Few areas of medicine are growing as rapidly as the treatment of peripheral vascular disease. The number of peripheral interventions performed annually in the United States has increased from 90,000 in 1994 to over 200,000 in 1997. In the past, patients with this disease had few treatment options—either medical or surgical. However, it is estimated that in the near future endovascular techniques will replace up to 50% of traditional vascular operations.
Peripheral vascular interventions promise to avoid the risks encountered with use of general or epidural anesthesia, to reduce the risk, discomfort, and recovery time associated with surgical procedures, and to reduce the cost of treatment. The enthusiasm for these interventions is shared alike by specialists in cardiology, interventional radiology, and vascular surgery, each of whom brings particular skills and knowledge to the field. To gain expertise in these procedures, an interventionist must understand the natural history and anatomic changes that are seen in peripheral vascular disease. The interventionist must also develop specialized endovascular skills and in-depth knowledge of the various therapeutic options available.
The rapid growth of this field makes it challenging for interventionists to stay abreast of the skills and knowledge necessary to provide the best care to patients with peripheral vascular disease. This section of the Texas Heart Institute Journal, for the June and September issues, is intended to provide updated information about recent changes in the techniques and devices that are used for peripheral interventions. Among the topics covered are aneurysm exclusion, carotid stenting, renal artery angioplasty and stenting, and state-of-the-art diagnostic imaging.