Endovascular intervention for peripheral artery disease.

摘要: Advances in endovascular therapies during the past decade have broadened options for treating peripheral vascular disease percutaneously. Endovascular treatment offers a lower risk alternative to open surgery many patients with multiple comorbidities. Noninvasive physiological tests and arterial imaging precede an intervention help localize plan procedure. The timing need revascularization are broadly related 3 main clinical presentations of claudication, critical limb ischemia, acute ischemia. Many claudication can be treated by exercise medical therapy. procedures considered when these fail improve quality life function. In contrast, ischemia threaten require more urgent revascularization. general, treatments greater long-term durability aortoiliac than femoral popliteal disease. Infrapopliteal is generally reserved Balloon angioplasty stenting mainstays New well-tested innovations include drug-eluting stents drug-coated balloons. Adjunctive devices crossing chronic total occlusions or debulking plaque atherectomy less rigorously studied niche roles. Patients receiving structured surveillance follow-up care. This includes intensive cardiovascular factors prevent myocardial infarction stroke, which causes death. Limb aims identify restenosis new beyond intervened segments, both may jeopardize patency lead recurrent symptoms, functional impairment, threatened limb.