Introduction

The treatment of infrainguinal peripheral vascular disease is essential to the practice of interventional radiology. In fact, most interventionalists are surprised to discover that over half of endovascular procedures being performed involve treatment of the femoral artery. Furthermore, this fact is interesting because the existing data for endovascular revascularization are less than ideal. The importance of medical and noninvasive management of peripheral vascular disease is likely the fastest growing and most important facet of the treatment of peripheral vascular disease. We are fortunate in this issue of Techniques in Vascular and Interventional Radiology to have Dr Michael Jaff and colleagues from the Massachusetts General Hospital discuss the medical management of peripheral vascular disease. Their article focuses on when and how to treat these patients.

Once the decision has been made to revascularize a patient with PVD, the role of noninvasive vascular studies, along with morphologic imaging studies such as CTA and MRA, becomes critical. The role and the use of these studies were discussed by Drs Danny Chan and Bart Dolmatch from UT Southwestern in Dallas during the second article of this issue. Their article focuses on the practical issues involved with these noninvasive vascular studies.

The daily challenges involved in the invasive treatment of femoral artery disease are described in the next 2 articles. Dr Parag Patel, along with a number of his colleagues from the University of Wisconsin at Madison, discussed the techniques involved in crossing the occluded femoral artery. The treatment options that presently exist for treating the diseased SFA have been summarized by Dr Jerry Gibbs while he was a fellow at Baptist Cardiac and Vascular Institute in Miami.

The next 3 articles hope to welcome novel and evolving techniques in the treatment of peripheral vascular disease. The use of debulking techniques and devices is addressed by Dr Thomas Zeller from Germany. This article focuses on the individual devices, their best application and strategies to ensure treatment success. The use of embolic protection devices in infrainguinal interventions has gained recent popularity and is addressed in a article by Dr Robert Lookstein from Mount Sinai Hospital in New York. The future may seem bright with the development of drug eluting balloons. Dr Nicolas Diehm and his colleagues from Europe address the development and early experiences with these devices in the final article.

I would like to thank all the contributing authors for their time and effort on this issue. We all hope that this issue of Techniques in Vascular and Interventional Radiology is helpful in daily practice. As the technology improves and new randomized trials are released in the upcoming months, we hope that the clinical and endovascular management of SFA disease continues to improve.