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Wonho Kim, Ramon Quesada, Melanie B Schernthaner, Raul E Herrera, Juan-Carlos Zevallos, Victor N Becerra, Juan M Acuña, Barry T Katzen
OBJECTIVE: We investigated whether successful revascularization of total occlusion of a large lower-extremity artery is associated with improvement of left ventricular (LV) diastolic function. BACKGROUND: Total occlusion of a large lower-extremity artery might affect the systemic vascular resistance and increase the afterload, because the left ventricle must work harder to eject blood into a smaller vascular bed. Chronic elevation of afterload is a cause of LV diastolic dysfunction...
October 15, 2016: Journal of Invasive Cardiology
Erik Debing, Dimitri Aerden, Alain Vanhulle, Sarah Gallala, Karl von Kemp
BACKGROUND: Several trials have shown that drug coated balloon (DCB) angioplasty reduce the rates of restenosis in the femoropopliteal artery. This controlled, prospective, multicenter study was designed to demonstrate the efficacy of DCB to inhibit restenosis of the infra- inguinal arteries in an exclusive diabetic population. METHODS: Between 2012 and 2014, 106 diabetic patients with symptomatic peripheral arterial disease (PAD) were enrolled at 11 sites in Belgium, 54 treated with DCB angioplasty and 52 treated with plain old balloon angioplasty (POBA)...
October 11, 2016: Journal of Cardiovascular Surgery
Shinsuke Mori, Keisuke Hirano, Yoshiaki Ito, Masahiro Yamawaki, Motoharu Araki, Norihiro Kobayashi, Hideyuki Takimura, Yasunari Sakamoto, Masakazu Tsutsumi, Takuro Takama, Yohsuke Honda, Takahiro Tokuda, Kenji Makino, Shigemitsu Shirai
AIM: To investigate the relationship between intravascular ultrasound (IVUS) findings and restenosis after stent implantation for long occlusive femoropopliteal (FP) lesions using the intraluminal approach. METHODS: This was a single-center retrospective study of 45 patients (49 lesions) with de novo long occlusive FP lesions treated with bare metal stents implanted using the intraluminal approach under IVUS guidance from April 2007 to December 2014. All patients were followed up at least 12 months...
October 1, 2016: Journal of Atherosclerosis and Thrombosis
B S Sukovatykh, L N Belikov, M B Sukovatykh, D V Sidorov, M A Inarkhov, E B Inokhodova
AIM: to improve treatment of patients with severe atherosclerotic lesion of lower extremities arteries followed by critical ischemia by optimization of femoropopliteal bypass surgery. MATERIAL AND METHODS: Treament and survey of 60 patients with severe atherosclerotic lesion of femoropopliteotibial segment and critical lower limb ischemia were analyzed. Patients were divided into 2 groups depending on technique of femoropopliteal bypass. Conventional in situ autovenous technique was used in group 1...
2016: Khirurgiia
Tomas Grus, Lukas Lambert, Rohan Banerjee, Gabriela Grusova, Vilem Rohn, Tomas Vidim, Petr Mitas
Aim. To compare the differences between medial and intercondylar infragenicular femoropopliteal prosthetic bypasses in terms of their midterm patency and limb salvage rates. Methods. Ninety-three consecutive patients with peripheral arterial disease who underwent a simple distal femoropopliteal bypass using a reinforced polytetrafluorethylene graft were included in this retrospective study. The bypass was constructed in the intercondylar route in 52 of the patients (group A) and in 41 in the medial route (group B)...
2016: BioMed Research International
Laura Andrade Rocha, Carlos Eli Piccinato, Mauricio Serra Ribiero, Christiane Becari, Renata Dellalibera Joviliano, Edwaldo Edner Joviliano
OBJECTIVE: The purpose of this study was to investigate the roles of the kallikrein-kinin system and matrix metalloproteinases (MMPs) in the development of arterial restenosis attributable to intimal hyperplasia in the femoropopliteal arteries. METHODS: This report describes a single-center prospective study of 27 patients with peripheral artery disease who required percutaneous transluminal angioplasty and stenting of the femoropopliteal segment using covered stent grafts...
September 22, 2016: Journal of Vascular Surgery
Xin Jia, Jiwei Zhang, Baixi Zhuang, Weiguo Fu, Danming Wu, Feng Wang, Yu Zhao, Pingfan Guo, Wei Bi, Shenming Wang, Wei Guo
OBJECTIVES: The aim of this study was to investigate the efficacy and safety of a new paclitaxel-coated balloon catheter in the treatment of stenotic or occluded femoropopliteal arteries. BACKGROUND: The incidence of restenosis can be reduced by the use of drug-coated balloons. However, dose, coating composition, and technology are decisive for efficacy. METHODS: Two hundred Chinese patients with peripheral arterial occlusive disease were prospectively randomized to treatment with new paclitaxel-coated or standard uncoated balloon catheters...
September 26, 2016: JACC. Cardiovascular Interventions
Ríona Ní Ghriallais, Kevin Heraty, Bob Smouse, Martin Burke, Paul Gilson, Mark Bruzzi
PURPOSE: To quantify the deformation behavior of the diseased femoropopliteal segment and assess the change to deformation behavior due to various stent placements. METHODS: The length and curvature changes of 6 femoropopliteal segments (the right and left superficial femoral and popliteal arteries) from 3 cadavers were measured in 3-dimensional space based on rotational angiography image data in straight leg and flexed hip/knee (50°/90°) positions before and after placement of nitinol stents of varying type (EverFlex, Misago, and BioMimics 3D) and length (60, 100, and 200 mm) in different locations along the arteries...
September 19, 2016: Journal of Endovascular Therapy
Marc Bosiers, Koen Deloose, Joren Callaert, Patrick Peeters, Michel Bosiers
Endovascular techniques have improved markedly over the past several decades. Plain old balloon angioplasty can only reach patencies around 40% after 1 year. Scaffolding stents have resulted in improved short-term results but encountered limitations for longer-term durability. With the introduction of drug-eluting technologies the process of intimal hyperplasia might be slowed, resulting in improved long-term patency results. At first, limus-eluting technologies were not able to transfer the enthusiasm from the coronaries to the infrainguinal vascular bed...
December 2016: Journal of Cardiovascular Surgery
Ehtisham Mahmud, Florian Schmid, Peter Kalmar, Hannes Deutschmann, Franz Hafner, Peter Rief, Marianne Brodmann
OBJECTIVES: The goal of this study was to evaluate the feasibility and safety of a robotic-assisted platform (CorPath 200, Corindus Vascular Robotics, Waltham, Massachusetts) for treating peripheral artery disease. BACKGROUND: A robotic-assisted platform for percutaneous coronary intervention is available for treating coronary artery disease. METHODS: In this prospective single-arm trial, patients with symptomatic peripheral artery disease (Rutherford class 2 to 5) affecting the femoropoplital artery were enrolled...
October 10, 2016: JACC. Cardiovascular Interventions
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
M V Mel'nikov, V A Zelinskiĭ
The authors analysed clinical peculiarities of atherosclerosis of peripheral arteries (hereinafter referred to as APA) in patients presenting with abdominal aortic calcification (AAC). In order to determine the incidence rate of AAC in the population of patients with APA we analysed medical records of a total of 1,800 patients. The study itself included a total of 193 patients with APA further subdivided into two groups: 108 patients with AAC (Study Group) and 85 patients without AAC. Beside general clinical examination all patients were subjected to transthoracic echocardiography, duplex scanning of the aorta and lower-limb arteries, extended lipidogram and coagulogram...
2016: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Fay Crawford, Karen Welch, Alina Andras, Francesca M Chappell
BACKGROUND: Peripheral arterial disease (PAD) of the lower limb is common, with prevalence of both symptomatic and asymptomatic disease estimated at 13% in the over 50 age group. Symptomatic PAD affects about 5% of individuals in Western populations between the ages of 55 and 74 years. The most common initial symptom of PAD is muscle pain on exercise that is relieved by rest and is attributed to reduced lower limb blood flow due to atherosclerotic disease (intermittent claudication). The ankle brachial index (ABI) is widely used by a variety of healthcare professionals, including specialist nurses, physicians, surgeons and podiatrists working in primary and secondary care settings, to assess signs and symptoms of PAD...
September 14, 2016: Cochrane Database of Systematic Reviews
Monika Herten, Giovanni B Torsello, Eva Schönefeld, Stefan Stahlhoff
Peripheral arterial disease, particularly critical limb ischemia, is an area with urgent need for optimized therapies because, to date, vascular interventions often have limited life spans. In spite of initial encouraging technical success after femoropopliteal percutaneous transluminal angioplasty or stenting, postprocedural restenosis remains the major problem. The challenging idea behind the drug-coated balloon (DCB) concept is the biological modification of the injury response after balloon dilatation. Antiproliferative drugs administered via DCBs or drug-eluting stents are able to suppress neointimal hyperplasia, the main cause of restenosis...
2016: Vascular Health and Risk Management
Moritz Wildgruber, Maria Czubba, Teresa Aschenbrenner, Heiko Wendorff, Alexander Hapfelmeier, Almut Glinzer, Matthias Schiemann, Alexander Zimmermann, Hans-Henning Eckstein, Hermann Berger, Walter A Wohlgemuth, Reinhard Meier, Peter Libby, Alma Zernecke
BACKGROUND AND AIMS: We aimed at studying the association of three major human monocyte subsets after percutaneous transluminal angioplasty (PTA) in patients with femoropopliteal disease. METHODS: We prospectively studied 67 sequential patients (40 male, 27 female; mean age 71 ± 11 years) treated with femoropopliteal angioplasty. Multi-color flow cytometry characterized monocyte subsets from venous blood for expression of CD14 and CD16 and intracellular myeloperoxidase (MPO) prior to, and 3, 6 and 12 months post PTA...
October 2016: Atherosclerosis
Takashi Maekawa, Kimihiro Komori, Akio Kodama, Hiroshi Banno, Hiroshi Narita, Masayuki Sugimoto
PURPOSE: This study evaluated the early and long-term results of the sole use of endovascular treatment in the treatment of inflow lesions in claudicants with both aortoiliac and femoropopliteal (FP) lesions. METHODS: A retrospective study that included 100 limbs in 73 patients was performed. The patency rates of aortoiliac artery stents, the continued clinical improvement rates, the risk factors for persistent disabling claudication after inflow revascularization, and the rates of freedom from additional FP procedures were examined...
September 1, 2016: Surgery Today
Chris Klonaris, Athanasios Katsargyris, Mikes Doulaptsis, Dimitris Athanasiadis, Theodor Liakakos
Patency of femoropopliteal vein bypass above the knee has been estimated between 69% and 77% at 5 years. This article reports a case of a patent femoropopliteal vein bypass 45 years after implantation without any reintervention. The morphologic alterations observed after 45 years at this vein bypass graft are additionally discussed.
August 2016: Vascular and Endovascular Surgery
Stefan Müller-Hülsbeck
Drug-eluting stents promise to reduce restenosis following endovascular treatment of diseased arteries, but technologies used in peripheral arteries of the leg have not yet achieved desired success rates. Areas covered: The rationale behind the development of the Eluvia(TM) Drug-Eluting Vascular Stent (Boston Scientific, Marlborough, MA) is described and current preclinical and clinical evidence related to use of the stent is reviewed. Expert opinion: Stents remain an important endovascular treatment option for femoropopliteal lesions, especially those that are long, occluded, and calcified...
October 5, 2016: Expert Opinion on Drug Delivery
Konstantinos Stavroulakis, Giovanni Torsello, Ayad Manal, Arne Schwindt, Christiane Hericks, Arne Stachmann, Eva Schönefeld, Theodosios Bisdas
OBJECTIVE: Primary stenting is a well-established treatment option for femoropopliteal arterial disease. However, there is a paucity of data concerning the performance of this modality at ≥5 years. This study evaluated the long-term clinical and radiologic outcomes of primary stent therapy in patients with femoropopliteal arterial disease. METHODS: A prospective data collection and analysis was conducted in patients undergoing primary stent placement in femoropopliteal lesions between September 2006 and September 2007...
August 26, 2016: Journal of Vascular Surgery
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Keisuke Hirano, Yasutaka Yamauchi, Kan Zen, Hiroyoshi Yokoi, Masaaki Uematsu
OBJECTIVE: Although clinical trials demonstrated the superiority of the Zilver (Cook Medical, Bloomington, Ind) paclitaxel-eluting stent (PTX), a recently developed drug-eluting stent (DES), to conventional therapy for femoropopliteal (FP) lesions, the incidence and risk factors of the repetition of reintervention after DES implantation in clinical practice remained unrevealed. METHODS: This was a subanalysis of the ZEPHYR (ZilvEr PTX for tHe Femoral ArterY and Proximal Popliteal ArteRy) study, enrolling FP lesions undergoing endovascular therapy (EVT) with DES implantation...
August 26, 2016: Journal of Vascular Surgery
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