Endovascular femoropopliteal interventions: Evolving devices

Peripheral arterial disease (PAD) is caused by systemic atherosclerosis and is strongly associated with cardiovascular and cerebrovascular disease. Important risk factors for PAD include age >70, history of smoking, diabetes, hypertension, and hyperlipidemia, all known markers for cardiovascular disease [1]. While medical management in conjunction with an exercise regimen is the recommended initial approach, according to the American Heart Association/American College of Cardiology guidelines for the management of PAD, patients with lifestyle-compromising pain, nonhealing ulcers, or critical limb ischemia require invasive endovascular or surgical intervention [2]. There is some disagreement about the appropriate management of femoral-popliteal lesions among various groups of interventionalists, but the Inter-Society Consensus for the Management of PAD (TASC) provides a general approach. Because of the rapidly changing technology, for many interventionalists the endovascular option is the fi rst line of therapy, despite very poor evidence for many of the products currently on the market.