Current endovascular treatment of peripheral arterial disease.

Atherosclerotic peripheral arterial disease is a common medical problem worldwide and portends a poor prognosis because of increased cardiovascular morbidity and mortality. Regular exercise, weight loss, and aggressive risk factor modification, including treatment of dyslipidemia and complete cessation of smoking, is extremely important in this high-risk cohort. Vascular surgery in these patients, who often have concomitant coronary or cerebrovascular atherosclerosis, is associated with significant risk. Steady improvements in endovascular revascularization techniques have made this a safe and effective alternate revascularization modality. Percutaneous peripheral vascular interventions have increased dramatically in recent years, from 90,000 in 1994 to more than 200,000 in 1997, and endovascular techniques may soon replace up to 50% of traditional vascular operations. In this article, the authors review the current state of interventional treatment for peripheral arterial disease.