Background Peripheral artery disease accounts for more than 400 000 hospitalizations in the USA and results in symptoms ranging from claudication to gangrene.Recent advances in endovascular techniques have led to a more aggressive approach for treating peripheral artery disease.The aim of this retrospective study was to evaluate the outcomes of endovascular interventions on TransAtlantic InterSociety Consensus (TASC) Ⅱ C and D femoropopliteal occlusive disease.Methods Data for all patients undergoing endovascular interventions for femoropopliteal occlusive disease from December 2007 through December 2010 were reviewed.Demographic data,risk factor data,preprocedural and postprocedural ankle-brachial indices,technical success rates,and complication rates were obtained.Primary,assisted primary,and secondary patency were determined by Kaplan-Meier survival analysis.Univariate and multivariate analyses were performed to identify factors adversely affecting primary patency.Results The study group included 52 TASC Ⅱ C and 106 TASC Ⅱ D limbs in 126 patients (mean age,(68.0±18.0) years).The technical success rate was 91.1％.Complications occurred in 19 limbs (12.0％),including 8 (5.1％) major complications.The mean follow-up period was (17.6±5.1) months (range,12.0-48.0 months).Primary patency rates at 1,2,3,and 4 years were 95％,78％,74％,and 74％ in TASC Ⅱ C lesions and 89％,62％,52％,and 52％ in TASC Ⅱ D lesions,respectively.Secondary patency rates at 1,2,3,and 4 years were 97％,94％,94％,and 94％ in TASC Ⅱ C lesions and 97％,95％,83％,and 83％ in TASC Ⅱ D lesions,respectively.It is significantly different between primary patency rates (P ＜0.05) but not secondary patency rates of TASC Ⅱ C and D groups (P ＞0.05).Predictors of restenosis/occlusion included hyperlipidemia,lesion length,and popliteal artery involvement.Conclusions Endovascular treatment of TASC Ⅱ C and D femoropopliteal artery occlusion has a high technical success rate with favorable mid-term secondary patency rate.Hyperlipidemia,lesion length,and popliteal artery involvement were independent risk factors for in-stent restenosis.