[Percutaneous treatment of peripheral obstructive arteriopathy: the reasons for a choice]

Progressive aging of the Italian population is a relevant fact and this increases the occurrence of peripheral vascular disease in this subset of the population. At the same time, due to the national demographic decline, more and more aged people are going to live on their own. In this category the problem of self-caring is becoming highly relevant considering that only 12-13% of patients who had a limb amputation will walk with an artificial leg. This implies relevant social costs which are somewhat hidden because of their distribution in society (hospital, home care, individuals). Undoubtedly, there will be a dramatic reduction in the quality of life for these people. New technological progress and the development of new treatment modalities in the last decade have had a profound impact on the care of these patients. The role of peripheral vessel arteriography as a gold standard for the final evaluation of the disease and for the possibility of endovascular treatment has been widely accepted. Percutaneous transluminal intervention has proven to be more efficient economically with less morbidity and mortality than traditional vascular surgery, mainly in the limb salvage subgroup of patients. Health organization authorities should take these changes into account and modify their attitude towards the treatment of this pathology in order to provide better care for patients and to better allocate the economical resources of the National Health System.