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.

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