Evaluation and Percutaneous Management of Atherosclerotic Peripheral Vascular Disease

ATHEROSCLEROTIC peripheral vascular disease (PVD) of the lower extremities deprives a person of the ability to exercise to their satisfaction, later of the ability to perform the activities of their daily life, and finally of their legs themselves. Peripheral vascular disease has long been managed by the vascular surgeon utilizing endarterectomy and peripheral arterial bypass.^1-4 These surgical techniques have been shown to be effective in relieving symptoms and to be durable with the passage of time. Postoperative morbidity, rising health care costs, and refinement of percutaneous catheter technology have led to the development and use of nonsurgical modalities for the management of PVD.⁵ Patient acceptance of nonsurgical, percutaneous procedures such as percutaneous transluminal balloon angioplasty (PTA) is high.⁶ Increased utilization of these procedures has led to improved techniques and adjuncts to therapy, as well as more critical review of long-term results. This article will review the evaluation