Central Illustration.

Macrophage Polarization as an Alternative Target for Improved Long-Term Outcomes of Peripheral Artery Disease Intervention

Current drug-eluting peripheral artery disease interventions relying on antiproliferative drugs (eg, sirolimus, paclitaxel) suppress restenosis for the duration of drug elution but do not address underlying vessel injury and inflammation driven by M1 macrophages (Top). Additionally, current immunotherapy approaches focus solely on targeting individual cytokines sustaining vascular injury but are similarly only effective as long as the drug is eluted. Polarization of macrophages toward anti-inflammatory/tissue reparative M2 phenotypes represents a potentially more effective and long-lasting approach to suppress vascular inflammation by repairing injured vessels (Bottom).