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Percutaneous Versus Surgical Management of Lower Extremity Peripheral Artery Disease

Current Atherosclerosis Reports volume 17, Article number: 2 (2015) Cite this article

Abstract

Lower extremity peripheral artery disease (PAD) is highly prevalent and can manifest as intermittent claudication or, in the most advanced form, critical limb ischemia. Revascularization, which can be accomplished by an endovascular or surgical approach, is performed to improve quality of life or, in severe cases, for limb salvage. Over the past decade, percutaneous catheter-based techniques have improved such that acute procedural success is high even in complex anatomy. Patency rates have also increased with the use of atherectomy devices and drug-eluting stents. Often, patients with PAD have comorbidities that increase the risk of cardiovascular complications with surgical procedures. These factors have led to the adoption of an endovascular first strategy with surgical management reserved for selected patients. This review focuses on the most current clinical trials of endovascular therapy for PAD. In addition, older but relevant studies comparing endovascular and surgical approaches and contemporary surgical trials are presented for reference.

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Amit M. Kakkar and J. Dawn Abbott declare that they have no conflict of interest.

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  1. Vascular Medicine and Endovascular Interventions, Jacobi Medical Center, 1400 Pelham Pkwy South Cardiac Cath, Bld 1, 5, West Bronx, NY, 10461, USA

    Amit M. Kakkar

  2. Montefiore Medical Center, Bronx, NY, USA

    Amit M. Kakkar

  3. Brown Medical School, Rhode Island Hospital, 593 Eddy Street, APC 814, Providence, RI, 02903, USA

    J. Dawn Abbott

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  1. Amit M. Kakkar
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Kakkar, A.M., Abbott, J.D. Percutaneous Versus Surgical Management of Lower Extremity Peripheral Artery Disease. Curr Atheroscler Rep 17, 2 (2015). https://doi.org/10.1007/s11883-014-0479-0

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Keywords

  • Peripheral arterial disease
  • Claudication
  • Critical limb ischemia
  • Atherectomy
  • Stents
  • Drug-eluting stent
  • Drug-eluting balloon
  • Endovascular
  • Vascular surgery
  • Saphenous vein graft