Coronary Balloon-Expandable Drug-Eluting Stents for Focal Superficial Femoral Artery Disease: When is the Time Ripe for Challenging Conventional Wisdoms?

The management of patients with peripheral artery disease (PAD) largely depends on symptom status and disease location. Those symptomatic for lower limb atherosclerotic disease are often offered revascularization if medical therapy does not suffice in ameliorating such symptoms. Despite the inherent advantages of surgical revascularization, endovascular therapy appeals many patients given the low invasiveness. However, a plethora of devices and techniques is available, which complicates substantially decision making, especially for lesions located in the femoral vessels. Despite mounting evidence and experience that dedicated self-expandable drug-eluting stents (DES) represent the most favorable choice for many patients, we hereby make the case that in selected subjects with focal superficial femoral artery (SFA) disease, implantation of balloon-expandable drug-eluting stents originally developed for percutaneous coronary intervention (PCI) can prove remarkably safe and effective.