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(Circulation. 2007;116:2072-2085.)
© 2007 American Heart Association, Inc.

New Drugs and Technologies

Overview of New Technologies for Lower Extremity Revascularization

Jason H. Rogers, MD; John R. Laird, MD

From the Vascular Center and Division of Cardiovascular Medicine, University of California, Davis Medical Center, Sacramento.

Correspondence to John R. Laird, MD, Vascular Center and Division of Cardiovascular Medicine, University of California, Davis Medical Center, 4860 Y St, Ste 3400, Sacramento, CA 95817. E-mail john.laird{at}ucdmc.ucdavis.edu

Lower extremity peripheral arterial occlusive disease poses a unique challenge to traditional angioplasty-based endovascular therapies. The diffuse nature of lower extremity atherosclerotic disease, the presence of chronic total occlusions, poor distal runoff, and the presence of critical limb ischemia all have contributed to the disappointing results of balloon angioplasty for complex infrainguinal arterial disease. These challenges have spawned the development of a host of new technologies in an attempt to improve the safety and effectiveness of percutaneous revascularization for lower extremity peripheral arterial occlusive disease. This review summarizes the recent advances in available technologies, including novel angioplasty balloons; nitinol stents, stent grafts, and drug-eluting stents; excisional, laser, and rotational atherectomy devices; devices for crossing total occlusions; true-lumen reentry devices; thrombectomy catheters; and embolic protection devices.

Key Words: catheter • lower extremity • peripheral vascular diseases • technology

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