Reducing the risk of lower extremity amputation in diabetics is a top priority. To make progress in this area, we must bring all options to bear in the treatment of diabetic peripheral vascular disease. The "endovascular promise" of lower morbidity, while attaining the primary clinical goal (in this case, limb salvage), was late to arrive in the treatment of the ischemic diabetic lower extremity. This is due to complex and severe lesion morphologies requiring treatment, as well as the complexity of the vascular disease and the clinical scenario in diabetic critical limb ischemia. Although not without remaining challenges, significant strides have been made in the last 5 years that have increased the role of endovascular therapy in this setting.
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