THE CHALLENGES OF TODAYS ENDOVASCULAR INTERVENTIONS

Endovascular interventions are considered the main therapeutic treatme nt modality for many vascular occlusive diseases. New indications emer ge as short- and long-term successes are reported. For new devices, th ere is a need to determine the superiority of one device or technique over another. Evaluation of these techniques is further complicated by the fact that the alternative therapeutic options (medical and surgic al management) also are undergoing progressive refinement. While some of these results have been validated through state-of-the-art and expe nsive clinical trials, others are supported only by limited observatio nal data due to lack of sufficient funding or restrictive regulations. New and modified devices allow cardiac interventionists to perform mo re complicated procedures and successfully treat mole complex lesions in sicker and older patients. Still, there are many limitations such a s diffuse lesions, poor distal run-off; or too small vessels. Another limitation is that the procedure is not affordable for the majority of patients. There are many unanswered questions regarding the technique s, strategies, and effectiveness of these new modalities of treatment. Only through additional studies and the passage of time will we know the answers to these questions.