Endovascular Treatment for Chronic Total Occlusions of Peripheral Arteries

ABSTRACT

PURPOSE: The TransAtlantic Inter-Society Consensus offers the proper guidelines for the treatment of peripheral arterial disease (PAD). Many new devices and surgical techniques have been introduced to the medical field and these have been aggressively used to manage the patients with PAD. We performed this study to evaluate the current status of endovascular therapy based on the literature and we review the efficacy and safety of the new devices used in the field. METHODS: A search of the literature was performed in the PubMed and science websites. The keywords were "chronic total occlusions", "superficial femoral artery revascularization", "peripheral arterial disease" and "endovascular therapy". RESULTS: The variation of the results was large according to the studies. The rough technical success rate was 80~90% and the 1 year clinical success rate, the primary patency rate and the limb salvage rate for chronic total occlusions were approximately 50~70%, 50% and 80~90%. The efficacy and safety of the new devices used in the field were acceptable. CONCLUSION: Further refinement of the guidewires and sheaths and the development of adjunctive devices have allowed traversal of even the long lesions and this has increased the technical success. Although surgery remains the principal treatment for patients with lower limb ischemia, surgeons must now assess the benefits and risks associated with various treatment options, including endovascular therapy.