Peripheral vascular disease articles from across Nature Portfolio

Batan et al. show that inhibiting the antiangiogenic VEGF₁₆₅b isoform activates a previously unrecognized miR-17-20a-RCAN3 pathway that induces ischemic endothelial cell angiogenic capacity and promotes M2-like macrophage polarization to achieve perfusion recovery in murine peripheral artery disease (PAD) model.

Treatment alternatives are not available for a significant portion of critical limb ischemia patients. Here, the authors show a strategy to engineer mesenchymal stem cells-derived extracellular vesicles to induce revascularization in mice.

In the LIFE-BTK trial, treatment with an everolimus-eluting resorbable scaffold was superior to angioplasty in improving clinical outcomes in patients with chronic limb-threatening ischaemia due to infrapopliteal artery disease.

In patients with chronic limb-threatening ischaemia who had an adequate conduit for vein bypass, bypass surgery is associated with fewer adverse events or deaths than an endovascular procedure, according to findings from the BEST-CLI trial.

In ischaemic tissues, macrophages accumulate in the perivascular region and regulate blood flow by releasing nitric oxide derived from inducible nitric oxide synthase, thereby increasing muscle perfusion and improving limb function.

Although an unplanned, interim analysis from an ongoing randomized trial in Sweden has suggested no significant difference in mortality between patients with peripheral artery disease receiving paclitaxel-coated devices and those receiving uncoated devices for lower-extremity revascularization, the analysis did not resolve the question of whether paclitaxel-coated devices are safe for these patients.

Findings from the VOYAGER PAD study show that adding rivaroxaban to standard aspirin therapy can reduce ischaemic risk in patients with peripheral artery disease who have undergone lower-extremity revascularization.