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Tibial angioplasty

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https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#1
Jayer Chung
Diabetes mellitus (DM) is a rapidly worsening global epidemic over the last thirty-five years. The increased prevalence of DM has changed the phenotypic expression of atherosclerotic limb threatening ischemia (LTI), resulting in an increase in lesions in the tibial vessels. These patients are also afflicted with peripheral neuropathy, foot deformities, and medial calcification of the vasculature. In response to the evolving phenotype of atherosclerosis, newer minimally invasive tools and techniques have been developed to improve the blood supply in LTI...
March 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28303692/combined-radial-tibial-access-strategy-and-radial-tibial-reverse-cart-in-a-patient-with-aortobifemoral-graft-and-complex-superficial-femoral-artery-occlusion
#2
Elias B Hanna, Davey L Prout
We present the case of a patient with a history of aortobifemoral grafting who presented with left lower extremity ischemic rest pain. Aortofemoral angiography was performed through a left radial access and showed a long, calcified total occlusion of the left superficial femoral artery (SFA) and a subtotal popliteal occlusion. The popliteal artery and SFA were crossed retrogradely through a 4-Fr anterior tibial access; the retrograde devices went subintimally and did not reenter at the common femoral level...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28287292/-long-term-results-after-invasive-treatment-of-critical-limb-ischemia
#3
Zoltán Ruzsa, Ferenc Kuti, Balázs Berta, Károly Tóth, Zoltán Bánsághi, Zoltán Vámosi, Kálmán Hüttl
INTRODUCTION AND AIM: Surgical tibial bypass for critical limb ischemia is associated with significant morbidity, mortality, and graft failure, whereas percutaneous angioplasty and stenting has promising results. The objective of this study was the investigation of the long term results of below-knee percutaneous angioplasty for restoring straight inline arterial flow in patients with critical limb ischemia. METHOD: The clinical and angiographic data of 281 consecutive patients with critical limb ischemia treated by PTA between 2008 and 2011 was evaluated in a prospective register...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28199363/infrapopliteal-angioplasty-using-a-combined-angiosomal-reperfusion-strategy
#4
G K Ambler, A L Stimpson, B G Wardle, D C Bosanquet, U K Hanif, S Germain, C Chick, N Goyal, C P Twine
INTRODUCTION: Infra-popliteal angioplasty continues to be widely performed with minimal evidence to guide practice. Endovascular device selection is contentious and there is even uncertainty over which artery to treat for optimum reperfusion. Direct reperfusion (DR) targets the artery supplying the ischaemic tissue. Indirect reperfusion (IR) targets an artery supplying collaterals to the ischaemic area. Our unit practice for the last eight years has been to attempt to open all tibial arteries at the time of angioplasty...
2017: PloS One
https://www.readbyqxmd.com/read/28126175/risk-factors-for-30-day-unplanned-readmission-following-infrainguinal-endovascular-interventions
#5
Thomas C F Bodewes, Peter A Soden, Klaas H J Ultee, Sara L Zettervall, Alexander B Pothof, Sarah E Deery, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Unplanned hospital readmissions following surgical interventions are associated with adverse events and contribute to increasing health care costs. Despite numerous studies defining risk factors following lower extremity bypass surgery, evidence regarding readmission after endovascular interventions is limited. This study aimed to identify predictors of 30-day unplanned readmission following infrainguinal endovascular interventions. METHODS: We identified all patients undergoing an infrainguinal endovascular intervention in the targeted vascular module of the American College of Surgeons National Surgical Quality Improvement Program between 2012 and 2014...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28101616/successful-retrieval-of-an-embolized-vascular-closure-device-angio-seal-%C3%A2-after-peripheral-angioplasty
#6
Philipp Jud, Rupert Portugaller, Dennis Bohlsen, Thomas Gary, Marianne Brodmann, Gerald Hackl, Franz Hafner
A 55-year-old male with peripheral arterial disease underwent angioplasty of the right lower limb arteries via antegrade femoral access. Angio-Seal(®) closure device was used to treat the puncture site, whereby the intravascular sealing anchor accidentally embolized into the malleolar region of the right posterior tibial artery. Successful retrieval of the anchor was accomplished by a SpiderFX embolic protection device. This technique may be a useful approach to retrieve embolized foreign bodies via endovascular access...
January 18, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28100126/everolimus-eluting-stent-for-patients-with-critical-limb-ischemia-and-infrapopliteal-arterial-occlusive-disease
#7
Alessia Giaquinta, Ardita Vincenzo, Ester De Marco, Massimiliano Veroux, Pierfrancesco Veroux
BACKGROUND: Critical limb ischemia (CLI), despite revascularization, may result in minor or major amputations with devastating psychological effects and a negative impact on patient survival. Randomized clinical trials demonstrated that drug-eluting stents improve 1-year primary patency and decrease target lesion revascularization, compared to standard angioplasty and bare-metal stents, in patients with short occlusive below-the-knee lesions. OBJECTIVES: This prospective clinical study was designed to evaluate if one straight-line flow revascularization to the foot, using Xience-Prime Everolimus-Eluting Stent (EES), is an effective treatment of patients in Rutherford-Becker category 4 to 5 with distal popliteal and proximal tibial arteries long occlusive lesions up to 10 cm...
February 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/27928259/therapeutic-effects-of-successful-angioplasty%C3%A2-on-the%C3%A2-aorta-and-lower-limb-arteries-on-the-healing-of-chronic-ischemic-wounds
#8
Mohammad Reza Zafarghandi, Morteza Taghavi, Pezhman Farshidmehr, Azadeh Sayarifard
Background: Chronic wounds are a serious problem for the patient and can increase the socioeconomic burden on the healthcare system and community. This study aimed at investigating the effect of angioplasty on chronic ischemic wound healing. Methods: This study was conducted in Sina Hospital, affiliated to Tehran University of Medical Sciences. Thirty-eight patients with chronic ischemic wounds and a suspicion of the narrowing or blockage of arteries underwent peripheral angiography. Arteries under angioplasty in different patients comprised the aorta and the iliac, superficial femoral, popliteal, and tibial arteries...
April 13, 2016: Journal of Tehran Heart Center
https://www.readbyqxmd.com/read/27832987/immediate-changes-of-angiosome-perfusion-during-tibial-angioplasty
#9
Ulrich Rother, Katrin Krenz, Werner Lang, Raymund E Horch, Axel Schmid, Marco Heinz, Alexander Meyer, Susanne Regus
OBJECTIVE: In recent years, a controversial discussion about the clinical relevance of the angiosome concept during tibial angioplasty has developed. Therefore, we conducted a prospective study to evaluate the angiosome concept on the level of microcirculation during tibial vascular interventions. METHODS: Thirty patients with isolated tibial angioplasty were examined prospectively. Macrocirculation was evaluated by measurement of the ankle-brachial index (ABI)...
February 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27664555/drug-eluting-balloon-versus-standard-percutaneous-transluminal-angioplasty-in-infrapopliteal-arterial-disease-a-meta-analysis-of-randomized-trials
#10
REVIEW
Ridong Wu, Shi Tang, Mian Wang, Zilun Li, Chen Yao, Shenming Wang
BACKGROUND: Drug-eluting balloon (DEB) and standard percutaneous transluminal angioplasty (PTA) are commonly used endovascular therapeutic procedures for the revascularization of infrapopliteal arterial occlusive disease. However, which procedure is more beneficial for patients is unknown. METHODS AND RESULTS: We performed a meta-analysis, searching PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, ISI Web of Knowledge, and relevant websites without language or publication date restrictions for randomized trials that compared DEB with PTA in patients with infrapopliteal arterial occlusive disease...
November 2016: International Journal of Surgery
https://www.readbyqxmd.com/read/27626262/-assessment-of-surgical-risk-in-patients-with-lower-limb-chronic-critical-ischaemia
#11
Iu I Kazakov, I B Lukin, N Iu Sokolova, M A Strakhov
Analysed herein are both immediate and remote results of surgical treatment of 93 patients presenting with chronic atherosclerotic occlusion of the femoral-popliteal-tibial segment in the stage of critical ischaemia. The patients were subjected to autovenous femoropopliteal bypass grafting to the isolated arterial segment or balloon angioplasty with stenting of the superficial femoral artery. While choosing the method of arterial reconstruction we assessed concomitant diseases, primarily lesions of the coronary and cerebral circulation...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/27539693/experience-with-the-absorb-everolimus-eluting-bioresorbable-vascular%C3%A2-scaffold-in%C3%A2-arteries-below-the-knee-12-month-clinical-and-imaging-outcomes
#12
Ramon L Varcoe, Olaf Schouten, Shannon D Thomas, Andrew F Lennox
OBJECTIVES: The aim of this study was to investigate the midterm performance of an everolimus-eluting, bioresorbable vascular scaffold (Absorb, Abbott Vascular, Santa Clara, California) for the treatment of focal tibial and distal popliteal lesions. BACKGROUND: Drug-eluting stents are used below the knee to improve technical success and durability, but the ongoing presence of a permanent metal scaffold may have deleterious effects on the local vessel. METHODS: Tibial and distal popliteal angioplasty with scaffold placement was performed using an everolimus-eluting, bioresorbable scaffold (Absorb)...
August 22, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27490003/drug-eluting-balloon-angioplasty-versus-uncoated-balloon-angioplasty-for-peripheral-arterial-disease-of-the-lower-limbs
#13
REVIEW
Ahmed Kayssi, Talal Al-Atassi, George Oreopoulos, Graham Roche-Nagle, Kong Teng Tan, Dheeraj K Rajan
BACKGROUND: Atherosclerotic peripheral arterial disease (PAD) can lead to disabling ischemia and limb loss. Treatment modalities have included risk factor optimization through life-style modifications and medications, or operative approaches using both open and minimally invasive techniques, such as balloon angioplasty. Drug-eluting balloon (DEB) angioplasty has emerged as a promising alternative to uncoated balloon angioplasty for the treatment of this difficult disease process. By ballooning and coating the inside of atherosclerotic vessels with cytotoxic agents, such as paclitaxel, cellular mechanisms responsible for atherosclerosis and neointimal hyperplasia are inhibited and its devastating complications are prevented or postponed...
August 4, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27488199/rearfoot-transcutaneous-oximetry-is-a-useful-tool-to-highlight-ischemia-of-the-heel
#14
Valentina Izzo, Marco Meloni, Sebastiano Fabiano, Daniele Morosetti, Laura Giurato, Antonio Chiaravalloti, Valeria Ruotolo, Roberto Gandini, Luigi Uccioli
PURPOSE: To demonstrate the usefulness of rearfoot transcutaneous oximetry to assess the peripheral arterial disease in diabetic patients with heel ulcer. METHODS: From our database of 550 critical limb ischemia diabetic patients followed after a percutaneous transluminal angioplasty, we have selected patients with below the knee arterial disease. Patients were grouped according to the dorsal transcutaneous oximetry value (Group A < 30 mmHg; Group B ≥ 30 mmHg)...
January 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/27465390/promising-role-of-drug-coated-balloons-in-the-tibial-vessels
#15
REVIEW
Ralf Langhoff, Andrea Behne, Eva Buschmann
In order to assess the role of drug-coated balloons (DCB) in below-the-knee (BTK) artery interventions, we analyzed randomized trials which compare coated to non-coated balloons and additionally a direct comparison of drug-eluting stents (DES) with DCB. As angioplasty with non-coated balloons is per guideline-recommendation still standard of care for below-the-knee artery endovascular treatment, we focused on the direct comparison of efficacy and clinical outcome data of both treatment modalities. Data from peer reviewed and published trials were consulted...
October 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27432201/semiquantitative-assessment-of-tibial-artery-calcification-by-computed-tomography-angiography-and-its-ability-to-predict-infrapopliteal-angioplasty-outcomes
#16
In Sook Kang, Wonkyung Lee, Byoung Wook Choi, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang, Young-Guk Ko
OBJECTIVE: Tibial artery calcification (TAC) is associated with increased risk of amputation and mortality in peripheral artery disease. We sought to investigate whether the severity of TAC based on semiquantitative analysis of computed tomography angiography (CTA) can predict outcomes of endovascular therapy in patients with critical limb ischemia. METHODS: We reviewed medical records of 124 patients who underwent lower extremity CTA before intervention. Based on CTA, TAC severity was categorized into three groups: minimal calcification (MC; n = 43), intermediate calcification (IC; n = 36), or extensive calcification (EC; n = 45)...
November 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/27423721/a-case-of-endofibrosis-presenting-with-embolic-symptoms-in-a-43-year-old-cyclist
#17
REVIEW
Charles S DeCarlo, Emily L Spangler, Jennifer A Stableford
BACKGROUND: Endofibrosis is a rare clinical entity that usually manifests as claudication in cyclists and other endurance athletes. We report a case of a 43-year-old cyclist presenting with pain and cyanosis of his toes due to an embolism to his left anterior tibial artery. The source of the embolus was found to be an ulcerated, endofibrotic plaque in his left common femoral artery. METHODS: We performed an extensive literature search using the PubMed database and identified 60 results on endofibrosis...
October 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27409058/retrograde-transpedal-access-for-revascularization-of-below-the-knee-arteries-in-patients-with-critical-limb-ischemia-after-an-unsuccessful-antegrade-transfemoral-approach
#18
J P Goltz, M Planert, M Horn, M Wiedner, M Kleemann, J Barkhausen, E Stahlberg
PURPOSE: To evaluate the safety and technical and clinical success of endovascular below-the-knee (BTK) artery revascularization by a retrograde transpedal access. MATERIALS AND METHODS: We retrospectively identified 16/172 patients (9.3 %) with endovascular BTK revascularization in whom a transfemoral approach had failed and transpedal access had been attempted. The dorsal pedal (n = 13) or posterior tibial (n = 3) artery was accessed using a dedicated access set and ultrasound guidance...
October 2016: RöFo: Fortschritte Auf Dem Gebiete der Röntgenstrahlen und der Nuklearmedizin
https://www.readbyqxmd.com/read/27332681/promising-role-of-drug-coated-balloons-in-the-tibial-vessels
#19
Ralf Langhoff, Andrea Behne, Eva E Buschmann
To judge on the role of drug-coated balloons (DCB) in below-the-knee (BTK) artery interventions, we analyzed randomized trials which compare coated to non-coated balloons and additionally a direct comparison of drug-eluting stents (DES) with DCB. As angioplasty with non-coated balloons is per guideline-recommendation still standard of care for below- the-knee artery endovascular treatment, we focused on the direct comparison of efficacy and clinical outcome data of both treatment modalities. Data from peer reviewed and published trials were consulted...
June 22, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27207678/retrograde-approach-using-surgical-cutdown-technique-for-limb-salvage-in-a-case-of-critical-limb-ischemia-with-severely-calcified-tibial-occlusive-disease
#20
Tatsuya Shiraki, Osamu Iida, Kotaro Suemitsu, Yoriko Tsuji, Masaaki Uematsu
We here report a successful angioplasty for tibial artery occlusion using direct tibial puncture and subsequent retrograde approach under surgical cutdown technique. An 82-year-old man with ulcer/gangrene in first and second digits was referred to our hospital for endovascular therapy (EVT) of lower extremity ischemia. Diagnostic angiogram revealed anterior tibial artery (ATA) occlusion with severe calcification. Subintimal angioplasty was attempted using a 0.014-inch hydrophilic guidewire but was unsuccessful...
May 2016: Vascular and Endovascular Surgery
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