PERIPHERAL ARTERY DISEASE – AN UPDATE AND FUTURE DIRECTIONS

*Arnon Blum M.D., Anthon Kvasha, M.D., Mohammad Hayder, M.D.

ABSTRACT

Objectives: Atherosclerosis is a dynamic, progressive disease that affects both the coronary and peripheral vascular beds. Its development is driven by traditional and non-traditional cardiovascular risk factors, all of which contribute to endothelial dysfunction — a central mechanism in the pathogenesis of atherosclerosis. To summarize the key role of endothelial dysfunction in atherosclerotic disease progression and to propose a novel therapeutic strategy for patients with peripheral artery disease (PAD). Approach and Results: We reviewed established mechanisms linking risk factors such as hypercholesterolemia, diabetes, hypertension, and cigarette smoking to vascular injury and endothelial dysfunction. We also examined current therapeutic limitations in PAD and evaluated the potential utility of a stem-cell–based approach delivered through a novel endovascular platform capable of sustained, localized cellular release. Endothelial dysfunction accompanies major cardio metabolic disorders and promotes atherosclerotic plaque formation and progression. Existing PAD therapies—including pharmacologic agents, exercise programs, and revascularization—do not reverse the underlying atherosclerotic process and often fail to prevent limb-threatening complications. Emerging evidence suggests that endothelial function can be improved by correcting metabolic disturbances and enhancing endogenous nitric oxide production. Continuous delivery of therapeutic stem cells via a dedicated endovascular device may offer sustained vascular repair, attenuation of endothelial injury, and potential stabilization or regression of atherosclerosis. Conclusions: Peripheral artery disease remains a serious clinical condition with limited disease modifying treatments. A combined strategy using stem cell technology and long-term endovascular delivery may represent a promising therapeutic avenue capable of slowing or possibly halting the progression of atherosclerosis.

Keywords:

PAD; CLI; amputation; stem cells; innovation.

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