CURRENT STATUS OF PERCUTANEOUS VASCULAR PROCEDURES

The current nonsurgical therapeutic options for patients with peripher al vascular disease are rapidly expanding. No longer is conservative m anagement the only alternative for patients with significantly symptom atic but noncritical limb ischemia. Certainly for vascular disease abo ve the inguinal ligament interventional procedures especially with adj unctive stent placement have excellent success and long term patency. Femoropopliteal vascular disease of relatively limited nature also is well-treated with interventional procedures. Infrapopliteal vascular d isease treated with a surgical venous bypass appears to have superior results than intervention. However, for poor surgical risk patients or in patients without the necessary venous conduit, limb salvage is sti ll good with a percutaneous approach. Renal artery stenosis appears no w to be well treated with interventional techniques. Early data with u p to one year follow-up shows that even ostial stenoses respond well w hen vascular stents are utilized. Extending the life of failing hemodi alysis grafts is another area where interventional techniques are of b enefit. In the future, more extensive vascular disease and other vascu lar disease entities such as cerebrovascular disease and abdominal aor tic aneurysm may be successfully treated by a percutaneous approach.