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 Improving Endovascular Treatments For Peripheral Artery Disease

In an attempt to mitigate restenosis, the use of drug-eluting stents (DES) and drug-coated balloons (DCB) has increased significantly in recent years, with many studies demonstrating a significant improvement in patency compared with bare-metal stents (BMS) and plain old balloon angioplasty (POBA). However, longer-term follow up of PAD patients beyond 12 months has shown that their performance is no better than POBA or BMS.

Articles of Interest

Common Femoral Interventions: Is Endovascular Therapy Ready For Prime Time?

While endovascular intervention has emerged as the preferred revascularization strategy for most lower extremity anatomic subsets, endarterectomy has remained the gold standard therapy for common femoral artery (CFA) disease due to its relative ease and durability and theoretical concerns for stenting in this high flexion area. As a result, the evidence base supporting endovascular treatment of the CFA has been understandably meager compared with the aortoiliac and femoropopliteal segments where new endovascular technologies have resulted in significant increases in utilization, often at the expense of surgical revascularization procedures.

Endovascular Intervention for Peripheral Artery Disease

Endovascular therapy is embraced by a wide variety of operators, including interventional cardiologists trained in vascular disease, interventional radiologists, and vascular surgeons trained in endovascular techniques. Key factors for the successful implementation of an endovascular program are the ability to select patients who are likely to benefit over medical therapy and experience outcomes comparable with surgical intervention, skill with the range of technology available (especially the treatment of chronic total occlusions [CTOs]), and careful surveillance for restenosis or new de novo disease that may limit long-term durability.

Endovascular Treatment of Peripheral Artery Disease

Endovascular intervention for peripheral artery disease (PAD) is indicated for lifestyle-limiting claudication or limb preservation in patients with critical limb ischemia. Currently, procedural success rates are improving for increasingly complex disease due to expanding operator experience and improvements in available technology. However, the evidence base lags behind procedural success, with few randomized comparisons among the available devices to achieve revascularization.

Management of chronic peripheral artery disease patients with indication for endovascular revascularization

With an increasing global burden of patients with chronic peripheral artery disease (PAD) the safe and effective provision of lower limb revascularisation is a growing medical need. Endovascular procedures for the treatment of PAD have become a crucial cornerstone of modern vascular medicine, and the first line revascularisation approach if technically feasible and taking patient choice into consideration.

Modern Endovascular Therapy for Peripheral Arterial Disease

Without any doubt, the next decade should allow active research in percutaneous interventions with promising perspectives and progress in all these aspects, especially with the use of artificial intelligence. In this setting,

Recent Trends in Endovascular and Surgical Treatment of Peripheral Arterial Disease

Since the 1960s, the treatment of peripheral arterial disease (PAD) has progressed from an exclusively open surgical approach to one that includes percutaneous minimally invasive options. The latter technique was first developed and described by two radiologists, Dotter and Judkins, to treat lower extremity arteries.

The predictors of clinical outcome after endovascular intervention for lower extremity peripheral arterial disease

This textbook on Angiography and Endovascular Therapy for Peripheral Artery Disease provides a comprehensive angiographic approach to assess and determine optimal treatment strategies for peripheral artery disease (PAD). Each chapter focuses on angiography as it relates to the outcomes of endovascular work. It is an overview of the results obtained from a large number of actual cases with over 100...

Treatment of Peripheral Arterial Disease Using Rotational Atherectomy

Endovascular therapy continues to have significant limitations. Balloon angioplasty of complex lesions and chronic total occlusions (CTOs) is associated with dissection, perforation, and distal embolization. Stents must be able to withstand significant biomechanical forces including compression, flexion, and stretching, which may lead to stent fractures, in-stent stenosis, and stent occlusion. Atherectomy offers the ability to debulk atherosclerotic plaque with minimal change in vessel diameter4 and reduce the need for subsequent stent placement.