[Operation and angioplasty in peripheral arterial occlusive disease]

The treatment of peripheral arterial occlusive disease is based on conservative treatment, surgical revascularization, and percutaneous transluminal catheter-based methods. The differential indication for treatment is mainly influenced by clinical and angiographic parameters. The indications for surgical and catheter-based revascularization are relatively clear: Short occlusions and stenoses of the iliac and femoropopliteal arteries in symptomatic patients are ideal indications for PTA. In patients with critical leg ischemia percutaneous revascularization techniques should always be considered to treat these patients with the minimal invasive approach. Long occlusions of iliac and femoral arteries and diffuse occlusions of multiple segments in patients with severe claudication, ischemic rest pain or gangrene are best treated by primary surgical revascularization. Beside the established percutaneous transluminal balloon angioplasty several new interventional techniques were developed to extend the indications for percutaneous treatment, improve acute success rates and reduce complications. Probably, also long-term results after catheter-based therapy of peripheral arterial occlusive disease may be improved by these new technologies.