Bifurcated coronary stents for infrapopliteal angioplasty in critical limb ischemia

Abstract

Preliminary data suggest that the Nile Croco bifurcated stent for below-the-knee angioplasty in selected patients with CLI is associated with high rates of technical success, early and midterm patency, and clinical improvement. Limb salvage rates are acceptable for this technically highly challenging anatomy, yet further studies with larger patient populations are necessary to validate these results.

Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease

“…For example, the interest in stent-supported below-the-knee (BTK) angioplasty is on the rise thanks to studies that have investigated the safety and efficacy of both bare metal stents or drug-eluting stents, potential alternatives to standard balloon angioplasty. 21,22 However, long-term patency of these stents is undermined by the constant foreign body reaction, stress on the vessel wall, and stent fractures; furthermore, stents could also hinder subsequent surgical treatment.…”

Abluminal-Coated Drug-Eluting Bifurcation-Dedicated Stent for the Treatment of Tibioperoneal Bifurcation

“…6,11 Therefore, use of coronary bifurcationdedicated devices could be a valuable alternative in this setting. 7,8 In this case, we reported a provisional approach of a BTK bifurcation with Axxess stent implantation in the proximal segment of main branch, using skirt technique, with the overlapping of a drug-eluting stent in distal main branch. Although the Biomatrix Flex stent showed encouraging long-term clinical outcomes for the treatment of focal infrapopliteal lesions, 12 the Axxess stent has never been tested in peripheral vascular disease despite interesting reports on safety and efficacy in the coronary setting.…”

“…To date, different devices dedicated for coronary bifurcation disease are available, and they have been previously tested in small registries or case reports. [6][7][8] The Axxess stent (Biosensors Europe SA, Morges, Switzerland) is a self-expanding Biolimus A9-eluting stent designed to treat the complex anatomy of coronary bifurcation lesions. The stent has an abluminal polymer coating composed of polylactic acid, which is biodegradable into carbon dioxide and water within 6 to 9 months of deployment, and the semisynthetic sirolimus analogue Biolimus A9, which has antiproliferative effects and has been proven superior over the first-generation sirolimus-eluting drug-eluting stent (DES).…”

Durability and Efficacy of Tibial Arterial Stent Placement for Critical Limb Ischemia

“…Tibioperoneal stent placement was performed after post-PTA angiography. Stents used included straight and bifurcated bare metal balloonexpandable stents in short lesions (r 3-4 cm) or lesions at the tibial bifurcations (17), nitinol self-expandable stents in longer lesions (4 3-4 cm), and, in more recent years, drug-eluting stents in patients with a single patent inline vessel to the foot or trophic lesions (18). Stents used included Amazonia Croco (Minvasys, Gennevilliers, France), Xpert (Abbott Vascular, Santa Rosa, California), Nile Croco (Minvasys), Cypher drugeluting stents (Cordis/Johnson and Johnson, Bridgewater, New Jersey), Dexamet dexamethasone-eluting stents (Abbott Vascular), and Chromis Deep (Invatec, Roncadelle, Italy) stents.…”