On the horizon: what's coming next for lower extremity interventions

Multiple endovascular interventions exist for the treatment of lower extremity peripheral arterial disease (PAD), with some exhibiting better outcomes than others. As these procedures become more numerous and accepted, the type of interventionalist providing the care is changing. Despite advances in technology and techniques, there are many obstacles to overcome in order to improve the treatment of patients with vascular disease. These can be divided into managing recurrent disease, protection of the distal vasculature, and the prevention of disease. Studies are already underway in areas involving drug-eluting balloons and stents for the periphery, brachytherapy, bioabsorbable stents, distal protection, and therapeutic angiogenesis. As knowledge about the treatment of peripheral arterial disease is acquired that can be applied to the concept of personalized health care, there is hope to be able to slow or arrest the progression of this disease.