During the review process in several endovascular journals, we become more and more surprised by the lack of basic medical principles, such as clinical examination and presented patients symptoms. Although, several recommendations was given which clearly define the degree of ischemia of lower extremities, it seems to us that not enough attention is given to the symptoms. Often, the symptoms are not displayed or even mentioned in the papers. However, symptoms of patients represent one of the most important criteria for a therapeutic option. Over the past few decades, a rapid development of endovascular techniques and new technology made possible the treatment of complicated arterial lesions, as well as the subintimal recanalization, stent graft implantation, etc.... Also, such development provides a great encouragement to vascular surgeons, particularly in the treatment of patients with significant co-morbidity or with vascular lesions unsuitable for open surgery which significantly reduced the complications rate, mortality and length of hospital stay.