title: SCAI expert consensus statement for femoral-popliteal arterial intervention appropriate use.
abstract: Successful endovascular intervention for femoral-popliteal (FP) arterial disease provides relief of claudication and offers limb-salvage in cases of critical limb ischemia. Technologies and operator technique have evolved to the point where we may now provide effective endovascular therapy for a spectrum of lesions, patients, and clinical scenarios. Endovascular treatment of this segment offers a significant alternative to surgical revascularization, and may confer improved safety for a wide range of patients, not solely those deemed high surgical risk. Although endovascular therapy of the FP segment has historically been hampered by high rates of restenosis, emerging technologies including drug-eluting stents, drug-coated balloons, and perhaps bio-absorbable stent platforms, provide future hope for more durable patency in complex disease. By combining lessons learned from clinical trials, international trends in clinical practice, and insights regarding emerging technologies, we may appropriately tailor our application of endovascular therapy to provide optimal care to our patients. This document was developed to guide physicians in the clinical decision-making related to the contemporary application of endovascular intervention among patients with FP arterial disease.
authors.affiliation: John Cochran VA Medical Center, St. Louis VA Healthcare System and St. Louis School of Medicine, St. Louis, Missouri.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Klein
authors.forename: Duane S
authors.initials: DS
authors.lastname: Pinto
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Gray
authors.forename: Michael R
authors.initials: MR
authors.lastname: Jaff
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: White
authors.forename: Douglas E
authors.initials: DE
authors.lastname: Drachman
mesh_terms: D032921:Consensus; D003251:Constriction, Pathologic; D057510:Endovascular Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000592:standards*; D005263:Femoral Artery / Q000503:physiopathology; D006801:Humans; D018579:Patient Selection; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D011150:Popliteal Artery / Q000503:physiopathology; D011237:Predictive Value of Tests; D015641:Radiography, Interventional / Q000592:standards*; D012307:Risk Factors; D015607:Stents / Q000592:standards; D016896:Treatment Outcome; D014654:Vascular Patency
keywords: appropriate use; atherectomy; directional/rotational; endovascular intervention; peripheral arterial disease