Strategies of endovascular intervention for patients with symptomatic lower extremity artery disease

Peripheral artery disease (PAD) is an obstructive arterial disease of the lower extremities. Due to the aging society and improved diagnostic techniques, the number of patients identified with PAD is increasing. Endovascular treatment (EVT) is a widely accepted interventional management method for diseased lower extremity arteries. Ana-tomically, the arteries of the lower extremities are divided into three segments: aortoiliac, femoropopliteal, and below-the-knee. The strategies of EVT recommended in the relevant guidelines are different for each segment. During the past 20 years, the indications and strategies of EVT have been evolving owing to the development of devices and improvement of clinical outcomes of EVT. Although it might be challenging to catch up with the evolving EVT strategies, we should develop an optimal EVT strategy for each PAD patient, considering that patient and lesion characteristics would also affect clinical outcomes. In this review, we describe the current knowledge of EVT strategies for each segment. We selected the EVT strategies that are currently performed for a majority of symptomatic PAD patients.