Efficacy of Cutting Balloon Angioplasty for Chronic Total Occlusion of Femoropopliteal Arteries

Shimada, Yoshihisa; Kino, Naoto; Tonomura, Daisuke; Yamanaka, Yuki; Nishiura, Satoshi; Yano, Kentarô; Ito, Kenichi; Yoshida, Masahiro; Tsuchida, Takao; Fukumoto, Hitoshi

doi:10.1016/j.avsg.2018.10.056

Cited by 7 publications

(9 citation statements)

References 34 publications

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“…With the development of economy and the gradual westernization of lifestyle, the incidence of diabetes continues to rise [ 11 ]. DM foot is one of the most common complications of diabetes [ 12 ]. Studies have shown that 15 out of every 100 diabetic patients will suffer from DM foot.…”

Section: Discussionmentioning

confidence: 99%

Intelligent Algorithm-Based Analysis on Ultrasound Image Characteristics of Patients with Lower Extremity Arteriosclerosis Occlusion and Its Correlation with Diabetic Mellitus Foot

Shen²,

Sun³

2021

Journal of Healthcare Engineering

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Objective. The study focused on the correlation between lower extremity arteriosclerosis and diabetic mellitus (DM) foot, and it was explored by virtue of ultrasound images processed by an intelligent algorithm. Methods. A total of 60 DM foot patients admitted to our hospital in the past three years were selected and divided into two groups according to their condition. Patients with DM foot alone were in group B (30 cases), and patients with DM foot combined with lower extremity arteriosclerosis occlusion were in group C (30 cases). 30 healthy people were in group A as a control. Color Doppler ultrasound was used to examine the arteries of the lower extremities of all subjects. It the intramedia thickness (IMT) from the femoral artery to the dorsal foot artery was recorded, whether there was plaque in the artery or knowing the size of the plaque, its echo, and distribution, and whether the artery had stenosis. Next, the stenosis percentage was calculated. Additionally, the general information of patients was analyzed. At the same time, an intelligent algorithm was used to process ultrasound images, and its effects on image quality were evaluated. Results. Doppler ultrasound images processed by Artificial Bee Colony (ABC) had less noise and better quality, and key information about the lesion was clearly displayed. There was no statistical difference between the general data of the three groups of patients; group B and group C had higher IMT value, plaque incidence, arterial stenosis incidence, and degree of stenosis versus group A, and there were statistically significant differences between groups B and C. In particular, the incidence of femoral artery stenosis and the degree of stenosis were significantly higher in group C than in group B. The rate of stenosis above grade I in group C was as high as 71%, while that in group B was only 19%; in Group C, the incidence of stenosis above grade II was 30%, and that in group B was 13.1%. Compared with group A, group B and group C had decreased peak arterial blood velocity (PSV), resistance index (RI), and pulse index (PI), and there were statistically significant differences between groups B and C. Conclusion. DM foot is a risk factor for arteriosclerosis occlusion; color Doppler ultrasound demonstrates good diagnostic effects on arteriosclerosis occlusion; the algorithm proposed in this study can improve the quality of Doppler ultrasound images and has a high application value.

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Section: Discussionmentioning

confidence: 99%

Intelligent Algorithm-Based Analysis on Ultrasound Image Characteristics of Patients with Lower Extremity Arteriosclerosis Occlusion and Its Correlation with Diabetic Mellitus Foot

Shen²,

Sun³

2021

Journal of Healthcare Engineering

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“…The diameter of the cutting/scoring balloon was selected to a balloon‐to‐reference vessel diameter ratio of approximately 1.0–1.1. Dilatation of the cutting/scoring balloon was performed using an incremental method as previously described 12 . Then, DCB was applied using SeQuent® Please (B. Braun Melsungen AG).…”

Section: Methodsmentioning

confidence: 99%

“…Dilatation of the cutting/ scoring balloon was performed using an incremental method as previously described. 12 Then, DCB was applied using SeQuent ® Please (B. Braun Melsungen AG). The inflation time of DCB was at least 1 min.…”

Section: Methodsmentioning

confidence: 99%

Laser vaporization of atherothrombotic burden before drug‐coated balloon application in ST‐segment elevation myocardial infarction: Two‐year outcomes of the laser‐DCB trial

Tonomura

Shimada

Yamanaka

et al. 2022

Cathet Cardio Intervent

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Objectives This study aimed to examine whether the combination of excimer laser coronary atherectomy (ELCA) and drug‐coated balloon (DCB) angioplasty can provide feasible clinical outcome in patients with ST‐segment elevation myocardial infarction (STEMI) with 8‐month and 2‐year scheduled follow‐up angiography. Background Intracoronary thrombus elevates the risk of interventional treatment in patients with STEMI and hampers drug absorption into the vasculature released from DCB. Methods Sixty‐two patients with STEMI within 24 h after the onset of symptoms were enrolled in this prospective, single‐center, single‐arm study. Results The laser catheter was successfully crossed distal to the culprit lesion in all cases. No ELCA‐related adverse events occurred. Bail‐out stenting was required in two patients (3.2%) after adjunctive ballooning; thus, the remaining 60 patients were completed with DCB angioplasty without stenting. Scheduled angiography at 8 months and 2 years was completed in 100% and 85.2%, respectively, and minimal lumen diameters were 3.4 ± 0.5, 3.4 ± 0.6, and 3.4 ± 0.5 mm after the procedure, at 8 months and at 2 years, respectively. Binary restenosis was observed in five patients (8.1%) in whom target lesion revascularization was performed. The duration of dual antiplatelet therapy was 2.3 ± 2.2 months, and neither abrupt vessel closure, reinfarction, cardiac death nor major bleeding was observed. Conclusion A combination of DCB angioplasty with ELCA is a feasible therapeutic option for STEMI.

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“…Cutting balloons were first used in coronary stenosis, but their indication has been extended to include infrainguinal steno-occlusive disease ( 6 ), resistant renal artery stenosis in pediatrics ( 7 ), and arteriovenous fistulae ( 8 ). Their use is limited in resistant fibrotic stenosis, and is mainly observed in vascular access for hemodialysis.…”

Section: Prevention Of Dissection and Recoilmentioning

confidence: 99%

Vessel Preparation Is Essential to Optimize Endovascular Therapy of Infrainguinal Lesions

Saucy

Probst

Trunfio

2020

Front. Cardiovasc. Med.

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Symptomatic peripheral arterial disease management involves medical treatment and interventional procedures. Intermittent claudication and critical limb threatened ischemia (CLTI) should be individually considered with specific outcomes and procedures. When intervention is required, an endovascular approach is usually the first-line option. Plain balloon angioplasty was previously used to dilate clinically significant femoropopliteal lesions with variable results. However, over recent years, the use of self-expanding nitinol stents has enabled treatment of long lesions, yielding significantly improved clinical results. Drug-eluting technology has also exhibited a capacity to limit in-stent restenosis and to drive target revascularization. Nevertheless, calcifications and elastic recoil of the arterial wall remain risk factors for early restenosis and failure. Therefore, vessel preparation using specific devices is required to modify vessel compliance and debulk obstructive calcification. In this short review, we provide an overview of the options for gaining lumen before stenting or dilation using drug-coated balloons.

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Efficacy of Cutting Balloon Angioplasty for Chronic Total Occlusion of Femoropopliteal Arteries

Cited by 7 publications

References 34 publications

Intelligent Algorithm-Based Analysis on Ultrasound Image Characteristics of Patients with Lower Extremity Arteriosclerosis Occlusion and Its Correlation with Diabetic Mellitus Foot

Intelligent Algorithm-Based Analysis on Ultrasound Image Characteristics of Patients with Lower Extremity Arteriosclerosis Occlusion and Its Correlation with Diabetic Mellitus Foot

Laser vaporization of atherothrombotic burden before drug‐coated balloon application in ST‐segment elevation myocardial infarction: Two‐year outcomes of the laser‐DCB trial

Vessel Preparation Is Essential to Optimize Endovascular Therapy of Infrainguinal Lesions

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