ABSTRACT
This chapter describes the basic equipment and adjunctive endovascular therapies used to manage peripheral vascular disease. Hemostatic introducer sheaths are generally used for all endovascular procedures. Sheaths are used for a variety of purposes, to straighten out the tortuous iliofemoral vessels, to improve torque control and to facilitate guide catheter, stent and stent graft advancement. In addition to providing a safe port of access to the vascular system, they allow catheter instrumentation without ongoing blood loss or damage to the vessel. Vascular stents were developed to deal with residual stenosis after angioplasty, dissection, recoil, and late failure due to restenosis. The concept of vascular stenting originated with Charles Dotter in 1969. Renal artery stenting has shown superior results to balloon angioplasty by avoiding recoil and dissection. The stents are pre-mounted on a balloon that is lower in profile and specifically designed for visceral and renal artery stenting. Stents have become the most important mechanical innovation for percutaneous revascularization.
