Short-term results of femoropopliteal subintimal angioplasty

McCarthy, Robert J.; Neary, W.D.; Roobottom, Carl; Tottle, A.; Ashley, S.

doi:10.1046/j.1365-2168.2000.01633.x

Cited by 82 publications

(56 citation statements)

References 11 publications

(13 reference statements)

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“…7,8 We have confirmed that SA is simple in the presence of a good starting stump, the absence of a heavily calcified occlusion and at least one patent distal run-off vessel. SA offers many advantages compared to conventional bypass surgery.…”

Section: Discussionsupporting

confidence: 55%

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Subintimal Angioplasty: Feasible and Durable

DESGRANGES¹,

BOUFI²,

LAPEYRE³

et al. 2004

European Journal of Vascular and Endovascular Surgery

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Objective. To assess prospectively the feasibility and durability of subintimal angioplasty (SA) clinically and by duplex scans every 3 months. Patients and methods. Within a period of 54 months, we selected 96 patients with 100 occlusions (mean length: 11.5 cm) of femoro-popliteal or tibial arteries, for SA. Results. The technical success rate was 88% and seven out of 12 failures were treated by conventional surgery. Five belowthe-knee amputations were performed despite a patent recanalization. The following complications occurred: arterial perforation (6), arterial thrombosis (4), extensions beyond the planned re-entry site (5), and arterial dissection (2). Primary, assisted-primary and secondary patency rates were 61, 68 and 74%, respectively at 24 months. The 24 month-limb salvage and survival rates were 78 and 85%, respectively. Duplex imaging demonstrated 10 restenosis (five symptomatic . 70%, five asymptomatic 30 -70%), seven occlusions (five asymptomatic, two symptomatic treated by a bypass) and one asymptomatic dilatation. Conclusion. In a selected group of patients SA is feasible with a high initial technical success rate. SA is a good alternative in patients who are poor candidates for bypass surgery.

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Section: Discussionsupporting

confidence: 55%

“…In addition, SA provides much less wound complications than observed after removal of the great saphenous vein. With few exceptions (McCarthy et al, 7 ), other investigators have found SA to be durable. However, none of the reported series have carried out complete surveillance to evaluate the long-term patency of the procedures.…”

Section: Discussionmentioning

confidence: 99%

Subintimal Angioplasty: Feasible and Durable

DESGRANGES¹,

BOUFI²,

LAPEYRE³

et al. 2004

European Journal of Vascular and Endovascular Surgery

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“…Reported cumulative patency rates vary from 58% to 51% at 6-12 months. 3,4 Patient populations within these studies were very different with critical limb ischaemia representing 11-62% of the study groups. The purpose of this study was to describe our own short-and long-term results of subintimal angioplasty for superficial femoral artery (SFA) disease.…”

mentioning

confidence: 99%

Subintimal angioplasty for superficial femoral artery occlusion: poor patency in critical ischaemia

Smith

Stechman²,

Gibson³

et al. 2005

Ann R Coll Surg Engl

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INTRODUCTION Subintimal angioplasty has been proposed for the treatment of long segment occlusive disease and for patients with critical limb ischaemia (CLI) with significant co-morbidity. There is no consensus as to short-and long-term patency. We present our experience with this technique.METHODS Between 1995 and 2000, 43 consecutive patients (48 limbs) underwent subintimal angioplasty for superficial femoral artery occlusions. Outcome measures were haemodynamic and/or symptomatic patency. RESULTS Technical success was achieved in 14/17 limbs with CLI (82%) and 30/31 (97%) with intermittent claudication (IC). There were 7 complications (15%), 6 occurring in the claudicant group. The median occlusion length was 10 cm for CLI and 6 cm for IC. Patency at 12 and 36 months, on an intention-to-treat basis, was 69% and 58% for claudicants and 25% and 25% for patients with CLI (P = 0.0005 and P = 0.0044, respectively). Following only technically successful procedures, 12-month patency was 72% (IC) and 31% (CLI) (P = 0.009). Patients with occlusions ≥ 10 cm were more likely to re-occlude than those < 10 cm (12-month patency 60% versus 25%; P = 0.037).CONCLUSIONS In this series, short-and long-term patency in patients with CLI is poor. Subintimal angioplasty in the treatment of CLI should be reserved for those patients not fit for surgical bypass.

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“…Subintiminė arterijų angioplastika (SA) -tai nuo aterosklerozės užakusių arterijų endovaskulinis gydymo metodas, kai, naudojant specialias priemones, be operacinio pjūvio, atkuriama kraujotaka suformuojant subintiminį spindį šalia užakusio arterijos segmento (8). SA atliekama vietinės anestezijos sąly-gomis, o tai labai svarbu seniems žmonėms, kurie serga keletu ligų vienu metu.…”

Section: įVadasunclassified

“…Tą patvirtina P. K. Min teigdamas, kad, implantavus stentą, pagerinamas arterinio kraujo tekėjimas subintiminiu spindžiu, kartu pagerėja ir vėlyvieji rezultatai . Komplikacijų dažnis (8,8 proc.) panašus į kitų autorių pateiktus duomenis: T. Florenes -6,7 proc., A. Mousa -9 proc., B. M. Smith -15 proc.…”

Section: Paviršinės šLaunies Arterijos Užakimas Kai Užakusiunclassified

Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital

Aleksynas¹,

Kaupas

2006

Medicina

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Kardiologijos instituto Invazinės kardiologijos laboratorija ĮvadasĮvairaus laipsnio periferinė arterijų liga JAV žmo-nėms vyresniems kaip 70 metų diagnozuojama 10 procentų atvejų, o tai sudaro apie 10 milijonų žmonių grupę (1). Dažniausiai periferinė arterijų liga pasireiškia protarpiniu raišavimu. Žmonių, kuriems atsirado protarpinis šlubavimas, 5, 10 ir 15 metų mirtingumas sudaro atitinkamai -30, 50 ir 70 procentų (2). Mirties priežastis yra širdies ir vainikinių arterijų nepakankamumas, kurį didina rūkymas, cukrinis diabetas ir lėtinės dializės. Žmonių, sergančių kritine kojų išemija (ramybės skausmai arba negyjančios žaizdos), penkerių metų mirtingumas -70 procentų, o 10 metų mirtingumas padidėja iki 85 procentų (3). Pacientų po chirurginės kojos išemijos operacijos penkerių metų išgyvenamumas siekia nuo 50 iki 60 procentų (4, 5). Apie 80 procentų ligonių, sergančių periferine arterijų liga, miršta nuo kraujagyslių patologijos. Iš jų apie 60 procentų miršta nuo išeminės širdies ligos, 10 procentų -nuo insulto (6). Populiacijos grupėje nuo 40 iki 60 metų vien protarpinis raišavimas nustatomas 2 proc. žmonių, o vyresnių kaip 70 metų grupėje nustatoma jau 6 proc. Populiacijai senstant, 2040 metais žmonių, sergančių periferine arterijų liga, skaičius padidės iki 22 procentų (7). Atsižvelgiant į JAV tyrėjų pateiktus duomenis, galima teigti, jog Lietuvoje situacija yra panaši.Subintiminė arterijų angioplastika (SA) -tai nuo aterosklerozės užakusių arterijų endovaskulinis gydymo metodas, kai, naudojant specialias priemones, * The full-length article in English can be found at

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Short-term results of femoropopliteal subintimal angioplasty

Abstract: In this series the short-term clinical success of subintimal angioplasty was poor because of a high incidence of reocclusion and restenosis, despite a relatively high initial technical success rate.

Cited by 82 publications

References 11 publications

Subintimal Angioplasty: Feasible and Durable

Subintimal Angioplasty: Feasible and Durable

Subintimal angioplasty for superficial femoral artery occlusion: poor patency in critical ischaemia

Subintimal angioplasty for superficial femoral artery occlusions: first experience in Kaunas University of Medicine Hospital

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