Key Points of Endovascular Procedures and Devices in 2023:

FDA Actions:

• Lifted restrictions on paclitaxel-coated balloons and stents for PAD after updated data showed no increased mortality risk.
• Approved coverage of carotid artery stenting for Medicare beneficiaries with severe stenosis.
• Approved the LimFlow device for diverting blood flow in severe CLTI patients, offering limb salvage hope.
• Approved the Paradise and Symplicity Spyral systems as the first renal denervation devices in the US.

CLTI Debate:

• Conflicting data from the BEST-CLI (surgery preferred) and BASIL-2 (endovascular preferred) trials emphasize patient-specific treatment decisions.

Other Developments:

• LIFE-BTK trial showed promising results for a new resorbable scaffold in below-the-knee interventions.
• PEERLESS II, HI-PEITHO, and STORM-PE trials are investigating advanced therapies for pulmonary embolism.

Future Outlook:

• The endovascular field is poised for continued innovation with new technologies and ongoing research.
• There is a need for operator training and reimbursement clarity for novel techniques like renal denervation.
• Upcoming PE trials are expected to provide level 1 evidence for improved treatment options.