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Macrophage Polarization as a Novel Therapeutic Target for Endovascular Intervention in Peripheral Artery Disease
- Source :
- JACC: Basic to Translational Science
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Highlights • Revascularization for PAD has been characterized by the adaptation of technologies from the treatment of CAD, with few therapies specifically developed for PAD. • In light of recent increases in all-cause mortality driven by endovascular PAD interventions that employ elution of antiproliferative agents, this review highlights the unmet need to address underlying local inflammation and proposes an alternative therapeutic approach. • Development of next-generation PAD-specific endovascular interventions will benefit from integration of specialized immunotherapies that target macrophage polarization and focus on vessel healing.<br />Summary Peripheral artery disease (PAD) has a significant impact on human health, affecting 200 million people globally. Advanced PAD severely diminishes quality of life, affecting mobility, and in its most severe form leads to limb amputation and death. Treatment of PAD is among the least effective of all endovascular procedures in terms of long-term efficacy. Chronic inflammation is a key driver of PAD; however, stents and coated balloons eluting antiproliferative drugs are most commonly used. As a result, neither stents nor coated balloons produce durable clinical outcomes in the superficial femoral artery, and both have recently been associated with significantly increased mortality. This review summarizes the most common clinical approaches and limitations to treating PAD and highlights the necessity to address the underlying causes of inflammation, identifying macrophages as a novel therapeutic target in the next generation of endovascular PAD intervention.<br />Central Illustration
- Subjects :
- medicine.medical_specialty
BMS, bare-metal stent
Arterial disease
macrophage polarization
CAD, coronary artery disease
medicine.medical_treatment
Macrophage polarization
endovascular intervention
Inflammation
Disease
paclitaxel
chemistry.chemical_compound
Quality of life
peripheral arterial disease
SFA, superficial femoral artery
Intervention (counseling)
drug-eluting stent
medicine
vascular inflammation
DES, drug-eluting stent
FP, femoropopliteal
TGF, transforming growth factor
PAD, peripheral artery disease
TNF, tumor necrosis factor
business.industry
vascular healing
IL, interleukin
Surgery
drug-eluting balloon
PTA, percutaneous transluminal angioplasty
Paclitaxel
chemistry
Drug-eluting stent
State-of-the-Art Review
MI, myocardial infarction
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Subjects
Details
- ISSN :
- 2452302X
- Volume :
- 6
- Database :
- OpenAIRE
- Journal :
- JACC: Basic to Translational Science
- Accession number :
- edsair.doi.dedup.....58e4ee4b9cd9a162099cb42e89723720