Mid-term results with laser atherectomy in the treatment of infrainguinal occlusive disease

Stoner, Michael C.; deFreitas, Dorian J.; Phade, Sachin V.; Parker, Frank M.; Bogey, William M.; Powell, Steve

doi:10.1016/j.jvs.2007.04.019

Cited by 49 publications

(35 citation statements)

References 31 publications

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“…In this regard, a reduction of target lesion revascularization has been reported with the use of drug-eluting stents 36-38 or laser atherectomy. 39 …”

Section: Study Limitationsmentioning

confidence: 99%

Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

Kobayashi

Hirano

Nakano

et al. 2014

Circ J

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“…In this regard, a reduction of target lesion revascularization has been reported with the use of drug-eluting stents 36-38 or laser atherectomy. 39 …”

Section: Study Limitationsmentioning

confidence: 99%

Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

Kobayashi

Hirano

Nakano

et al. 2014

Circ J

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“…48 Furthermore, Stoner et al reported an overall 12-month patency rate of 44% in treating 47 FP and infrapopliteal lesions with the laser. 49 Finally, in the CELLO (Clirpath Excimer Laser System to Enlarge Lumen Openings) trial, 65 FP de novo lesions were treated with excimer laser. Patency rates were 59 and 54% at 6 and 12 months, respectively.…”

Section: Biological Factorsmentioning

confidence: 99%

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

Shammas¹

2013

Int J Angiol

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ReviewPeripheral arterial disease is highly prevalent in the general population affecting 12 to 14% of people and leading to claudication or threatened limb ischemia. 1 Endovascular lower extremity arterial interventions have increased exponentially over the past decade. 2 The femoropopliteal (FP) segment represents 40% of vessels treated and its treatment continues to be a challenge to the endovascular specialist. Despite a high rate of acute procedural success, target lesion revascularization (TLR) and target vessel revascularization remain elevated. 3,4 We have previously proposed a triad of optimal peripheral vascular revascularization strategy (►Fig. 1) 5 with an emphasis on three key principles: (1) Mechanical, improve vessel compliance to allow dilatation of a stenotic segment at low balloon inflation pressure and reduce dissection and recoil. Low balloon inflation pressure would theoretically preserve vessel integrity by minimizing barotrauma and bailout stenting. (2) Biological, inhibit smooth muscle cell (SMC) proliferation to improve patency rates and reduce repeat revascularization. (3) Procedural, preserve the outflow vessels by minimizing distal embolization (DE) and reduce procedural time and radiation exposure to both operator and patient.In this overview, we examine these principles to determine whether current data support their validity. We recognize the lack of uniform performance criteria and reporting standards in clinical trials in peripheral arterial disease. This unfortunately makes comparisons across studies difficult. Mechanical FactorsThe concept of improving vessel compliance as a prerequisite to a more definitive treatment of the FP artery has gained more attention over the past few years. Measurement of vessel compliance in vivo is difficult to obtain. One surrogate endpoint is the minimum balloon pressure (MBP) needed to fully stretch the artery to a lumen diameter equal to a normal reference segment with the use of a noncompliant balloon sized 1:1 to the reference vessel. The balloon is typically inflated to two atmospheres then the inflation pressure is increased by increment of one atmosphere at a time until full balloon expansion is achieved. 6,7 According to Laplace's law, tension (T) in the vessel wall is equal to (pressure (P) gradient across the arterial wall * radius (R) of artery)/wall thickening (M), or (T¼ [P * R]/M). In order for MBP change to reflect on compliance, the segments under comparison need to have similar radius and lesion Keywords AbstractTreatment of the femoropopliteal (FP) artery remains a challenge to the endovascular specialist. Long-term patency is low with a high rate of target lesion revascularization. The true patency rate varies considerably between studies partly because there is a lack of uniform performance criteria and reporting standards in peripheral arterial interventions. Literature review supports three principles that emerge as important components of an optimal strategy in treating the FP artery: (1) improving vessel compliance and sub...

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“…However, they also offer clinicians the potential to revascularize limbs of patients who are not optimal candidates for open bypass. Several novel endovascular therapies have garnered considerable attention, 3,4 but they also have not yet withstood the rigors of objective randomized clinical trials.…”

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confidence: 99%

Midterm outcome predictors for lower extremity atherectomy procedures

Sarac

Altinel

Bannazadeh

et al. 2008

Journal of Vascular Surgery

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Mid-term results with laser atherectomy in the treatment of infrainguinal occlusive disease

Cited by 49 publications

References 31 publications

Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

Wound Healing and Wound Location in Critical Limb Ischemia Following Endovascular Treatment

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

Midterm outcome predictors for lower extremity atherectomy procedures

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