing with lesion length. As the population with femoropopliteal stenting continues to increase, ...