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 th e most useful and versatile of all catheter interventions. Common ilia c artery lesions, if short and stenotic, are best managed with angiopl asty. Percutaneous therapy of femoral-popliteal lesions is less satisf actory but applicable in a small subset of patients with favorable les ions. Intravascular stents and thrombolysis are viewed as major develo pments 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 profoun dly current strategies and techniques in the treatment of vascular dis eases.