Objectives: to evaluate the feasibility and preliminary results at 1 year of subintimal angioplasty of tibial occlusions in critical limb ischaemia (CLI).
Material: from December 1997 to December 1999, we intended to treat 36 patients and 40 limbs by subintimal angioplasty of occlusions of tibial vessels. Thirty-one had gangrene or ulceration and nine had rest pain. Twenty-seven occlusions were more than 10 cm, 10 were 5 to 10 cm and three were less than 5 cm in length. Three patients had an occluded previous ipsilateral bypass graft. All patients were followed 3 monthly for a median of 10 months by means of clinical and duplex examination.
Results: the technical success rate was 78% (31/40). Nine technical failures were treated by conventional surgery or angioplasty of another diseased tibial vessel. The clinical success rate was 68% (27/40). Four below-the-knee amputations were performed despite a patent recanalisation. Primary and secondary patency rates at 12 months were 56% (72% without technical failures). The 12-month limb salvage rate was 81% and survival rate was 78%. Three of five complications were treated by endovascular procedures. The length of occlusion (>10 cm) but not the location of distal re-entry, the type of vessel re-entry and the presence of diabetes are predictors of technical success and patency.
Conclusions: subintimal angioplasty can be used to treat tibial occlusions in patients with CLI. Technical failure does not preclude conventional surgery and complications may often be treated by endovascular procedures. However, the durability of angioplasty is as yet uncertain.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1053/ejvs.2000.1200 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Successful endovascular therapy with "Direct tip injection in occlusive lesions (DIOL)" fashion for persistent sciatic artery aneurysmal occlusion: A case report.
J Cardiol Cases
December 2024
Department of Cardiology, Asia Medical Group, Sapporo Heart Center, Sapporo Cardio Vascular Clinic, Sapporo, Japan.
Unlabelled: Persistent sciatic artery (PSA) is a rare congenital anomaly that may involve aneurysmal formations. During endovascular treatment for PSA aneurysm (PSAA) occlusion, guidewire crossing can be challenging due to complex anatomy. We report successful endovascular intervention for PSAA occlusion using the "direct tip injection in occlusive lesions (DIOL)" fashion, in which hydraulic pressure with contrast facilitates guidewire crossing by visualizing the vessel course and expanding the microchannel and vessel lumen.
View Article and Find Full Text PDFGiant aneurysmal degeneration after subintimal fluoropolymer-coated paclitaxel-eluting stent implantation for the superficial femoral artery occlusion: a case report.
Eur Heart J Case Rep
December 2024
Department of Cardiology, Ishikawa Prefectural Central Hospital, 2-1, Kuratsuki-higashi Kanazawa, Ishikawa 920-8530, Japan.
Article Synopsis
- - Drug-eluting therapies, especially the Eluvia stent, have significantly reduced restenosis rates in treating peripheral artery disease, but concerns over aneurysm formation following their use are emerging.
- - An 80-year-old man developed a giant aneurysm 27 months after receiving the Eluvia stent for a blocked artery, which was identified through ultrasound and treated with endovascular-covered stents.
- - The presence of a 'low echoic area' near the stent is a common ultrasound finding after Eluvia implantation; while typically benign for two years, it can lead to serious complications like aneurysms due to factors such as overlapping stents and mechanical stress.
Combined antegrade and retrograde dissection and re-entry techniques: A two-in-one chronic total occlusion procedure.
Catheter Cardiovasc Interv
November 2024
St Thomas' Hospital, Guy's and St Thomas' National Health Service Foundation Trust, London, UK.
Treatment of chronic total occlusions (CTOs) by percutaneous coronary intervention (PCI) is technically challenging, with exponential difficulty in the presence of specific anatomical features. We present a complex case where procedural success was achieved by sequential PCIs to two separate CTOs in a 'two-in-one' procedure.
View Article and Find Full Text PDFMicrocatheter tip fracture and acute vessel occlusion rescued with subintimal tracking and re-entry: Move the tip.
Catheter Cardiovasc Interv
November 2024
Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
Article Synopsis
- The rise of advanced microcatheters has improved the success rates of complex heart procedures, but their use can lead to significant complications.
- A case study highlighted a serious incident where a Turnpike Spiral catheter tip fractured, causing a blockage in the right coronary artery despite its tortuous and calcified nature.
- To resolve the blockage, a specialized technique called antegrade dissection and re-entry was used, successfully restoring blood flow and avoiding a heart attack by placing stents after navigating around the fractured tip.
Percutaneous Deep Venous Arterialization by Balloon Angioplasty without Stent Implantation for Patients with Chronic Limb-Threatening Ischemia Undergoing Hemodialysis: A Retrospective Cohort, Single-Center, Single-Arm Study.
Cardiovasc Intervent Radiol
October 2024
Cardiovascular Center, Takatsu General Hospital, 1-16-7 Mizonokuchi, Takatsu-Ku, Kawasaki-Shi, Kanagawa, 213-0001, Japan.
Purpose: This retrospective, single-center study aimed to determine the efficacy of percutaneous deep venous arterialization in patients on hemodialysis with chronic limb-threatening ischemia.
Materials And Methods: Twenty-one consecutive limbs on hemodialysis with chronic limb-threatening ischemia were treated with percutaneous deep venous arterialization using balloon angioplasty following a failed pedal arterial reconstruction between May 2021 and June 2022. An arteriovenous fistula near the ankle joint was created to ensure sufficient venous flow reversal to the pedal veins.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!