Presented today, late-breaking data from the second year of the LIFE-BTK clinical trial demonstrate the long-term effectiveness of the US Food and Drug Administration (FDA)-approved Esprit BTK everolimus-eluting resorbable scaffold system (Abbott Vascular) in patients with the most severe form of below-the-knee (BTK) peripheral arterial disease (PAD). The data show that the Esprit BTK offers sustained benefits over balloon angioplasty with fewer repeat procedures at two years.

Using the most conservative delta between the two groups in terms of the primary efficacy endpoint at 365 days, not inclusive of the treatment window, the Esprit BTK scaffold costs an additional US$7,086 per primary efficacy endpoint avoided. This led Parikh to report that the Esprit BTK scaffold achieves a 64% probability of cost-effectiveness at a US$10,000 willingness-to-pay threshold compared to angioplasty. As a result of this, he averred: “The use of Esprit BTK at one year alone is likely to be cost effective.”

Using peptides replicating the membrane-distal portion of CD31, which is prominently exposed on the inner side of healthy vessels, can simulate the surface of a healthy endothelium. This approach effectively prevents the deposition and activation of blood platelets and leukocytes, which are abnormally prolonged by the presence of a foreign body at sites of endovascular stent implantation, and promotes the acquisition of physiological phenotype by the ECs covering the surface.

Peripheral artery disease (PAD) is the lower limb manifestation of systemic atherosclerotic disease. PAD may initially present with symptoms of intermittent claudication, whilst chronic limb-threatening ischaemia (CLTI), the end stage of PAD, presents with rest pain and/or tissue loss. PAD is an age-related condition present in over 10% of those aged ≥65 in high-income countries. Guidelines regarding definition, diagnosis and staging of PAD and CLTI have been updated to reflect the changing patterns and presentations of disease given the increasing prevalence of diabetes.

Despite medical and technical progress, therapy of lower extremity arterial disease (LEAD) remains limited by subsequent disease progression and ultimate limb ischaemia. Even today, interventional and surgical revascularisation does not enable long-term success in all patients, and/or may not be technically feasible in end-stage LEAD anymore. Subsequent intractable claudication, impaired quality-of-life and work capacity, limb loss, and associated morbidity and mortality have thus generated impetus for alternative therapies.

Humacyte recently announced it has been granted Regenerative Medicine Advanced Therapy (RMAT) designation from the US Food and Drug Administration (FDA) for its investigational acellular tissue engineered vessel (ATEV), designed to treat patients with advanced peripheral arterial disease (PAD). This RMAT designation was granted at the same time as the FDA cleared a new Investigational New Drug (IND) application for the PAD indication for ATEV, formerly referred to as the human acellular vessel (HAV).

Despite decades of effort aimed at developing clinically effective cell therapies, including mixed population mononuclear cells, to revascularize the ischemic limb, there remains a paucity of patient-based studies that inform the function and fate of candidate cell types. In this study, we showed that circulating proangiogenic/arteriogenic monocytes (PAMs) expressing the FcγIIIA receptor CD16 were elevated in patients with chronic limb-threatening ischemia (CLTI), and these amounts decreased after revascularization. Unlike CD16-negative monocytes, PAMs showed large vessel remodeling properties in vitro when cultured with endothelial cells and smooth muscle cells and promoted salvage of the ischemic limb in vivo in a mouse model of hindlimb ischemia. PAMs showed a propensity to migrate toward and bind to ischemic muscle and to secrete angiogenic/arteriogenic factors, vascular endothelial growth factor A (VEGF-A) and heparin-binding epidermal growth factor.

CD31-coated surfaces promoted the acquisition of a physiologic endothelial cell phenotype and rapid coverage at a significantly higher extent as compared to bare metallic surfaces in vitro. Nitinol and cobalt-chromium stents coated with CD31-mimetic peptides were rapidly integrated within the arterial wall in vivo without thrombo-inflammatory signs up to 30 days after implantation.

DES was the best regarding 3-year primary patency, TLR, mortality, and 5-year TLR. DCB was the best regarding 3- and 5-year major amputation, and 5-year primary patency. DES and DCB should be given priority in treating de novo femoropopliteal lesions.

Although evidence suggests that the performance of DCBs is independent of lesion complexity, there continues to be a bailout stent ratio > 40% in long lesions (> 20 cm), severely calcified lesions, and a high number of chronic total occlusions. In arteries that are obstructed by overwhelming atherosclerotic plaque deposition, balloon angioplasty increases the vessel lumen through uncontrolled dissection, resulting in longitudinal tears and creating tissue flaps with varying degrees of severity. Additional data also suggest that untreated dissections following plain old balloon angioplasty (POBA), including non–flow-limiting dissections, are associated with reduced patency.

VenoStent has developed an absorbable extravascular stent, SelfWrap, which not only retains the function of a non-absorbable extravascular stent like the VasQ, but can also be absorbed by the human body, and more importantly, it can be personalized for the patient to better meet his or her needs. Due to its technological innovation, SelfWrap received FDA Breakthrough Device designation in 2022 and was approved by the FDA for an IDE study last year.

Cardiovascular diseases have been primarily characterized by the dysfunction of the myocardium as the primary and major cause of morbidity and mortality and have shown an increased rate across the globe. Both experimental and clinical studies show that the activation of inflammatory responses, myocardial necrotic, apoptotic, and autophagic processes substantially aggravate cardiac dysfunction, leading to the development of heart failure, ventricular arrhythmias, and sudden cardiac death.

Poly-L-lactic acid (PLLA) stents have broad application prospects in the treatment of cardiovascular diseases due to their excellent mechanical properties and biodegradability. However, foreign body reactions caused by stent implantation remain a bottleneck that limits the clinical application of PLLA stents. To solve this problem, the biocompatibility of PLLA stents must be urgently improved. Albumin, the most abundant inert protein in the blood, possesses the ability to modify the surface of biomaterials, mitigating foreign body reactions—a phenomenon described as the “stealth effect”.

A new joint guideline from the American Heart Association (AHA), the American College of Cardiology (ACC) and nine other medical societies reports early diagnosis and treatment of peripheral artery disease is essential to improve outcomes and reduce amputation risk, heart attack, stroke and death for people with Peripheral Artery Disease (PAD).

The company said the proceeds would support its pivotal clinical trial in patients with severe vessel blockages below the knee, including people facing the potential loss of the limb, as well as help scale up its manufacturing base.

Among patients with CLTI due to infrapopliteal artery disease, the use of an everolimus-eluting resorbable scaffold was superior to angioplasty with respect to the primary efficacy end point.

The Chocolate Touch showed statistically superiority in its primary efficacy endpoint of 12-month true DCB success—a measure of the target vessel remaining patent without the need for bail-out stenting. Primary patency by Kaplan-Meier (KM) estimate was 83.3% for the Chocolate Touch and 73.0% for Lutonix DCB at 12 months.

STAND (A Clinical Evaluation of the MicroSTent PeripherAl Vascular SteNt in subjects with Arterial Disease Below the Knee) enrolled its final patient earlier this month marking the completion of the study. MicroStent is a vascular stent specifically designed to achieve and maintain tibioperoneal arterial patency improving blood flow and wound healing for below-the-knee amputation reduction in patients with CLTI resulting from progressive peripheral artery disease (PAD).

Using data from Medicare inpatient and outpatient hospital claims made between 2016–2019, beneficiaries over the age of 65 who were diagnosed with CLTI and underwent a major lower-limb amputation were identified. Patients were required to have at least one year of Medicare enrolment before major amputation to allow for the ascertainment of intensity of vascular care, and two years enrolment following the procedure to ensure adequate follow-up.

For patients living with PAD or chronic limb-threatening ischemia (CLTI) who are from racial/ethnic minority groups, economically disadvantaged, or living in areas without access to good vascular care, the future is often dimmed by unnecessary amputations and early death. That reality has been met by a profound lack of accountability and desire for change among the medical professionals they rely on for help, experts said in a special session at VIVA 2022.