Recent advances in endovascular technologies have made catheter-based interventions a preferred treatment strategy in patients with intermittent claudication or ischemic rest pain of the lower extremity. Although the current body of literature is inundated with clinical reports favoring countless endovascular devices and treatment techniques for femoropopliteal occlusive disease, analysis of available clinical reports regarding femoropopliteal lesions can be an overwhelming undertaking. In this report, we examine various challenges associated with data interpretation of clinical literature on endovascular treatment of femoropopliteal occlusive disease. Particular attention is focused on prospective randomized trials and clinical registries evaluating treatment efficacy of self-expanding nitinol stent implantation in femoropopliteal lesions. Prospective trials on the efficacy of drug-eluting stent placement and covered stent implantation of the superficial femoral artery are also discussed. Understanding current literature related to prospective randomized trials on femoropopliteal disease interventions is important to formulate an optimal treatment strategy based on appropriate patient selection and disease stratification so that successful treatment outcome can be achieved.
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