This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications. A subintimal crossing technique was necessary in 388 lesions (27% overall in 1335 lesions; 34% ( n=351) in 1023 femoropopliteal lesions, and 12% ( n=37) in 312 infrapopliteal lesions, p<0.01) with a lower procedural ( p<0.01) and technical ( p<0.01) success than the intraluminal in both femoropopliteal and infrapopliteal interventions. There were no significant differences in procedural complications, major adverse cardiac events, or clinically driven target limb revascularization at 1 year between the two groups, except a higher residual dissection rate in the subintimal crossing group than the intraluminal group in femoropopliteal target vessels ( p = 0.04).

Download full-text PDF

Source
http://dx.doi.org/10.1177/1358863X17735192DOI Listing

Publication Analysis

Top Keywords

peripheral artery
16
subintimal crossing
12
infrainguinal peripheral
8
artery chronic
8
chronic total
8
total occlusions
8
procedural complications
8
target limb
8
comparative assessment
4
assessment patient
4

Similar Publications

Background: Delirium is associated with patient prognosis after transcatheter aortic valve implantation (TAVI). However, the prognostic impact of subsyndromal delirium, described as an intermediate stage between delirium and normal cognition, is uncertain. The present study aimed to investigate the prognostic impact of delirium severity in patients undergoing TAVI.

View Article and Find Full Text PDF

Endothelial cell (EC)-specific CTGF/CCN2 Expression Increases EC Reprogramming and Atherosclerosis.

Matrix Biol

January 2025

Department of Surgery, Emory University, Atlanta, GA, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, USA; Research Services, Atlanta VA Medical Center, Decatur, GA, USA. Electronic address:

Arterial endothelial cells (ECs) reside in a complex biomechanical environment. ECs sense and respond to wall shear stress. Low and oscillatory wall shear stress is characteristic of disturbed flow and commonly found at arterial bifurcations and around atherosclerotic plaques.

View Article and Find Full Text PDF

The clinical presentation and genetic diagnosis of Tangier disease in the pediatric age group.

J Pediatr Endocrinol Metab

January 2025

Division of Pediatric Neurology, Department of Pediatrics and Child Health, Erciyes University, Faculty of Medicine, Kayseri, Türkiye.

Objectives: Tangier disease (TD) is a rare autosomal recessive condition characterized by high-density lipoprotein (HDL) deficiency; involving symptoms of polyneuropathy, hyperplastic orange-yellow tonsils, vision disorder, and sudden cardiac death. The major clinical symptoms of TD may not all be co-present. This study evaluates patients diagnosed with TD in childhood to improve the possibility of early diagnosis of asymptomatic cases by reporting our patients' clinical characteristics in order to minimize delayed diagnosis and emphasize the importance of TD, easily detected by HDL measurement.

View Article and Find Full Text PDF

Introduction: Compared to aortic dissection and isolated visceral artery dissection, multiple peripheral arterial dissections have not been formally reported to date. Currently, there is no well-established treatment for this condition, and large-scale studies with extensive sample data are lacking.

Case Presentation: A 56-year-old male, was provisionally diagnosed with " idiopathic multiple peripheral arterial dissections.

View Article and Find Full Text PDF

HUVECs-derived exosomes increase neovascularization and decrease limb necrosis in hindlimb ischemia.

Narra J

December 2024

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia.

Chronic limb-threatening ischemia (CLTI) is the most severe manifestation of peripheral arterial disease (PAD) and imposes a significantly high burden due to its high risk of mortality and amputation. Revascularization is the first-line treatment for CLTI; however, the amputation rate remains high, and approximately one-third of patients are not eligible for this treatment. Therefore, there is an urgent need for more effective therapeutic strategies.

View Article and Find Full Text PDF

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!