ABSTRACT
Atherosclerotic peripheral arterial disease (PAD) has a prevalence of 15-20% in those older than 70 years and 3-10% in younger individuals. It affects more than 10 million people in the USA and is more common in those who smoke or have diabetes. The gold standard in limb salvage for infrapopliteal disease resulting in critical limb ischemia (CLI) has long been open surgical revascularization with autologous saphenous vein. Treatment of infrapopliteal disease includes the anterior tibial artery, tibioperoneal trunk, posterior tibial artery, peroneal (fibular) artery, and pedal arteries. Endovascular interventions for infrapopliteal PAD continue to evolve and provide additional options for patients with limited surgical targets or conduits, or those who are poor surgical candidates. Intervention via percutaneous transluminal angioplasty (PTA) occurs with a radial force exerted causing plaque fracture and intimal injury, which subsequently creates a larger channel.
