IMR Press / RCM / Volume 22 / Issue 3 / DOI: 10.31083/j.rcm2203070
Open Access Review
Progress on developing an effective below-the-knee drug-coated balloon
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1 Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA 94143, USA
2 Division of Angiology, Medical University Graz, 8036 Graz, Austria
Academic Editor: Bernardo Cortese This article belongs to the Special Issue: Drug-Coated balloons-The “leave nothing behind” strategy ().
Rev. Cardiovasc. Med. 2021 , 22(3), 585–595;
Submitted: 2 August 2021 | Revised: 18 August 2021 | Accepted: 25 August 2021 | Published: 24 September 2021

Infrapopliteal atherosclerotic disease continues to present the greatest conundrum for effective endovascular therapies. To date, conventional angioplasty has been fraught with early restenosis and recoil in these complex, long, calcified, and occlusive lesions. The success of metallic drug-eluting stents in coronary arteries has not carried over to below-the-knee arteries. Initial promise in paclitaxel-coated balloons has not been demonstrated in large randomized clinical trials. Furthermore, the potential association between paclitaxel and mortality continues to generate tremendous controversy. The goal of this review article is to discuss the evolution and challenges of drug-coated balloon (DCB) science, present the clinical results of currently available tibial DCBs, and introduce new horizons in DCB technology.

Drug-coated balloon
Device design
Peripheral arterial disease
Fig. 1.
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