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Tibial angioplasty

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https://www.readbyqxmd.com/read/29588023/managing-soft-tissues-in-severe-lower-limb-trauma-in-an-ageing-population
#1
Timothy M Noblet, Philippa C Jackson, Patrick Foster, David Martin Taylor, Paul J Harwood, Jay D Wiper
PURPOSE: With an ageing population, the incidence of trauma in those aged over 65 years is increasing. Strategies for dealing with these patients must be developed. At present the standard management of open tibial fractures in the UK is described by the BOAST4 guidelines (from the British Orthopaedic Association and British Association of Plastic & Aesthetic Surgeons). It is not clear to what extent these are appropriate for older patients. We describe our experience of managing elderly patients presenting with open tibial fractures...
March 13, 2018: Injury
https://www.readbyqxmd.com/read/29518519/techniques-for-infrapopliteal-arterial-bifurcation-stenting
#2
Hong Kuan Kok, Shirish G Prabhudesai, Irfan Ahmed, Narayan Karunanithy, Said Abisi, Konstantinos Katsanos, Athanasios Diamantopoulos
PURPOSE: Endovascular treatment of infrapopliteal peripheral arterial disease (PAD) is an established and effective treatment strategy for patients with symptomatic PAD. Increasingly, complex infrapopliteal lesions are treated with an endovascular first approach, especially in the setting of critical limb ischemia for limb salvage, avoiding major amputations which impact on mobility and quality of life. However, many complex infrapopliteal lesions involving the bifurcation of the tibial arteries remain challenging to treat due to recoil or acute dissection following angioplasty and may require stenting using specialized techniques...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29518503/early-outcomes-following-endovascular-open-surgical-and-hybrid-revascularization-for-lower-extremity-acute-limb-ischemia
#3
Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
BACKGROUND: Acute limb ischemia (ALI) of the lower extremity is a potentially devastating condition that requires urgent and definitive management. This challenging scenario is often treated with endovascular, open surgical, or hybrid revascularization (HyR) in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare the outcomes of endovascular, open surgical, and HyR for ALI in the contemporary era. METHODS: A large statewide cardiovascular consortium of 45 hospitals was queried for patients between January 2012 and June 2015 who underwent an endovascular, open surgical, or HyR for ALI deemed at high risk of limb loss if not treated within 24 hr (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29481944/prior-endovascular-intervention-is-not-detrimental-to-pedal-bypasses-for-ischemic-wounds
#4
Abhisekh Mohapatra, Mikayla N Lowenkamp, Jon C Henry, Aureline Boitet, Efthimios D Avgerinos, Rabih A Chaer, Michel S Makaroun, Steven A Leers, Eric S Hager
INTRODUCTION: Endovascular strategies are often preferred for revascularization of ischemic foot wounds secondary to infrapopliteal disease due to the less invasive technique and faster recovery. Bypass is typically reserved for failures or lesions not amenable to balloon angioplasty. However, the effects of an endovascular-first approach on subsequent bypass grafts is largely unknown. This study evaluates the effects of prior tibial interventions on successive bypasses to pedal targets...
February 23, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29439600/initial-experience-with-the-outback-catheter-for-targeted-reentry-during-subintimal-angioplasty-of-the-infragenicular-arteries
#5
Athanasios Diamantopoulos, Serafino Santonocito, Narayanan Thulasidasan, Panos Gkoutzios, Irfan Ahmed, Hany Zayed, Konstantinos Katsanos
PURPOSE: To report use of the Outback reentry device for targeted distal reentry during subintimal recanalization of chronic total occlusions (CTOs) in the infragenicular arteries. METHODS: During an 18-month period, the Outback device was applied in 10 patients (mean age 71.8±18.8 years; 8 men) to achieve reentry at the infragenicular segment following either unsuccessful spontaneous reentry after subintimal crossing of a CTO or when a targeted reentry was desired...
April 2018: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/29402670/infrapopliteal-angioplasty-of-one-or-more-than-one-artery-for-critical-limb-ischaemia-a-randomised-clinical-trial
#6
Rodrigo B Biagioni, Luisa C Biagioni, Felipe Nasser, Marcelo C Burihan, José C Ingrund, Adnan Neser, Fausto Miranda
OBJECTIVE: The aim was to analyse the effect of the treatment of more than one infrapopliteal artery with respect to wound healing and limb salvage. METHODS: Seventy-eight patients were enrolled prospectively for 80 procedures (80 limbs) that were randomly divided into two groups: 40 in the single vessel (SV) group and 40 in the multiple vessel group (MV). All patients had tissue loss. The choice of the first artery to treat was based on an analysis of two factors: the ease of the required endovascular technique and the presence of adequate distal outflow...
February 2, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29354628/femoral-endovenectomy-with-iliac-stenting-for-chronic-iliofemoral-venous-occlusion
#7
Won Pyo Cho, Sungsin Cho, Min-Ji Cho, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Seung-Kee Min
A 62-year-old man with progressive swelling on his left thigh and leg was referred to the Division of Vascular Surgery. Anticoagulation therapy did not prevent or improve the symptoms of chronic deep vein thrombosis (DVT) from his left external iliac vein to posterior tibial vein. He had no trauma history nor any accidents. He underwent femoral endovenectomy, thrombectomy and stent insertion in left iliac vein. The patient had additional balloon angioplasty for stenosis in left common femoral vein. He had an uneventful postoperative recovery without complication...
December 2017: Vascular Specialist International
https://www.readbyqxmd.com/read/29317991/successful-recanalization-of-long-femoro-crural-occlusive-disease-after-failed-bypass-surgery
#8
Grigorios Korosoglou, Tom Eisele, Dorothea Raupp, Christoph Eisenbach, Sorin Giusca
Patients with critical limb ischemia necessitate immediate intervention to restore blood flow to the affected limb. Endovascular procedures are currently preferred for these patients. We describe the case of an 80-year-old female patient who presented to our department with ischemic rest pain and ulceration of the left limb. The patient had history of left femoral popliteal bypass surgery, femoral thromboendarterectomy and patch angioplasty of the same limb 2 years ago. Doppler sonography and magnetic resonance angiography revealed an occlusion of the left superficial femoral artery (SFA) and popliteal artery and of all three infra-popliteal arteries...
December 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/29240587/reclaiming-autologous-amputated-tissue-for-limb-salvage-of-a-diabetic-foot-burn-with-underlying-critical-limb-ischemia
#9
Catherine N Tchanque-Fossuo, Andrew M Wishy, Kaitlyn I M West, David L Dawson, Sara E Dahle, John G Carson
BACKGROUND: Diabetes mellitus is a worldwide pandemic that impacts more than 387 million people, with 29 million individuals affected in the United States alone. Diabetic patients have a 25% lifetime risk of developing a diabetic foot ulcer (DFU). Having a DFU is associated with a risk of recurrence approaching 70%. In addition, 1 in 6 patients with DFU will have a lower-limb amputation, with an associated increase in mortality ranging from 47% to 70%. Therefore, limb salvage is critical in patients with DFU...
January 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/28964617/tibiodistal-vein-bypass-in-critical-limb-ischemia-and-its-role-after-unsuccessful-tibial-angioplasty
#10
Florian K Enzmann, Sebastian K Eder, Thomas Aschacher, Manuela Aspalter, Patrick Nierlich, Klaus Linni, Thomas J Hölzenbein
OBJECTIVE: Technical progress in angioplasty expanded its application to very distal arterial lesions of the lower extremity. In cases of unsuccessful angioplasty tibiodistal bypass surgery may be required for limb salvage. We investigated the long-term outcome of this technique in patients with critical limb ischemia. The purpose of this study was to evaluate whether tibiodistal bypasses done after unsuccessful tibial angioplasty had inferior patency, limb salvage, or survival rates compared with primary tibiodistal bypasses...
September 27, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28884985/staged-endovascular-repair-of-critical-limb-ischemia-in-high-risk-patients-the-procedural-and-clinical-outcomes
#11
Guang Liu, Chaoyi Cui, Minyi Yin, Kaichuang Ye, Xaiobing Liu, Jinbao Qin, Huihua Shi, Xintian Huang, Min Lu, Xinwu Lu, Weimin Li, Mier Jiang
BACKGROUND: The aim of this paper was to retrospectively evaluate the procedural and clinical outcomes after staged angioplasty in high-risk, chronic, critical limb ischemia (CLI) patients. METHODS: Between 2013 and 2015, 29 patients (29 limbs) (mean age 77 years) were treated by staged revascularization procedures in 1) the iliac artery-DFA alone or with the femoropopliteal artery followed by 2) the femoropopliteal artery and a below-the-knee artery. All patients had long-segment iliofemoral artery and below-the-knee artery (TASCII D) occlusions with abnormal serum myoglobin and ischemic lesions...
February 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/28856423/longitudinal-cracking-with-a-guidewire-tail-for-extremely-calcified-lesions-in-infrainguinal-arteries-picking-technique
#12
Osami Kawarada, Teruo Noguchi, Satoshi Yasuda
PURPOSE: To report a percutaneous intravascular cracking with a guidewire tail (PICKING) technique to longitudinally crack the underlying calcification and facilitate the balloon catheter passage for the treatment of severely calcified chronic occlusions in the infrainguinal artery. MATERIALS AND METHODS: Three patients underwent PICKING technique between November 2014 and March 2017. The PICKING technique with the stiff tail of 0.018-inch guidewire in the straight configuration was considered in cases of failed passage of the smallest balloon catheter because of the underlying severely calcified occlusion following passage of 0...
February 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28852581/one-year-primary-patency-of-infrapopliteal-angioplasty-using-drug-eluting-balloons-single-center-experience-at-king-hussein-medical-center
#13
Sizeph Edward Haddad, Jan Mohammad Shishani, Izzeddin Qtaish, Mohammad Abdelmajeed Rawashdeh, Belal Saleh Qtaishat
OBJECTIVE: Conventional percutaneous transluminal angioplasty (PTA) for long lesions in the below-the-knee (BTK) arteries in patients presenting with critical limb ischemia (CLI) has high restenosis rates at 1 year. Our goal is to evaluate whether paclitaxel drug-eluting balloons (DEB) have higher 1 year primary patency rates compared to conventional PTA. METHODS: This is a single-center, prospective, randomized trial that was conducted from June 2013 to December 2015...
2017: Journal of Clinical Imaging Science
https://www.readbyqxmd.com/read/28705341/-is-ultrasound-guidance-contributive-to-vascular-access-in-endovascular-therapy
#14
B Dakhil, F Couineau, J Hernigou, J Bardet, E Tella, P Bagan
OBJECTIVES: The aim of this study was to evaluate the contribution of ultrasound guidance (UG) to vascular puncture in endovascular therapy. Ultrasound guidance was evaluated by comparison with the rates of failures and complications of the traditional techniques of percutaneous vascular access. MATERIALS AND METHODS: We reviewed all the consecutive percutaneous revascularizations (percutaneous transluminal angioplasty and/or stenting, treatment of aneurysms and vascular traumatisms) since the standardization of the systems of closing (extra- and endovascular)...
July 2017: Journal de Médecine Vasculaire
https://www.readbyqxmd.com/read/28647629/histological-analysis-of-a-new-route-after-subintimal-crural-angioplasty
#15
Daijirou Akamatsu, Fumiyoshi Fujishima, Hitoshi Goto, Munetaka Hashimoto, Ken Tsuchida, Keiichirou Kawamura, Yuta Tajima, Michihisa Umetsu, Syunya Suzuki, Takashi Kamei
BACKGROUND: Subintimal angioplasty is an alternative approach in treating critical limb ischemia with crural artery disease. However, route or location of the newly created channel is not understood. CASE PRESENTATION: A 68-year-old man was referred to our hospital with ischemic gangrene of the right big toe. We performed endovascular treatment because he was a poor candidate for bypass surgery. The posterior tibial artery was treated using subintimal angioplasty, although it resulted in early occlusion...
June 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28646446/innovations-in-the-endovascular-management-of-critical-limb-ischemia-retrograde-tibiopedal-access-and-advanced-percutaneous-techniques
#16
REVIEW
Jihad A Mustapha, Larry J Diaz-Sandoval, Fadi Saab
PURPOSE OF REVIEW: Retrograde tibiopedal access and interventions have contributed to advance of endovascular techniques to treat critical limb ischemia (CLI) patients. This review encompasses the spectrum from advanced diagnostic imaging and technical therapeutic approaches for infrapopliteal occlusions, to a discussion of current standards and future directions. RECENT FINDINGS: Contemporary studies of infrapopliteal angioplasty show suboptimal short-term and 1-year clinical outcomes...
August 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28618851/crush-deformation-of-a-balloon-expandable-stent-implanted-in-an-infrainguinal-bypass-graft
#17
Nida Ahmed, Rym El-Khoury, Moustafa N Sabri, John V White, Chad E Jacobs, Lewis B Schwartz
A 59-year-old man with critical claudication underwent left femoro-anterior bypass grafting, which was uneventful. The graft was tunneled medially across the knee, then anterior to the tibia. His symptoms recurred 1 year later and he was found to have critical stenosis of the vein graft just proximal to the anterior tibial arterial anastomosis. This was treated with scaffolded balloon angioplasty and implantation of a coronary, zotarolimus-eluting balloon-expandable stent, which was also uneventful. However, his claudication again recurred 1 year later...
August 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28479467/the-natural-history-and-outcomes-of-endovascular-therapy-for-claudication
#18
Julia T Saraidaridis, Emel A Ergul, W Darrin Clouse, Virendra I Patel, Richard P Cambria, Mark F Conrad
BACKGROUND: The natural history of claudication is well-characterized and traditional therapy includes risk factor modification and exercise protocols with revascularization reserved for patients who are severely impaired. However, the reduced periprocedural morbidity with endovascular therapy has led physicians to broaden the indications for intervention for peripheral artery disease, and more claudicants are undergoing procedures for disease that is moderately limiting to their lifestyle...
October 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28457200/simultaneous-antegrade-retrograde-subintimal-revascularization-of-a-femoropopliteal-chronic-total-occlusion-by-a-reentry-device-facilitated-puncture-of-a-retrogradely-inserted-balloon
#19
Jan Peter Goltz, Susanne Anton, Marcus Wiedner, Jörg Barkhausen, Erik Stahlberg
PURPOSE: To report a rendezvous technique for subintimal revascularization of a chronic total occlusion (CTO) of the superficial femoral artery (SFA). TECHNIQUE: This maneuver is appropriate after failure to cross a long SFA CTO via intra- and subintimal approaches from the ipsilateral femoral as well as retrograde posterior tibial artery (PTA) access sites. After predilation of the subintimal space from the femoral access, a reentry device was placed at the level of the first popliteal artery segment...
April 1, 2017: Journal of Endovascular Therapy
https://www.readbyqxmd.com/read/28349710/endovascular-devices-and-revascularization-techniques-for-limb-threatening-ischemia-in-individuals-with-diabetes
#20
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...
September 2017: Journal of Diabetes Science and Technology
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