Endovascular Management as First Therapy for Chronic Total Occlusion of the Lower Extremity Arteries:<b>Comparison of Balloon Angioplasty, Stenting, and Directional Atherectomy</b>

Abstract

The endovascular management of CTO results in reasonable primary patency; moreover, secondary patency at 2 years is excellent. Endovascular therapy should be the first-line option for many patients with peripheral artery disease, including those with CLI, claudicants with poor bypass conduit, or patients at high medical risk for surgery. The presence of CTOs does not appear to change these recommendations. Although multiple reinterventions may be required, endovascular therapies can be considered a primary therapy for many patients with CTO.