International Journal of Research in Medical Sciences | May 2018 | Vol 6 | Issue 5 Page 1474 International Journal of Research in Medical Sciences Dave B et al. Int J Res Med Sci. 2018 May;6(5):1474-1483 www.msjonline.org pISSN 2320-6071 | eISSN 2320-6012 Review Article Peripheral stent technology and current status for endovascular treatment of femoropopliteal artery disease: a clinical review Bhargav Dave*, Rikin Shah INTRODUCTION Globally, peripheral arterial disease (PAD) is estimated to affect more than 200 million people. It is one of the leading cause of morbidity and mortality which predominantly affects the elderly population. 1 PAD usually appears after the age of 50 years, with an exponential increase after the age of 65. This rate reaches around 20% by the age of 80. 2 Claudicating in PAD reduces walking distance and impairs quality of life after the blood flow is limited in the area. PAD in superficial femoral arteries (SFA) and popliteal arteries (PPA) share common significant risk factors for atherosclerosis. Quarterly of the total patients with PAD present intermittent claudication (IC) and progress to critical limb ischemia which leads to significant disability and limb loss. Patients with asymptomatic as well as symptomatic PAD are at an increased risk of cardiovascular morbidity and mortality compared with subjects without PAD. 3-7 Challenges in management of PAD with current technology: focus on device characteristics As per current standards, personal and family clinical history of the patient should be assessed initially to detect the presence of cardiovascular disease (CVD) as well as LEAD to evaluate risk factors and co-morbidities. Lifestyle habits and physical activities also need to be systematically investigated to provide reasonably accurate outcome measures and determine the Research Scientists, Divine CSRD, LLC, 2804 Field Hollow Dr, Pearland TX USA-77584 Received: 13 February 2018 Accepted: 28 March 2018 *Correspondence: Dr. Bhargav A. Dave, E-mail: pt.davebhargav@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Over the past decade, the treatment of peripheral artery disease poses a number of technical challenges for the physician. The primary rationale of this article is to review the available literature on the current practices involved in the treatment of peripheral artery disease (PAD), particularly the femoropopliteal lesions. It is evident from the landmark clinical trials that the use of self-expanding drug-eluting stents (DES) has become the most favored clinical strategy for treating peripheral lesions above the knee. It is chiefly due to higher patency rates, and minimal in-stent restenosis and stent fracture rates associated with the use of DES. The technical evolution in the endovascular approach from the use of bare nitinol stents to DES for treating PAD and the factors responsible for this transformation have also been reviewed with their respective justification. Presently there is a need of DES technology for the treatment of femoropopliteal lesions, which can reduce the risk of stent fracture and in-stent restenosis for longer lesions while maintaining patency during long-term follow-up. To conclude, this review establishes that self-expanding DES and drug coated balloons using anti-proliferative drugs like sirolimus and paclitaxel are currently the most effective method of treating the femoropopliteal lesions in PAD. Keywords: Ankle brachial index, Drug-eluting stents, Endovascular, Femoropopliteal, Nitinol, Peripheral artery disease, Self-expanding, Sirolimus DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20181743