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Femoral-popliteal disease

Frank M Davis, Jeremy Albright, Katherine A Gallagher, Hitinder S Gurm, Gerald C Koenig, Theodore Schreiber, P Michael Grossman, Peter K Henke
OBJECTIVES: 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 in an urgent basis, but the comparative effects of such therapies remain poorly defined. The purpose of this study was to compare outcomes of endovascular, open surgical, and hybrid revascularization 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 hybrid revascularization for ALI deemed at high risk of limb loss if not treated within 24 hours (Rutherford class IIA or IIB)...
March 5, 2018: Annals of Vascular Surgery
Sevan Komshian, Thomas W Cheng, Alik Farber, Marc L Schermerhorn, Jeffrey A Kalish, Denis Rybin, Douglas W Jones, Jeffrey J Siracuse
OBJECTIVE: Retrograde popliteal artery (RPA) access to treat superficial femoral artery and popliteal artery disease is an option when treatment through common femoral artery (CFA) access is not possible. Our goal was to compare the safety and efficacy of RPA access with CFA access for treatment of femoral and popliteal artery lesions. METHODS: The Vascular Quality Initiative was queried for all patients undergoing RPA access from 2010 to 2016 for symptomatic peripheral arterial disease...
March 1, 2018: Journal of Vascular Surgery
Artem Rabtsun, Andréi Karpenko, D G Zoloev, Vladimir Starodubtsev, Pavel Ignatenko, Anne Lejay, Nabil Chakfe
OBJECTIVES: Superficial femoral artery (SFA) remote endarterectomy offers the advantage of preserving anatomy and geometry of the native artery but the risk of restenosis still exists. The particular role of the adductor canal (AC) in mechanical constraints has been highlighted. The aim of this study was to assess if a surgical protocol associating remote SFA endarterectomy and AC freeing would modify the SFA geometrical changes during physiological limb flexion. METHODS: From January 2015 to March 2015, 10 patients (Rutherford 3-5) with unilateral SFA occlusion were included...
February 27, 2018: Annals of Vascular Surgery
Kaspars Maleckis, Eric Anttila, Paul Aylward, William Poulson, Anastasia Desyatova, Jason MacTaggart, Alexey Kamenskiy
Endovascular stenting has matured into a commonly used treatment for peripheral arterial disease (PAD) due to its minimally invasive nature and associated reductions in short-term morbidity and mortality. The mechanical properties of the superelastic Nitinol alloy have played a major role in the explosion of peripheral artery stenting, with modern stents demonstrating reasonable resilience and durability. Yet in the superficial femoral and popliteal arteries, even the newest generation Nitinol stents continue to demonstrate clinical outcomes that leave significant room for improvement...
February 22, 2018: Annals of Biomedical Engineering
Akihiro Nakamura, Masanori Kanazawa, Kazuki Noda, Hideaki Endo, Tohru Takahashi, Eiji Nozaki
The percutaneous transradial artery approach for coronary angiography and intervention has been recognized as a safe and effective method, however, it is limited for endovascular therapy (EVT) for femoro-popliteal artery because of lack of devices with longer shaft. Herein, we report two EVT cases for superficial femoral artery disease treated with a long shaft balloon through the radial artery. Although femoro-popliteal artery intervention with this approach has several limits for available devices and technical issues, it is effective for particular patients who are impossible in EVT with femoral artery approach...
January 2018: Indian Heart Journal
Pierleone Lucatelli, Marco Cini, Giulio Tommasino, Antonio Benvenuti, Giulia Guaccio, Stefano Bascetta, Eugenio Neri, Carmelo Ricci
PURPOSE: To prospectively evaluate the safety and efficacy of using the Tigris vascular stent (Gore, Flagstaff, Arizona) alone or in combination with the Viabahn stent (Gore) for revascularizing femoropopliteal Trans-Atlantic Intersociety Consensus (TASC) type B-D lesions with varying degrees of calcification. MATERIALS AND METHODS: Patients with Rutherford stage ≥ 3 and TASC type ≥ B were included in the study. From January 2015 to April 2017, 31 segments in 31 patients (21 men, ovarall mean age 73...
February 13, 2018: Journal of Vascular and Interventional Radiology: JVIR
Megumi Fuke, Makoto Narita, Yuko Wada, Tatsuichiro Seto, Kenji Okada, Jun Nakayama, Hiroto Izumi, Ken-Ichi Ito
Critical limb ischemia (CLI) is the most severe complication of peripheral arterial disease (PAD). Understanding the molecular mechanisms underlying tissue repair after CLI is necessary for preventing PAD progression. Y-box binding protein-1 (YB-1) regulates the expression of many genes in response to environmental stresses. We aimed to determine whether YB-1 is involved in ischemic muscle regeneration. A mouse ischemic hind-limb model was generated; namely, the femoral, saphenous, and popliteal arteries in the left hind limb were ligated...
2018: Tohoku Journal of Experimental Medicine
Dainis Krievins, Janis Savlovskis, Natalija Ezite, Andrew Hill, Kaspars Kisis, Marcis Gedins, Edgars Zellans, Andrew Holden
BACKGROUND: Long segment occlusive disease in the superficial femoral artery remains a treatment challenge despite advances in open surgical and endovascular approaches. We report initial clinical results of an entirely new procedure to perform femoropopliteal bypass using the DETOUR System to create a stentgraft bypass which originates in the SFA, travels through the femoral vein, and ends in the popliteal artery, bypassing the diseased segment. METHODS: Review the initial results of the first five patients at a single site enrolled in IRB-approved, prospective clinical study using the DETOUR System...
January 9, 2018: Journal of Cardiovascular Surgery
Peter A Schneider, John R Laird, Gunnar Tepe, Marianne Brodmann, Thomas Zeller, Dierk Scheinert, Christopher Metzger, Antonio Micari, Ravish Sachar, Michael R Jaff, Hong Wang, Melissa S Hasenbank, Prakash Krishnan
BACKGROUND: Randomized controlled trials have reported favorable 1-year outcomes with drug-coated balloons (DCBs) for the treatment of symptomatic peripheral arterial disease when compared with standard percutaneous transluminal angioplasty (PTA). Evidence remains limited on the durability of the treatment effect with DCBs in the longer term. METHODS AND RESULTS: IN.PACT SFA is a single-blind, randomized trial (Randomized Trial of IN.PACT Admiral Paclitaxel-Coated Percutaneous Transluminal Angioplasty [PTA] Balloon Catheter vs Standard PTA for the Treatment of Atherosclerotic Lesions in the Superficial Femoral Artery [SFA] and/or Proximal Popliteal Artery [PPA]) that enrolled 331 patients with symptomatic (Rutherford 2-4) femoropopliteal lesions up to 18 cm in length...
January 2018: Circulation. Cardiovascular Interventions
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
Pradeep Kumar Mada, Folusakin Ayoade, Ailing Li, John Todd
A 59-year-old man with a history of peripheral vascular disease status post femoral popliteal bypass presented with critical limb ischaemia of the left leg. An arterial Doppler ultrasound showed an occluded graft requiring an above knee amputation. Five days after surgery, the patient developed fever, leucocytosis, significant stump swelling and pain, and serosanguinous discharge from his wound. Wound swab cultures from the stump grew Trichosporon asahii A venous Doppler ultrasound revealed extensive thrombosis of the left lower extremity...
January 6, 2018: BMJ Case Reports
Derek de Grijs, Pedro Teixeira, Steven Katz
OBJECTIVE: It has long been known that hydroxymethylglutaryl-coenzyme A reductase inhibitors (statins) broadly reduce cardiovascular events in patients with peripheral vascular disease. It was the goal of this study to determine whether there is an association between statin therapy and primary patency after stenting of superficial femoral and popliteal arteries. METHODS: The records of all patients undergoing primary nitinol stenting of the femoral and popliteal arteries at a single institution and by a single surgeon during a 10-year period were reviewed...
December 7, 2017: Journal of Vascular Surgery
Yi-Hui Qiu, Guan-Feng Yu, Huan-Hao Zhou, Hu-Wei Xia, Li Chen, Hao-Tian Chen, Yuan-Yong Jiao, Zi-Heng Wu, Xiang-Tao Zheng
BACKGROUND: For long femoropopliteal occlusive lesions, the immediate technical failure (ITF) of endovascular treatment (EVT) is relatively high. Therefore, this study aims to reveal risk factors and establish a prediction model of ITF of EVT in femoropopliteal occlusive disease (FPOD) patients based on preoperative clinical date that may be helpful to the clinical procedures. METHODS: A retrospective analysis of 1,563 FPOD patients who underwent above-the-knee EVT was undertaken...
December 5, 2017: Annals of Vascular Surgery
J-M Fichelle
Long-term iliofemoral complications induced by radiation include vascular (arterial and venous) lesions, nervous lesions and soft tissue loss that can be cutaneous and subcutaneous and potentially lead to radionecrosis with vessel exposure. We present five cases of groin radionecrosis. There were three men and two women (age 30-73 years). Radiotherapy had been delivered 15 years earlier in three cases, and 2 years earlier in two cases. Symptoms were intermittent claudication (n=1), critical ischemia (n=1), and septic hemorrhage (n=1)...
December 2017: Journal de Médecine Vasculaire
Yara Azar, Brian DeRubertis, Donald Baril, Karen Woo
BACKGROUND: Atherectomy has become an increasingly utilized modality for the endovascular treatment of peripheral arterial occlusive disease. The objective of this study was to determine the incidence and risk factors for atherectomy-associated complications. METHODS: A retrospective review was performed for all atherectomy procedures performed between January 2011 and December 2015 in the Southern California Vascular Outcomes Improvement Collaborative. Atherectomy was defined as laser, orbital, or excisional atherectomy...
November 29, 2017: Annals of Vascular Surgery
Pasqualino Sirignano, Wassim Mansour, Alessandro d'Adamo, Simone Cuozzo, Laura Capoccia, Francesco Speziale
BACKGROUND: To report our experience in treating severely claudicant patients, employing a "nitinol-constrained" balloon (Chocolate, TriReme Medical Inc., Pleasanton, CA-USA) before drug-coated balloon (DCB) in a standardized protocol. METHODS: Eighty-one (84 limbs) consecutive Rutherford category (RC) 3 patients treated between December 2014 and December 2016 for superficial femoral artery (SFA) and popliteal arterial (PA) disease by nitinol-constrained balloon followed by DCB were enrolled...
November 20, 2017: Cardiovascular and Interventional Radiology
Mingjie Gao, Yang Hua, Xinyu Zhao, Lingyun Jia, Jie Yang, Beibei Liu
This retrospective study determined the duplex ultrasound scanning criteria for detecting 50%-69% and 70%-99% stenosis of the superficial femoral artery (SFA). Examinations of 278 limbs in 185 patients with peripheral arterial disease were performed. Duplex ultrasound scanning was used to measure the diameter of the vascular lumen, the peak systolic velocity (PSV) at the stenotic segment of the SFA (PSVst), the segment proximal to the stenosis (PSVpro) and the popliteal artery (PSVpop, distal to the stenosis)...
November 14, 2017: Ultrasound in Medicine & Biology
Kjersti Wendt, Ronny Kristiansen, Kirsten Krohg-Sørensen, Fredrik Alexander Gregersen, Erik Fosse
OBJECTIVE: The numbers of lower extremity revascularisations and amputations are insufficiently reported in Norway. To support future policy decisions regarding the provision of vascular treatment, knowledge of such trends is important. METHODS: This retrospective cross-sectional study from 2001 to 2014 used data from the Norwegian Patient Registry. The revascularisation treatments were categorised in multilevel, aortoiliac, femoral to popliteal and popliteal to foot levels and sorted as open, endovascular and hybrid...
November 14, 2017: BMJ Open
Hans Ravn, Karin Pansell-Fawcett, Martin Björck
OBJECTIVES: Ninety-five per cent of those operated on for popliteal artery aneurysm (PA) are men. Thus, PAs in women are difficult to investigate. The aim was to study the disease in women. METHODS: Women treated for PA in 1987-2012, prospectively registered in the Swedish vascular registry, Swedvasc, supplemented by case records, were compared with the larger male cohort. Survival was determined through cross linkage with the National Population Registry. RESULTS: 1509 patients (men and women), 1872 legs, were identified; of these 74 patients (4...
December 2017: European Journal of Vascular and Endovascular Surgery
Joung Hun Byun, Tae Gyu Kim, Yun Gyu Song
Background: Lesions in distal target arteries hinder surgical bypass procedures in patients with peripheral arterial occlusive disease. Methods: Between April 2012 and October 2015, 16 patients (18 limbs) with lifestyle-limiting claudication (n=12) or chronic critical limb ischemia (n=6) underwent femoral-above-knee (AK) polytetrafluoroethylene (PTFE) bypass grafts with a bridging stent graft placement between the distal target popliteal artery and the PTFE graft...
October 2017: Korean Journal of Thoracic and Cardiovascular Surgery
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