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Tibial angioplasty

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
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)...
November 7, 2016: Journal of Vascular Surgery
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...
September 21, 2016: International Journal of Surgery
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
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
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
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
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
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
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
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
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
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
Valerio Tolva, Renato Casana, Anne Huibers, Gianfranco Parati, Paolo Bianchi, Lea Cireni, Emanuele Ferrero, Allison Halliday
RATIONALE: Restenosis due to intimal hyperplasia (IH) is a major clinical issue that affects the success of lower limb endovascular surgery. After 1 year, restenosis occurs in 40% to 60% of the treated vessels. The possibility to reduce IH using local antiproliferative drugs, such as taxols, has been the rationale for the clinical applications of drug-eluting stents and drug-eluting balloons (DEBs). The purpose of this study was to evaluate the clinical and instrumental efficacy of DEBs versus simple percutaneous transluminal angioplasty (PTA) in patients affected by chronic limb ischemia (CLI) with tibial artery "de novo" lesions...
July 2016: Vascular and Endovascular Surgery
Mehdi H Shishehbor, Tarek A Hammad, Thomas Zeller, Iris Baumgartner, Dierk Scheinert, Krishna J Rocha-Singh
OBJECTIVE: Recent small single-center data indicate that the current hemodynamic parameters used to diagnose critical limb ischemia are insensitive. We investigated the validity of the societal guidelines-recommended hemodynamic parameters against core laboratory-adjudicated angiographic data from the multicenter IN.PACT DEEP (RandomIzed AmPhirion DEEP DEB vs StAndard PTA for the treatment of below the knee Critical limb ischemia) Trial. METHODS: Of the 358 patients in the IN...
May 2016: Journal of Vascular Surgery
Elias B Hanna, Davey L Prout
PURPOSE: To describe the combined use of radial-pedal access for recanalization of complex superficial femoral artery (SFA) occlusions unsuitable for transfemoral recanalization. TECHNIQUE: Patients are selected for this strategy if they have a long (≥ 10 cm) SFA occlusion with unfavorable aortoiliac anatomy, an absent ostial stump, or severely diseased and calcified distal reconstitution. Left radial artery and distal anterior or posterior tibial artery are accessed with 6-F and 4-F sheaths, respectively...
April 2016: Journal of Endovascular Therapy
Steven K Burke, Karen Bingham, Emma Moss, Daniel P Gottlieb, Marco D Wong, Kimberly S Bland, F Nicholas Franano
PURPOSE: This study was designed to determine whether vonapanitase (formerly PRT-201), a recombinant human elastase, treatment can fragment the protein elastin in elastic fibers and cause dilation of atherosclerotic human peripheral arteries subjected to ex vivo balloon angioplasty. MATERIALS AND METHODS: Seven patients undergoing lower limb amputation for peripheral artery disease or who died and donated their bodies to science donated 11 tibial arteries (5 anterior, 6 posterior) for this study...
April 2016: Journal of Cardiovascular Pharmacology
Matthew A Popplewell, Huw Davies, Hugh Jarrett, Gareth Bate, Margaret Grant, Smitaa Patel, Samir Mehta, Lazaros Andronis, Tracy Roberts, Jon Deeks, Andrew Bradbury
BACKGROUND: Severe limb ischaemia is defined by ischaemic rest/night pain, tissue loss, or both, secondary to arterial insufficiency and is increasingly caused by infra-popliteal (below the knee) disease, mainly as a result of the increasing worldwide prevalence of diabetes. Currently, it is unknown whether vein bypass surgery or the best endovascular treatment (angioplasty or stenting) represents the optimal revascularisation strategy in terms of amputation-free survival, overall survival, relief of symptoms, quality of life and cost-effective use of health care resources...
January 6, 2016: Trials
Hosam El-Sayed, Matthew E Bennett, Thomas M Loh, Mark G Davies
BACKGROUND: Endovascular revascularization is an established approach for limb salvage in the setting of critical limb ischemia. However, failure rate of antegrade recanalization in complex femoropopliteal to infrapopliteal occlusions is as high as 20%. We report a series of 21 patients who underwent retrograde pedal access and recanalization of below-the-knee chronic total occlusions after failed antegrade attempts. METHODS: This is a retrospective review of prospectively maintained data for all patients who underwent ultrasound-guided percutaneous pedal access for retrograde endovascular treatment of advanced tibial vessel disease between 2011 and 2014...
February 2016: Annals of Vascular Surgery
Usama Lotfi, Magdy Haggag
BACKGROUND: Percutaneous transluminal angioplasty of complex infrapopliteal lesions might be a true and complex challenge. Success rates remain suboptimal when employing standard approaches. Thus, recanalization techniques for infrapopliteal disease remain a seat of continuous evolution. AIM OF THE STUDY: We report our results of Trans Atlantic Inter Society Consensus D infrapopliteal disease recanalization using combined antegrade-retrograde approach through peroneal artery branches...
October 2016: Vascular
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