Endovascular intervention for tibial artery occlusive disease in patients with critical limb ischemia

Тhe Place of Endovascular Surgical Interventions in Patients With Critical Ischemia of the Lower Extremities

“…Слід відмітити, що технічне удосконалення ендоваскулярних операцій та відповідного інструментарію дозволило розширити показання до їх виконання, особливо при протяжному атеросклеротичному ураженні, а в деяких аспектах, вазобалонна ангіопластика стоїть поза конкуренції, коли питання стосується відновлення прохідності артерій дистального сегмента кінцівки при хронічній критичній ішемії нижніх кінцівок [3,4,6,7].…”

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

“…Critical limb ischemia (CLI) carries a high risk of amputation 1 . In patients with tissue loss secondary to peripheral arterial disease (PAD), prompt revascularization is necessary to maximize the chances of wound healing and limb salvage 2,3 . Historically, open surgical bypass has been the standard of care for lower extremity revascularization.…”

“…Historically, open surgical bypass has been the standard of care for lower extremity revascularization. However, endovascular therapies have evolved considerably and are becoming first line therapies in many situations with good clinical outcomes in patients with CLI 3–5 . Patients with infrapopliteal arterial disease are more likely to have coronary artery disease.…”

Prior Endovascular Intervention Is Not Detrimental to Pedal Bypasses for Ischemic Wounds

“…This is particularly challenging for CLI with tibial vessel involvement as both surgical and endovascular therapies are associated with poorer limb prognosis compared to more proximal disease [3]. The immediate goal of treatment in patients with CLI is wound healing and limb salvage, which historically has been accomplished through surgical bypass [4].…”