ABSTRACT
The treatment of patients with chronic lower limb ischemia should be tailored to the
individual’s clinical presentation, general health and pattern of disease. Many patients with
intermittent claudication (IC) will be best served by conservative management, instituting best
medical therapy and enrolling them in an exercise program. For a large proportion of patients
with critical lower limb ischemia (CLI) and a salvageable limb, or those with severe lifestyle
limiting IC unresponsive to conservative management, some form of revascularization
procedure will be required. Increasingly more complex atherosclerotic lesions are now being
successfully managed using endovascular techniques where previously only surgical revascu-
larization would have been offered. The present chapter reviews the results of randomized
trials of the management of patients with chronic lower limb ischemia with particular emphasis
on (i) stenting versus angioplasty, (ii) surgery versus angioplasty and (iii) exercise therapy
versus angioplasty.
