Dual antiplatelet therapy (DAPT) has become an essential medication in daily clinical practice, but the optimal duration of DAPT after the implantation of a DCB remains unknown. At the time of the first in vivo implantation of paclitaxel-DCB for the treatment of ISR in 2006, the protocol-defined DAPT duration was only 1 month. Subsequently, DAPT duration ranging from 1 to 12 months has been recommended by various trials. However, there have been no randomized controlled trials (RCTs) on the optimal duration of DAPT after DCB angioplasty. Current clinical guidelines normally recommend the duration of DAPT after DCB-only angioplasty based on data from RCTs on the optimal duration of DAPT after stenting. In this review, we summarized current clinical trials on DCB-only angioplasty for different types of CADs and their stipulated durations of DAPT, and compared their clinical results such as restenosis, target lesion revascularization (TLR) and stent thrombosis event.

While prolonged DAPT confers thrombotic risk reduction, it invariably increases bleeding complications, which are themselves associated with adverse prognostic implications. This dilemma has prompted the exploration of de-escalation strategies—gradual tapering of antiplatelet intensity or duration—as a means of optimising patient outcomes. Currently, the concept of DAPT de-escalation refers to the strategy of discontinuing aspirin after a short period of dual antiplatelet therapy after PCI, leaving patients on monotherapy with a potent P2Y12 inhibitor—typically ticagrelor, as supported by available evidence. The rationale behind this approach is to maximise ischaemic protection during the initial months after PCI, when the thrombotic risk is highest, while simultaneously mitigating the bleeding risk, which remains relatively constant and is directly associated with DAPT duration.

Vascular occlusive diseases, ranging from acute blockages to chronic arterial narrowing, represent a leading cause of morbidity and mortality worldwide. The deployment of vascular stents has long stood as a frontline therapeutic approach to restore blood flow within narrowed or obstructed vessels. Yet, despite advancements, the current landscape remains burdened by recurrent complications such as “intravascular restenosis,” where excessive smooth muscle cell proliferation narrows the vessel again, and delayed endothelial recovery that compromises vessel healing.

Thrombus treatment remains a significant challenge, primarily due to factors such as the short half-life of thrombolytic agents, suboptimal drug utilization, and limited therapeutic efficacy. In this study, we developed a platelet membrane-camouflaged bioactive glass nanoparticles (BGs) as drug carriers to load thrombolytic agent urokinase (UK) and anticoagulant drug tirofiban (TF). UK and TF were firstly incorporated onto BGs, and followed by a camouflage of polydopamine (PDA) and platelet membrane (PM) to form composite nano-formulation (TUBGs@PP). This composite nano-formulation leverages the PM camouflage to enhance its biocompatibility, prolong circulation time in vivo, and extend the half-life of drugs.

Pharmacologically, the trial used various paclitaxel-coated balloons without subgroup stratification, introducing heterogeneity in drug delivery and healing responses [2]. Furthermore, no platelet function or pharmacogenomic testing was employed to tailor antiplatelet therapy—despite known interindividual variability in response, especially with ticagrelor and clopidogrel [3]. This limits the precision and personalization of therapy.

Stentless treatment of acute coronary syndrome uses gradual, prolonged predilation. A perfusion balloon combined with a drug-coated balloon was used. The stentless strategy achieved successful revascularization in most patients. No acute occlusion or in-hospital major adverse cardiac events were reported. A low incidence of target vessel failure at 24 months was reported.

DCBs were similarly safe and effective as current-generation DES in the treatment of coronary arteries <3 mm, regardless of bleeding risk. In patients treated with DCB, there was a trend towards a reduction of severe bleeding events at 3 years.

While stroke treatment has dramatically changed in recent years, still around 795,000 people experience a new or recurrent stroke each year, and of all strokes 87% are ischaemic.1 A high variability in accessing stroke treatments exists across different countries or different regions within the same nation, even if at present guidelines are quite definitive in indicating endovenous thrombolysis and mechanical thrombectomy (MT) in selected cases as key treatment points. However, treatment indications are continuously evolving and so the vascular surgery world should be prepared to evolve accordingly.

“Tracking a bridging stent to its target lesion can be a challenge,” Haulon remarked, going into more detail about some issues commonly encountered during FEVAR. “You need to get a sheath all the way from the groin through the fenestration and into the target vessel to protect the tracking of your bridging stent, so you need a bridging stent that can adapt to the anatomy and be flexible enough to get all the way to the target vessel.”

A press release notes that the SirPAD (Major adverse limb events in patients with femoropopliteal and below-the-knee peripheral arterial disease treated with either sirolimus-coated or uncoated balloon) randomised controlled trial is the world’s largest study evaluating the treatment of PAD using the MagicTouch PTA sirolimus-coated balloon versus uncoated balloons and one of the largest device studies ever performed for PAD.

Several studies have demonstrated the benefits of drug-eluting therapy for femoropopliteal lesions, Brodmann noted, including sustained vessel patency, clinical improvement, and fewer reinterventions. The question of whether these benefits transfer to real-world practice, however, remains unanswered.

“The era of bioabsorbable scaffolds has really begun with the Esprit drug-eluting resorbable scaffold (DRS),” Secemsky commented, noting that this Abbott innovation “is what created the market in the USA”. Esprit DRS is the first device of its kind to receive approval from the US Food and Drug Administration (FDA), the presenter shared, highlighting positive data from the prospective, multicentre, randomised LIFE-BTK trial that now has results available out to two years.

A press release notes that Surmodics Pounce thrombectomy systems are intended for the non-surgical removal of thrombi and emboli from the peripheral arterial vasculature. The new Pounce XL thrombectomy system is indicated for use in vessels ranging from 5.5–10mm in diameter, sizes typical of iliac and femoral arteries. The Pounce XL system complements the Pounce and Pounce LP thrombectomy systems, which are indicated for 3.5–6mm and 2–4mm vessels, respectively.

“Ultrasound guidance is currently not a standard of care for all vascular access, but it is becoming increasingly common in daily clinical practice due to its ability to enhance success rates and reduce complications,” says lead co-author Annette Vegas, an anesthesiologist and director of Perioperative Echocardiography at Toronto General Hospital (Toronto, Canada). “Adopting the recommendations in this guideline will help clinicians better minimise risks, maximise technical competencies and ultimately, improve patient outcomes.”

Shape Memory Medical today announced the first European enrolment in the AAA-SHAPE pivotal trial, the company’s prospective, multicentre, randomised, open-label trial to determine the safety and effectiveness of the Impede-FX RapidFill device to improve abdominal aortic aneurysm (AAA) sac behavior when used with elective endovascular aneurysm repair (EVAR). The patient was treated by Jan Heyligers and Patrick Vriens at Elisabeth TweeSteden Hospital in Tilburg, The Netherlands.

Humacyte today announced the commercial launch of Symvess (acellular tissue engineered vessel-tyod) for use in adults as a vascular conduit for extremity arterial injury when urgent revascularisation is needed to avoid imminent limb loss, and when autologous vein graft is not feasible.

Cook Medical’s Zenith Alpha 2 (ZTA2) thoracic endovascular graft is now available throughout the United States. A company press release states ZTA2 is the first aortic device on the market that has evolved to accommodate CO2 flushing and has an approved flushing protocol.

The company is actively conducting clinical trials in both South Korea and the USA, which it says demonstrate “promising” results. In South Korea, seven patients have undergone the procedure, showing meaningful reductions in blood pressure without any adverse events during- or post-operation. The company aims to complete enrolment for its Korean clinical trial within the first quarter of 2025.

The creation of an arteriovenous fistula (AVF) to achieve long-term access to blood vessels is required for patients undergoing haemodialysis. However, narrowing of blood vessels in and around the AVF can interfere with haemodialysis delivery, resulting in potentially life-threatening consequences. The Wrapsody cell-impermeable endoprosthesis (CIE) is designed to help clinicians restore vascular access in patients on haemodialysis who experience stenosis in their venous outflow circuit.

This prospective, randomised (2:1 treatment to control) dual-centre study will enrol up to 60 patients. The study will utilise intravascular OCT imaging to demonstrate the mechanism of action (MOA) of the Serranator and compare the serration MOA to conventional angioplasty across a wide range of lesion morphologies in below-the-knee arteries.