[Treatment of peripheral arterial occlusive disease]

The choice of therapy for peripheral artery occlusive disease depends on functional stage, site and extent of vascular lesion, pathogenesis, and the individual needs of the patients. In stage I (according to Fontaine) the risk factors are sought and treated. In stage II walking exercise is the main pillar besides vasoactive drugs and secondary drug prevention. Transluminal angioplasty is recommended if vascular lesions are suitable (short stenoses or occlusions in iliac a/o femoro-popliteal arteries). Surgery may be performed in aorto-iliac arteries but only exceptionally in femoro-popliteal disease. In stage III/IV or chronic critical ischemia every possibility for revascularisation must be considered. In acute stages immediate therapy is necessary. In our hands catheter techniques (thrombolysis a/o aspiration) are the first line approach on the femoro-popliteal level while occlusions on aorto-iliac level are left to surgery.