Angiographic patency and clinical outcome after balloon‐angioplasty for extensive infrapopliteal arterial disease

Abstract

Restenosis-rate after angioplasty of extensive infrapopliteal arterial disease is high and occurs early after treatment. Despite this the clinical results are excellent, especially given the length of the arterial segments diseased.

Endovascular treatment of infrapopliteal arteries: angioplasty vs stent in the drug-eluting era

“…Angiographic results showed the DEB group with a primary patency of 72.6 % at 3 months versus 31 % in the PTA group and a target lesion revascularisation of 17.3 % at 1 year versus 50 % for the PTA group. The limb salvage rate was 95.6 % in the DEB group versus 100 % in the PTA group, and the complete wound healing rate was 74.2 % in DEB group versus 78.6 % in the historical group [19]. Besides the large population, this registry has some limitations: non-randomised; poor homogeneity between the two cohorts; clinical results during the follow-up not significantly different between DEB and PTA.…”

The concept of surgical treatment of critical limb ischemia

“…При оценке отдаленных результатов (до 5 лет) было по-казано, что проходимость аутовены почти в два раза вы-ше, чем при использовании протеза (75% против 42% со-ответственно) [49]. С учетом этих данных при выполне-нии реконструкции рекомендуется использовать аутове-нозный шунт из большой подкожной вены [2], однако описаны результаты эффективного применения трупных аллотрансплантатов в этой позиции [26,39].…”

Does Patency Matter in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization?

“…Restenosis was observed in more than two thirds of patients within 3 months after angioplasty of tibial arteries. 7,8,12) Despite the high incidence of tibial restenosis after angioplasty, endovascular revascularization has been established as a first line treatment strategy for most CLI patients. 3,4) Recent studies indicate, however, that the need for TLR may be as high as 48% within 12 months in this challenging patient subgroup.…”

“…To date, however, data on DEB for tibial revascularization are sparse. Current information on DEB technology for tibial revascularization are based on one series by Schmidt et al comparing DEB 26) with an historical comparison of POBA from a comparable study setting 12) and one single-center randomization (DEB versus POBA) performed by Liistro and colleagues. 8) Schmidt, et al were the first to publish first-experience data using DEB for tibial revascularization within a non-randomized single center trial.…”

“…In comparison to the results from an earlier study at the same center using POBA for tibial revascularization, DEB was shown to reduce tibial restenosis in >60% (27.4% versus 68.8% ). 12,26) The first prospective and randomized comparison of DEB versus POBA for tibial revascularization was performed by Liistro, et al within the aforementioned DEBATE-BTK trial. 8) Thereby, a significant reduction in binary restenosis was observed after 12 months 27% versus 74% when comparing DES (n = 67) and POBA (n = 65).…”