ABSTRACT
The emerging field of endovascular therapy is opening up new therapeutic avenues for the treatment of peripheral vascular disease. The infrapopliteal arterial bed is a complex vascular bed. Treatment is usually restricted to patients with limb-threatening ischemia. Although education and medical therapy play a cornerstone role in long-term success, endovascular therapy offers a potentially easy low-risk treatment for early healing of damaged tissue. Surgical therapy remains the gold standard of treatment, but there remains significant associated morbidity and mortality. A clear understanding of the vascular anatomy, disease process, extent of tissue damage and comorbidities is necessary in forming the treatment plan for any particular patient. Close follow-up and possible retreatment is a key responsibility for the endovascular physician.