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Endovascular-first strategy for all patients with peripheral blood vessel illness

Alessandra Narciso Garcia, Ana Beatriz Carvalho, Giordano Marcio Gatinho Bonuzzi

Different treatment options are available for patients with intermittent claudication, depending on patients? symptoms and their reduction in quality of life. While supervised exercise training has tremendous effects in certain subgroups of these patients, it otherwise frequently fails in those with severely limited walking capacity. Furthermore, vasoactive drugs are of only limited benefit. Therefore, patients with very short painfree walking distance are candidates for revascularization despite the fact that evidence of any long-term benefit of revascularization treatment compared with supervised exercise and best medical treatment is lacking. Otherwise, in patients with critical limb ischemia, revascularization is obligatory for limb salvage, whenever technically possible