The role of endovascular therapy in lower extremity revascularization. Lessons learned and current strategies

Percutaneous endovascular therapy has emerged as an important modality in the treatment of lower extremity ischemia. Its role is relatively small but better defined at present. Balloon angioplasty remains as the most useful and versatile of all catheter interventions. Common iliac artery lesions, if short and stenotic, are best managed with angioplasty. Percutaneous therapy of femoral-popliteal lesions is less satisfactory but applicable in a small subset of patients with favorable lesions. Intravascular stents and thrombolysis are viewed as major developments in the field. Critically ischemic limbs are seldom amenable to endovascular recanalization. The subspecialty of endovascular therapy should become increasingly the focus of attention by the contemporary vascular surgeon. Catheter technology is destined to influence profoundly current strategies and techniques in the treatment of vascular diseases.