الفهرس 
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Abstract
Peripheral arterial disease (PAD) affects almost 12 % of the general population and is responsible for substantial healthcare costs. PAD primarily results in a decreased functional capacity and deterioration in quality of life and is associated with an increased risk of limb amputation, myocardial infarction, stroke, and death.
Two-thirds to three-fourths of patients initially presenting with intermittent claudication (IC) symptoms will remain stable for several years after the initial diagnosis, whereas the remaining one-third to one-fourth will show progressive disease, but only 1–5 % of the PAD population will eventually undergo amputation. Patients suffering from PAD typically present with symptoms of IC or Critical limb ischemia (CLI).
In our study, 25 patients are included all with symptoms suggestive of lower limb ischemia; 15 patients presented with non-healing ulcer (60%), eight patients presented with incapacitating intermittent claudication (32%), two patients presented with rest pain (8%).
All are diabetic, 64% hypertensive, 44% are cardiac and 16% with a previous history of cerebrovascular stroke.
The overall complete technical success rate was 96% with some complications like subintimal dissection but without flow obstruction in three cases (12%), puncture site hematoma in three cases (12%) and distant thromboembolism in tow patient (8%).
The endovascular approach is recommended as the first-line treatment in the majority of lesions of the superficial femoral and/or popliteal arteries and infra popliteal arteries.
Recanalization can be achieved using either intraluminal or subintimal techniques. In more challenging cases, more complex techniques (i.e., SAFARI technique) and advanced devices (re-entry devices, atherectomy catheters) may be required to achieve crossing of the occluded segment. However, preservation of long-term patency remains a challenge, mainly due to progressive neointimal hyperplasia and vascular restenosis.
The use of colored duplex ultrasound is very useful in diagnosing and follow up of patients with lower limb ischemia as it is reliable, inexpensive, radiation free and provide both anatomical and hemodynamic information about the scanned vessels.