Remote Endarterectomy and Lamina Vastoadductoria Dissection Improves Superficial Femoral Artery Biomechanical Behavior during Limb Flexion

Rabtsun, Artem; Карпенко, А. А.; Zoloev, D G; Ignatenko, Pavel; Lejay, Anne; Chakfé, Nabil

doi:10.1016/j.avsg.2017.12.007

Cited by 12 publications

(6 citation statements)

References 20 publications

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“…The methods consist of the dissection the by Gunter’s canal fascia and crossing two pairs of arteries that bend around the knee joint. The safety of this procedure was confirmed by our pilot study [4].…”

Section: Introductionmentioning

confidence: 72%

One-year results of long femoropopliteal lesions stenting with fasciotomy lamina vastoadductoria

Чебан

Osipova

Ignatenko

et al. 2022

Preprint

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ObjectiveFasciotomy can increase the mobility of the superficial femoral artery and reduce the incidence of stent breakage. This study aimed to compare the long-term patency of drug-eluting nitinol stents with and without fasciotomy in patients with prolonged SFA occlusions.MethodsA randomized clinical trial was conducted in 60 (1:1) patients with long femoropopliteal steno-occlusive lesions more than 200 mm. Patients in group 1 (Zilver) underwent recanalization of occlusion of the femoropopliteal artery with stenting. In group 2 (ZilverFas), recanalization of the femoropopliteal occlusion with stenting and fasciotomy of Gunter’s canal were performed. The follow up evaluation of patency at 6, 12 months.Results12-month primary patency in Zilver and ZilverFas groups was 51% and 80%, respectively (p = 0.02). The freedom from target revascularization (TLR) in Zilver and ZilverFas groups was 50% and 76%, respectively (p = 0.04). At one-years, primary-assisted and secondary patency for the ZilverFas and Zilver groups were 83% versus 62% (p = 0.07), 86% versus 65% (p = 0.05), respectively. In groups Zilver and ZilverFas, the number of stents fracture was 14 and 7, respectively (p = 0.05). The Cox multivariables regression indicated that the stent fracture, diabetes mellitus were the independent predictor of restenosis and reocclusion. Fasciotomy reduced the chance of reocclusion and restenosis by 2.94 times.ConclusionsOur study has shown that a decompressing the stented segment with fasciotomy significantly improves the patency of the femoropopliteal segment and significantly reduces the number and severity of stents fractures.

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Section: Introductionmentioning

confidence: 72%

One-year results of long femoropopliteal lesions stenting with fasciotomy lamina vastoadductoria

Чебан

Osipova

Ignatenko

et al. 2022

Preprint

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“…6, 21 To a certain extent, this is due to the unique features of SFA biomechanics, which are not found in other vessels. 23 This study aimed to determine the effect of the new technique on the results of stenting of SFA extended lesions (TASC-II D) with the use of self-expanding nitinol bare-metal stents. Our results on primary patency within the 2-year follow-up in patients with fascia dissection was 60%, which is comparable and higher than what is observed in retrospective studies such as DURABILITY-200 (Physician Initiated Trial Investigating the Efficacy of the Implant of EverFlex 200mm Long Nitinol Stents in TASC C&D Femoropopliteal Lesions) (64.8%), STELLA (Long Superficial Femoral Artery Stenting With SuperA Interwoven Nitinol Stents) (66%), SUPERStudy (Randomised Trial of the SMART Stent versus Balloon Angioplasty in Long Superficial Femoral Artery Lesions) (45.9%).…”

Section: Discussionmentioning

confidence: 99%

Influence of Lamina Vastoadductoria Dissection on the Outcomes of Femoral Artery Extensive Lesion Stenting: A Pilot Randomised Investigation

Karpenko

Rabtsun

Popova

et al. 2022

Preprint

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Objective: Aim of the study was to improve the immediate and long-term results of stenting of the superficial femoral artery in extended lesions with the changing of the biomechanics of SFA and of the first portion of the popliteal artery. Methods: Pilot randomized prospective single-center study were included 70 patients. Patients were randomized into two groups in 1x1 format for 35 people using the envelope method. Self-expanding bare metal stents were used in all cases. At the first group standard revascularization procedures with SFA stenting were performed; in the second group, the superficial femoral artery stenting was supplemented with fasciotomy in the Hunter canal with the superficial femoral artery intersection. The total observation period was 2 years. During the observation period an assessment of the clinical symptoms of the lower extremities, measurement of the ankle-brachial index and ultrasound duplex scanning of the operated segment were performed. Results: All procedures in both groups were successfully performed. Primary patency through 24 months was 28.5% (10 of 35) in group 1 and 60% (21 of 35) in group 2 (p=0,015). Conclusions: Changing the biomechanical properties of the distal of the superficial femoral artery segment and of the first portion of the popliteal artery is safe and contributes to the primary patency improvement during the stenting of extended of the superficial femoral artery lesions compared to standard SFA stenting. Dissection of the lamina vastoadductoria with transection of the collateral branches of the knee joint network reduces frequent and severe damages of stents after the stenting of the superficial femoral artery extended lesion. According to the frequency of complications in the early and mid-term postoperative period, limb salvage, mortality and the secondary patency rates, the new method is comparable with standard of the superficial femoral artery stenting.

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Section: Discussionmentioning

confidence: 99%

Influence of lamina vastoadductoria dissection on the outcomes of femoral artery extensive lesion stenting: A pilot randomised investigation

Karpenko

Rabtsun

Popova

et al. 2022

Journal of Biomechanics

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Remote Endarterectomy and Lamina Vastoadductoria Dissection Improves Superficial Femoral Artery Biomechanical Behavior during Limb Flexion

Cited by 12 publications

References 20 publications

One-year results of long femoropopliteal lesions stenting with fasciotomy lamina vastoadductoria

One-year results of long femoropopliteal lesions stenting with fasciotomy lamina vastoadductoria

Influence of Lamina Vastoadductoria Dissection on the Outcomes of Femoral Artery Extensive Lesion Stenting: A Pilot Randomised Investigation

Influence of lamina vastoadductoria dissection on the outcomes of femoral artery extensive lesion stenting: A pilot randomised investigation

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