{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T06:52:50Z","timestamp":1791355970034,"version":"4.3.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,10,6]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Drug\u2010coated balloon treatment is the recommended strategy for endovascular peripheral artery disease treatment. Besides proliferation and migration of smooth muscle cells, endothelial dysfunction and inflammation are known contributors in the restenosis process. Sirolimus and paclitaxel are both antirestenotic agents, exerting different pharmacomechanic properties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We investigated the differential effects of sirolimus\u2010 and paclitaxel\u2010coated balloons (SCBs and PCBs, respectively) in the endovascular treatment of severe PAD on endothelial function and inflammation. Clinical outcomes were also assessed. LIMUS FLOW Trial (Sirolimus Versus Paclitaxel Drug\u2010Coated Ballons for Femoropopliteal Disease: The LIMUS FLOW Randomized Trial) was a proof\u2010of\u2010concept investigator\u2010initiated randomized controlled trial with 70 patients randomized to SCBs or PCBs. Endothelial function restoration was assessed via endothelial\u2010dependent vasomotion measured by flow mediated dilatation of the superficial femoral artery. Inflammatory markers, perfusion, primary patency, and target lesion revascularization were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      At 12\u2009months, SCBs led to a greater improvement in endothelial function compared with PCBs (40% improvement with SCBs versus 22% with PCBs,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.023). The improvement in endothelial function was associated with reduced inflammatory markers following sirolimus application at 1\u2010month follow\u2010up. No differences were observed for primary patency or freedom from target lesion revascularization between the groups after 12\u2009months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">LIMUS FLOW explores a novel concept to achieve a more profound mechanistic understanding of vasomotion restoration after application of drug\u2010coated balloons. Improved endothelial function restoration through 12\u2009months, reduction of inflammatory markers through 30\u2009days, with no difference in clinical outcomes, were observed following SCBs versus PCBs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>REGISTRATION<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">www.clinicaltrials.gov<\/jats:ext-link>\n                      ; Unique identifier: NCT05450042.\n                    <\/jats:p>\n                  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