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Below the knee angioplasty

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https://www.readbyqxmd.com/read/30116413/review-of-transmetatarsal-amputations-in-the-management-of-peripheral-arterial-disease-in-an-asian-population
#1
Ming Ngan Aloysius Tan, Zhiwen Joseph Lo, Soon Hong Lee, Rui Ming Teo, Wei Leong Glenn Tan, Sadhana Chandrasekar
Objective : To evaluate outcomes after transmetatarsal amputation (TMA) in peripheral arterial disease (PAD) limb salvage in an Asian population and identify risk factors associated with TMA failure. Methodology : A retrospective review of 147 patients with PAD, who had undergone TMA between 2008 and 2014, was carried out. Univariate and multivariate analysis were used to identify predictors of TMA failure. Kaplan-Meier survival analysis was used to calculate major amputation and all-cause mortality rates. Results : The mean age was 66 years...
June 25, 2018: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/30019194/percutaneous-deep-venous-arterialization-for-severe-critical-limb-ischemia-in-patients-with-no-option-of-revascularization-early-experience-from-two-european-centers
#2
C Del Giudice, D Van Den Heuvel, J Wille, T Mirault, E Messas, R Ferraresi, S Kum, M Sapoval
PURPOSE: To report our initial experience of fully percutaneous deep venous arterialization (pDVA) for the treatment of chronic critical limb ischemia (cCLI) after failed distal angioplasty. MATERIALS AND METHODS: pDVA was performed in five consecutive patients by creating an arteriovenous fistula (AVF) between a below the knee artery and its satellite deep vein. In this early experience, only patients with failed prior interventional attempts at establishing flow with no distal targets for an arterial bypass were selected...
July 17, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29804736/a-systematic-review-and-meta-analysis-of-revascularization-outcomes-of-infrainguinal-chronic-limb-threatening-ischemia
#3
REVIEW
Jehad Almasri, Jayanth Adusumalli, Noor Asi, Sumaya Lakis, Mouaz Alsawas, Larry J Prokop, Andrew Bradbury, Philippe Kolh, Michael S Conte, M Hassan Murad
BACKGROUND: The optimal strategy for revascularization in infrainguinal chronic limb-threatening ischemia (CLTI) remains debatable. Comparative trials are scarce, and daily decisions are often made using anecdotal or low-quality evidence. METHODS: We searched multiple databases through May 7, 2017, for prospective studies with at least 1-year follow-up that evaluated patient-relevant outcomes of infrainguinal revascularization procedures in adults with CLTI. Independent pairs of reviewers selected articles and extracted data...
August 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29721495/current-strategies-for-the-manufacture-of-small-size-tissue-engineering-vascular-grafts
#4
REVIEW
Michele Carrabba, Paolo Madeddu
Occlusive arterial disease, including coronary heart disease (CHD) and peripheral arterial disease (PAD), is the main cause of death, with an annual mortality incidence predicted to rise to 23.3 million worldwide by 2030. Current revascularization techniques consist of angioplasty, placement of a stent, or surgical bypass grafting. Autologous vessels, such as the saphenous vein and internal thoracic artery, represent the gold standard grafts for small-diameter vessels. However, they require invasive harvesting and are often unavailable...
2018: Frontiers in Bioengineering and Biotechnology
https://www.readbyqxmd.com/read/29688737/endovascular-procedures-in-treatment-of-infrapopliteal-arterial-occlusive-disease-single-center-experience-with-69-infrapopliteal-procedures
#5
Pasternak J Janko, Budakov B Nebojsa, Petres V Andrej
BACKGROUND: Peripheral arterial occlusive disease (PAD) includes acute and chronic disorders of the blood supply as a result of obstruction of blood flow in the arteries of the limb. Treatment of PAD can be conservative, surgical and endovascular. Percutaneous transluminal angioplasty with or without stenting has become a recognized method, which is increasingly used in treatment of arterial occlusive disease. This study aimed to determine early results of endovascular treatment of critical limb ischemia (CLI) patients with infrapopliteal lesions...
March 1, 2018: Archives of Iranian Medicine
https://www.readbyqxmd.com/read/29628469/calcified-nodules-projecting-into-the-popliteal-artery-successfully-treated-through-the-use-of-myocardial-biopsy-forceps
#6
Takenobu Shimada, Tsuyoshi Goto, Shunsuke Kubo, Seiji Habara, Hiroyuki Tanaka, Kazushige Kadota
A 69-year-old man on maintenance dialysis underwent endovascular therapy for a refractory wound due to critical limb ischemia in the popliteal and below-knee arteries. Because of bulky calcified nodules projecting into the popliteal artery, conventional balloon angioplasty alone did not seem to provide a sufficient lumen area, and we ablated the calcified nodules by using myocardial biopsy forceps for lesion preparation. Under roadmap guidance, we repeated ablation 39 times to carefully tear off the bulky calcified nodules, and subsequently performed balloon angioplasty in the popliteal artery...
May 30, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29573541/treatment-of-infrapopliteal-post-pta-dissection-with-tack-implants-12-month-results-from-the-toba-btk-study
#7
Marianne Brodmann, Christian Wissgott, Andrew Holden, Robert Staffa, Thomas Zeller, Thodur Vasudevan, Peter Schneider
OBJECTIVES: The Tack implant is designed for focal, minimal metal management of dissections. This study evaluated Tacks for treating postpercutaneous transluminal angioplasty (PTA) dissection in patients with below-the-knee (BTK) arterial occlusive disease. BACKGROUND: PTA is the most commonly used endovascular treatment for patients with occlusive disease of the BTK vessels. Post-PTA dissection is a significant clinical problem that results in poor outcomes, but currently there are limited treatment options for managing dissections...
March 24, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29466934/thirty-six-month-outcomes-of-drug-eluting-balloon-angioplasty-in-the-infrapopliteal-arteries
#8
Berkan Ozpak, Sahin Bozok, Mustafa Cagdas Cayir
Objectives To evaluate 36-month outcomes of drug-eluting balloons in infrapopliteal (=below-the-knee) arterial segments, we made a prospective registry enrolling patients (Rutherford class 2 to 5, ankle-brachial index 0.4-0.7) who were revascularized with drug-eluting balloon from August 2011 to December 2014. Methods Three hundred and seven infrapopliteal arteries were revascularized only with drug-eluting balloon. Endpoints included target lesion revascularization, primary patency rate, and changes in ankle-brachial index and Rutherford class...
January 1, 2018: Vascular
https://www.readbyqxmd.com/read/29429146/graft-type-for-femoro-popliteal-bypass-surgery
#9
REVIEW
Graeme K Ambler, Christopher P Twine
BACKGROUND: Femoro-popliteal bypass is implemented to save limbs that might otherwise require amputation, in patients with ischaemic rest pain or tissue loss; and to improve walking distance in patients with severe life-limiting claudication. Contemporary practice involves grafts using autologous vein, polytetrafluoroethylene (PTFE) or Dacron as a bypass conduit. This is the second update of a Cochrane review first published in 1999 and last updated in 2010. OBJECTIVES: To assess the effects of bypass graft type in the treatment of stenosis or occlusion of the femoro-popliteal arterial segment, for above- and below-knee femoro-popliteal bypass grafts...
February 11, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29250834/comparison-of-drug-eluting-balloon-angioplasty-to-infrapopliteal-artery-critical-lesions-with-or-without-additional-pedal-artery-angioplasty-in-patients-with-diabetes-mellitus-and-critical-limb-ischemia
#10
Burak Teymen, Süleyman Aktürk
BACKGROUND: The purpose of this study is to investigate the feasibility and outcome of balloon angioplasty for the treatment of below the ankle (BTA) lesions in addition to below the knee (BTK) lesions in diabetic patients with critical limb ischemia (CLI). METHODS: Inclusion criteria are diabetes mellitus (DM), CLI (Rutherford class 4 or higher) and revascularized significant stenosis or occlusion of at least 1 below-the-knee vessel with incomplete or no pedal loop...
June 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29237360/endovascular-treatment-of-thromboangiitis-obliterans-buerger-s-disease
#11
REVIEW
Mohammad-Hadi S Modaghegh, Shahab Hafezi
PURPOSE: When critical limb ischemia (CLI) occurs in patients with thromboangiitis obliterans (TAO) or Buerger's disease, smoking cessation alone may be insufficient to relieve rest pain and promote wound healing. Accordingly, adjunctive measures are warranted to restore adequate blood flow required for limb salvage. This study aimed to evaluate the feasibility and efficacy of percutaneous transluminal angioplasty (PTA) for the treatment of patients with TAO and CLI. In addition, a review of the literature on endovascular management of TAO is included...
February 2018: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29234736/vein-patch-closure-using-below-the-knee-greater-saphenous-vein-for-femoral-endarterectomy-procedures-is-not-always-a-safe-choice
#12
M Berner, Th Lattmann, Ph Stalder, P Wigger
Background: The complication of vein patch rupture is well described after carotid patch angioplasty; however, there is a paucity of data about the safety of vein patch closure in the setting of femoral endarterectomy. Methods/results: From May 2012 to May 2015, 115 femoral endarterectomies with patch closure were performed. A patch rupture occurred in three cases (2.6%) with a mortality rate of 66% (2/3). In all cases the greater saphenous vein below the knee was used as patch material...
2017: EJVES Short Reports
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#13
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29157024/critical-limb-ischemia-update-and-the-evolving-role-of-drug-elution-technologies
#14
REVIEW
Jared B Hooker, Beau M Hawkins
Critical limb ischemia (CLI) is a prevalent condition associated with cardiovascular mortality and limb loss. Areas covered: This review discusses the epidemiology of CLI, revascularization options, and drug-elution therapies. Expert commentary: Drug-eluting stents (DES) and drug-coated balloons (DCB) improve patency rates in the femoropopliteal segment, and are generally used as first-line therapies. For below-knee disease, angioplasty is the default strategy unless lesions are focal whereby DES can be used to reduce restenosis risk...
December 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29147164/a-series-of-210-peripheral-arterial-disease-below-knee-amputations-and-predictors-for-subsequent-above-knee-amputations
#15
Jing Ting Wu, Maggie Wong, Zhiwen Joseph Lo, Wei-En Wong, Sriram Narayanan, Glenn Wei Leong Tan, Sadhana Chandrasekar
Objective : To review patient characteristics and outcomes after peripheral arterial disease (PAD)-related below-knee amputation (BKA), and identify risk factors predicting subsequent above-knee amputation (AKA). Materials and Methods : A retrospective study of 210 BKAs between May 2008 and December 2015. Results : The mean age of the study population was 66 years. Most of the patients had cardiovascular comorbidities, and 33% had end-stage renal failure (ESRF); 89% were American Society of Anesthesiologists 3 or 4...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29100807/predictors-of-delayed-wound-healing-after-successful-isolated-below-the-knee-endovascular-intervention-in-patients-with-ischemic-foot-ulcers
#16
Sushant Kumar Das, Yi Feng Yuan, Mao Quan Li
OBJECTIVE: The purpose of this study was to explore the predictors of delayed wound healing and their use in risk stratification for endovascular treatment (EVT) of patients with critical limb ischemia (CLI) due to isolated below-the-knee lesions. METHODS: Wound healing rates were analyzed retrospectively in patients who underwent successful below-the-knee percutaneous transluminal balloon angioplasty for CLI with tissue loss between May 2008 and June 2013. We also analyzed the independent predictors of delayed wound healing and their use in risk stratification...
April 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28975777/the-evolving-role-of-drug-coated-balloons-for-the-treatment-of-complex-femoropopliteal-lesions
#17
REVIEW
Grigorios Korosoglou, Michael Lichtenberg, Sultan Celik, Joachim Andrassy, Marianne Brodmann, Martin Andrassy
Conventional therapies for transcatheter treatment of patients with infrainguinal obstructive disease remain compromised by high restenosis rates. Drug-coated balloons (DCB) offer a novel therapeutic alternative targeting the source of neo-intimal hyperplasia, without the need for a permanent endovascular scaffold and their inherent limitations. A systematic research of the medical databases (Pubmed) has been conducted for this up-to-date review. Key words, such as "drug-coated balloons" (DCB), "drug-eluting balloon," "in-stent-restenosis" (ISR), "de-novo stenosis," "plain old angioplasty," "atherectomy," "debulking," "superficial femoral artery," "popliteal artery," "above/below the knee," and "peripheral artery disease" have been used for literature search...
February 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28951878/the-effect-of-charcot-neuroarthropathy-on-limb-preservation-in-diabetic-patients-with-foot-wound-and-critical-limb-ischemia-after-balloon-angioplasty
#18
COMPARATIVE STUDY
Mehmet Burak Çildağ, Ömer Faruk Kutsi Köseoğlu
OBJECTIVE: The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. METHODS: This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/28884985/staged-endovascular-repair-of-critical-limb-ischemia-in-high-risk-patients-the-procedural-and-clinical-outcomes
#19
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/28866449/fractional-flow-reserve-in-below-the-knee-arteries-with-critical-limb-ischemia-and-validation-against-gold-standard-morphologic-functional-measures-and-long-term-clinical-outcomes
#20
Zoltán Ruzsa, Szilárd Róna, Gábor G Tóth, Péter Sótonyi, Olivier F Bertrand, Balázs Nemes, Béla Merkely, Kálmán Hüttl
INTRODUCTION: The aim of this study was to assess the applicability of fractional flow reserve measurement (FFR) in below-the-knee (BTK) arteries and to evaluate its correlation with non-invasive functional parameters before and after angioplasty. METHODS: We enrolled 39 patients with severe BTK arterial lesions. Inclusion criteria were critical limb ischemia (Rutherford 4-6) and angiographically proven arterial stenosis of the distal lower limb (percent diameter stenosis ≥70%)...
March 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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