Clinical outcome of angiosome-oriented infrapopliteal percutaneous transluminal angioplasty for isolated infrapopliteal lesions in patients with critical limb ischemia

Jeon, Eui Yong; Cho, Young Kwon; Yoon, Dae Young; Kim, Dae Jung; Woo, Jeong Joo

doi:10.5152/dir.2015.15129

Cited by 16 publications

(32 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We found that the wound healing rate in this cohort was poor overall, with approximately one in four wounds healing successfully at 6 months. Wound healing rates vary widely in the literature, highlighting a large variation in practice patterns and reporting definitions, but generally reflect a poor ability to heal wounds in patients with tibial disease 6,15–17 . The reasons for this are likely multifactorial; even with appropriate revascularization and a satisfactory hemodynamic result, concomitant issues such as diabetes, renal impairment, and poor nutritional status can limit the success of wound healing.…”

Section: Discussionmentioning

confidence: 99%

Bypass versus endovascular intervention for healing ischemic foot wounds secondary to tibial arterial disease

Mohapatra

Henry

Avgerinos

et al. 2018

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Bypass versus endovascular intervention for healing ischemic foot wounds secondary to tibial arterial disease

Mohapatra

Henry

Avgerinos

et al. 2018

Journal of Vascular Surgery

View full text Add to dashboard Cite

show abstract

“…We identified eight such studies, all of which were retrospective case series or cohort studies and had a high risk of bias. Six studies concluded that direct revascularisation according to the angiosome concept was associated with higher rates of wound healing when compared with indirect revascularisation, 15,[17][18][19][20][21] however only four of these studies reported higher rates of limb salvage.…”

Section: Angiosome-directed Revascularisationmentioning

confidence: 99%

Effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral artery disease: A systematic review

Forsythe

Apelqvist

Boyko

et al. 2020

Diabetes Metabolism Res

View full text Add to dashboard Cite

In patients with diabetes, foot ulceration and peripheral artery disease (PAD), it is often difficult to determine whether, when and how to revascularise the affected lower extremity. The presence of PAD is a major risk factor for non‐healing and yet clinical outcomes of revascularisation are not necessarily related to technical success. The International Working Group of the Diabetic Foot updated systematic review on the effectiveness of revascularisation of the ulcerated foot in patients with diabetes and PAD is comprised of 64 studies describing >13 000 patients. Amongst 60 case series and 4 non‐randomised controlled studies, we summarised clinically relevant outcomes and found them to be broadly similar between patients treated with open vs endovascular therapy. Following endovascular revascularisation, the 1 year and 2 year limb salvage rates were 80% (IQR 78‐82%) and 78% (IQR 75‐83%), whereas open therapy was associated with rates of 85% (IQR 80‐90%) at 1 year and 87% (IQR 85‐88%) at 2 years, however these results were based on a varying combination of studies and cannot therefore be interpreted as cumulative. Overall, wound healing was achieved in a median of 60% of patients (IQR 50‐69%) at 1 year in those treated by endovascular or surgical therapy, and the major amputation rate of endovascular vs open therapy was 2% vs 5% at 30 days, 10% vs 9% at 1 year and 13% vs 9% at 2 years. For both strategies, overall mortality was found to be high, with 2% (1‐6%) perioperative (or 30 day) mortality, rising sharply to 13% (9‐23%) at 1 year, 29% (19‐48%) at 2 years and 47% (39‐71%) at 5 years. Both the angiosome concept (revascularisation directly to the area of tissue loss via its main feeding artery) or indirect revascularisation through collaterals, appear to be equally effective strategies for restoring perfusion. Overall, the available data do not allow us to recommend one method of revascularisation over the other and more studies are required to determine the best revascularisation approach in diabetic foot ulceration.

show abstract

“…There have been five studies thus far comparing angiosome-guided endovascular revascularization in diabetic patients 5,6,24,40,41) and these have showed that the direct angiosome strategy has a better outcome with regard to wound healing and amputation free survival. 42) However, Jongsma s review highlighted that collaterals strongly influence wound healing and major amputation rates, and that indirect angiosome revascularization with an intact pedal arch or distal peroneal branch to the angiosome artery may achieve the same outcome after direct angiosome revascularization.…”

Section: Influence Of Collateral Circulation On the Angiosome Conceptmentioning

confidence: 99%

Angiosome～From the Standpoint of Bypass Surgery

Deguchi

2020

Annals of Vascular Diseases

View full text Add to dashboard Cite

Although several studies showed that angiosome-guided endovascular treatment improved wound healing and major amputation rates in patients with chronic limbthreatening ischemia (CLTI), effectiveness of the angiosome concept to the treatment of ischemic foot remains to be elucidated, especially in bypass surgery. Arterial anatomy of the foot and ankle shows that there are multiple supplementary circulation including arterial-arterial connections and choke nexus, which indicates angiosome concept may carry limited importance in bypass surgery for CLTI. On the other hand, patients with diabetes or renal dysfunction have partial occlusion of arterial-arterial connections and, therefore, quite a few patients with CLTI in Japan may present with limited but impaired supplementary circulation around the ankle. This article reviews the arterial anatomy and circulation of the foot and ankle and discusses availability and limitations of angiosome-guided bypass surgery.

show abstract

Clinical outcome of angiosome-oriented infrapopliteal percutaneous transluminal angioplasty for isolated infrapopliteal lesions in patients with critical limb ischemia

Cited by 16 publications

References 22 publications

Bypass versus endovascular intervention for healing ischemic foot wounds secondary to tibial arterial disease

Bypass versus endovascular intervention for healing ischemic foot wounds secondary to tibial arterial disease

Effectiveness of revascularisation of the ulcerated foot in patients with diabetes and peripheral artery disease: A systematic review

Angiosome～From the Standpoint of Bypass Surgery

Contact Info

Product

Resources

About