We started with Acrobat Pro about ten years ago to markup ISO's. About five or six years ago we switched to using the editor from Tracker Software. I've enjoyed good success with it:

https://www.tracker-software.com/

We've got a custom set of stamps that we use to annotate stress ISO's with restraint symbols, node numbers, along with approval/rejection stamps, and digital version of PE Seals for final sign-off of IFC's.

We're actually evaluating Bluebeam Revu right now and, I have to say I'm not impressed so far. Its approach to stamps and organization is very primitive compared to what I've become used to with PDF-Xchange.