Abstract
Bypass surgery（BSX）used to be the main revascularization therapy for peripheral arterial disease（PAD）. However, endovascular therapy（EVT）recently surpassed BSX due to advances in technology and evolution of devices. This also applies to critical limb ischemia（CLI）. Currently, cardiovascular interventionists play a major role in EVT. Although they can use technology based on percutaneous coronary intervention（PCI）, their knowledge of PAD is insufficient. Restenosis has been improved by drug-eluting stents in PCI, which is now an established treatment. However, restenosis after EVT is still unresolved, except for in aorto-iliac lesions. Therefore, the indications and strategy should be carefully considered. In particular, the performance of infrapopliteal EVT was reported to be poor and the restenosis rate within 3 months was over 70%（1）. As the primary goal of CLI treatment is improvement of pain and wound healing, it should not be treated by PCI. In this report, I present my opinions regarding the optimal EVT method for BTK lesions.
