Objectives: To evaluate the safety and efficacy of transpedal access for the management of complex peripheral artery disease (PAD).
Introduction: Critical limb ischemia is associated with high risk of limb loss, as well as cardiovascular and all-cause mortality. Transpedal access is a novel, increasingly utilized technique for the management of complex PAD.
Methods: We performed a literature search using PubMed from January 2003 to December 2016. Published studies on transpedal access were studied. We evaluated patient sample demographics, procedure indications, access and target vessel, procedural characteristics, outcomes, and complications.
Results: Ten studies and 881 patients were included in our study. The indication for transpedal access was critical limb ischemia in 68.4% and severe claudication in 29.5%. A chronic total occlusion was present in 93.7% (average occlusion length, 206 mm). Access was achieved by ultrasound in 57.1% and by fluoroscopy in 35.7%. The anterior tibial or dorsalis pedis were accessed in 54.7% and the posterior tibial in 28.0%. The angiographic procedural success rate was 92.6%. The most commonly reported complication was dissection (7.49%), followed by perforation (1.36%) and embolization (1.25%).
Conclusion: Based on the results of this systematic review, transpedal access appears to be a safe and effective technique for complex PAD.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Efficacy of retrograde revascularization in diabetic patients with chronic limb-threatening ischemia after a failed antegrade approach.
Vascular
May 2024
Interventional Radiology Unit, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Roma, Italy.
Background: Chronic limb-threatening ischemia is the end stage of peripheral arterial disease. The revascularization of patients suffering from diabetes mellitus who present chronic total occlusions of below-the-knee vessels can be technically very difficult and sometimes impossible to achieve by performing only an antegrade approach. As regards retrograde recanalization, several studies have investigated the efficacy and safety of this technique in the femoropopliteal axis or in the infrageniculate arterial vessels in patients with advanced atherosclerotic disease.
View Article and Find Full Text PDFComparative Analysis of Transpedal and Transfemoral Access During Genicular Artery Embolization for Knee Osteoarthritis.
Cardiovasc Intervent Radiol
October 2024
Department of Radiology, Basaksehir Cam and Sakura City Hospital, 34488, Istanbul, Turkey.
Purpose: This retrospective study aimed to compare the efficacy and safety of transpedal access (TPA) with transfemoral access (TFA) in Genicular Artery Embolization (GAE).
Materials And Methods: 60 patients who underwent GAE between January and June 2023, were recruited and outcomes were compared between the TFA (n = 37) and TPA (n = 23) groups. Technical and clinical success rates, complications, and patient-reported outcomes were assessed.
Safety of Retrograde Tibial-Pedal Access and Intervention in Patients with Single Remaining Non-Occluded Infra-Popliteal Runoff Artery.
J Cardiovasc Dev Dis
November 2023
Chinatown Cardiology, P.C., New York, NY 10013, USA.
Background: The adaptation of retrograde tibial-pedal access for peripheral angiogram and intervention is limited by the lack of operator experience and concern for small distal vessel injury. This study evaluates the safety of the retrograde tibial-pedal access for peripheral angiogram and intervention in patients with two vessel infra-popliteal artery chronic total occlusions, where the access point is the sole remaining non-occluded infra-popliteal artery.
Methods: A retrospective analysis of 5687 consecutive patients who underwent peripheral angiograms by retrograde tibial-pedal access via the single remaining non-occluded infra-popliteal artery was performed.
Alternative access for peripheral vascular interventions.
J Vasc Surg Cases Innov Tech
September 2023
Division of Vascular and Endovascular Surgery, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA.
Percutaneous endovascular interventions for advanced lower extremity peripheral arterial disease are becoming increasingly used, often as first-line treatment of chronic limb threatening ischemia. Advancements in endovascular techniques have provided safe and effective alternative revascularization options, especially for high-risk surgical patients. Although the classic transfemoral approach results in high technical success and patency rates, an estimated 20% of lesions remain challenging to access via an antegrade approach.
View Article and Find Full Text PDFInterventional Management of Acquired Lymphatic Disorders.
Radiographics
October 2022
From the Division of Vascular and Interventional Radiology, Mayo Clinic Arizona, 5777 E Mayo Blvd, Phoenix, AZ 85054 (K.S.Z., J.S.K., I.J.P., S.G.N., R.O., S.J.A.); Department of Radiological Sciences, University of California, Irvine, Orange, Calif (K.N.H.); Department of Radiology, Mayo Clinic, Rochester, Minn (A.K.); Department of Radiology, University of Vermont, Burlington, VT (B.S.M.); and Division of Vascular and Interventional Radiology, Mayo Clinic Jacksonville, Jacksonville, Fla (B.T.).
The lymphatic system is a complex network of tissues, vessels, and channels found throughout the body that assists in fluid balance and immunologic function. When the lymphatic system is disrupted related to idiopathic, iatrogenic, or traumatic disorders, lymphatic leaks can result in substantial morbidity and/or mortality. The diagnosis and management of these leaks is challenging.
View Article and Find Full Text PDFWant 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!