ABSTRACT
INTRODUCTION Minimally invasive endovascular treatment of peripheral arteries is one of the most rapidly evolving techniques in interventional therapies. In the early days of endovascular therapy, when it mainly consisted of plain balloon angioplasty, treatment was offered exclusively for short and easy lesions, whereas more complex and longer lesions generally were considered indications for open vascular surgery. This concept is still reflected by the guidelines of the Transatlantic intersociety consensus (TASC) I document published in the year 2000 (1). However, with increasing experience and confidence in the minimally invasive approach and upcoming advanced technologies, treatment of more complex lesions was becoming clinical routine. Seven years after publication of the first Transatlantic guidelines for treatment of patients with peripheral artery disease, the second version of the TASC document (2) defined more widespread indications for endovascular therapy. Meanwhile clinical practice has further advanced, and in many centers TASC II surgical indications are routinely and successfully treated by endovascular means. However, with lesions getting more complex, interventionists are also confronted with more diseased patients and thus there is an increased risk for complications. Nevertheless, increasing evidence suggests that particularly in heavily diseased high-risk patients, endovascular solutions may offer substantial advantages compared to vascular surgical procedures. Proper physician training, education of complex scenarios, and awareness of potential complications are key issues for running a peripheral interventions program, which offers the full range of what is technically possible today.
