Subintimal angioplasty and stenting in chronic total femoropopliteal artery occlusions: Early- and mid-term outcomes

Tatlı, Ersan; Buturak, Ali; Kayapınar, Osman; Doğan, Emir; Alkan, Mustafa; Gündüz, Yasemin

doi:10.5603/cj.a2014.0043

Cited by 9 publications

(4 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Failure of successful CTO intervention may be due to failure to cross the CTO proximal cap or the inability to reenter the true lumen after subintimal tracking. Subintimal angioplasty and stenting is a safe and effective therapy for chronic total occlusion revascularization with favorable patency at mid-term and a longterm patency that is comparable with secondary patency of autologous vein bypass [117][118][119]. In patients with CLI, retrograde pedal access after a failed antegrade recanalization attempt appears to be a safe, feasible and promising technique for limb salvage in high-risk patients who are not surgical candidates [120,121].…”

Section: Chronic Total Occlusionsmentioning

confidence: 96%

Endovascular therapy for critical limb ischemia

Domínguez

Bahadorani

Reeves

et al. 2015

Expert Review of Cardiovascular Therapy

View full text Add to dashboard Cite

Critical limb ischemia (CLI) represents an advanced disease state of peripheral arterial disease. It manifests as lower extremity ischemic rest pain or ischemic skin lesions leading to ulceration or gangrene. Patients with CLI often have multiple medical comorbidities and a 1-year mortality rate of 25% and a 1-year amputation rate of 25%. Historically, bypass surgery with autogenous veins for flow restoration has been the first-line therapy for CLI. However, advances in endovascular techniques and device technology have changed the treatment paradigm. Catheter-based technologies are rapidly evolving at a rate that is outpacing large-scale studies evaluating relevant clinical outcomes. Patients with CLI require a multidisciplinary management approach centered on aggressive medical therapies, wound care and prompt revascularization, with an emphasis on limb salvage. This review summarizes the contemporary endovascular therapies including balloon angioplasty, atherectomy and bare-metal stenting. In addition, we review emerging technologies, such as drug-eluting stents, drug-coated balloons and chronic total occlusion recanalization devices.

show abstract

Section: Chronic Total Occlusionsmentioning

confidence: 96%

Endovascular therapy for critical limb ischemia

Domínguez

Bahadorani

Reeves

et al. 2015

Expert Review of Cardiovascular Therapy

View full text Add to dashboard Cite

show abstract

“…However, as operators accumulated experience and adopted retrograde approaches from distal arteries and using re-entry devices, the technical success rate gradually improved ( Tables 1 and 2 ). 6) 7) 8) 9) 10) 11) 12) 13) 14) 15) 16) 17) 18) 19) 20) 21) 22) 23) 24) …”

Section: Technical Successmentioning

confidence: 99%

SFA Intervention: Intraluminal or Subintimal?

2018

Korean Circ J

View full text Add to dashboard Cite

Subintimal angioplasty (SA) is an endovascular technique to recanalize an occluded arterial segment through an extraluminal channel between the intima and media. Since its introduction in 1989, the technical success rate has improved with the accumulation of procedural experience and the development of retrograde approaches and re-entry devices. To date, no randomized trial has compared SA with intraluminal angioplasty (IA) for chronic total occlusion (CTO) of the superficial femoral artery (SFA). Based on limited data from several registry studies, SA appears to achieve a higher technical success rate than IA, whereas mid-term primary patency rates are comparable for both endovascular wiring strategies for SFA CTO. Additional clinical data are needed to confirm that SA is as effective as IA. The optimal stenting strategy and role of drug-eluting technologies also need to be defined to improve SA outcomes.

show abstract

“…It has been used as an effective recanalization method for crossing peripheral artery CTOs. 4 Passage of a guidewire or crossing device into the subintimal space can also be unintentional and requires bail-out techniques to re-enter the distal target vessel true lumen to successfully complete the procedure.…”

Section: Introductionmentioning

confidence: 99%

Comparative assessment of patient outcomes with intraluminal or subintimal crossing of infrainguinal peripheral artery chronic total occlusions

Kondapalli

Jeon–Slaughter

et al. 2017

Vasc Med

View full text Add to dashboard Cite

This study compares procedural complications and clinical outcomes between subintimal crossing versus intraluminal crossing during endovascular treatment of infrainguinal peripheral artery chronic total occlusions (CTO). We identified 1335 CTO interventions in 1001 patients from the multicenter Excellence in Peripheral Artery Disease (XLPAD) registry from January 2005 to October 2015. Outcomes included 30-day and 12-month all-cause death, non-fatal myocardial infarction or stroke, peripheral artery stent, or vessel, thrombosis (ST), need for any target limb endovascular or surgical revascularization, target limb major amputation and procedural complications. A subintimal crossing technique was necessary in 388 lesions (27% overall in 1335 lesions; 34% ( n=351) in 1023 femoropopliteal lesions, and 12% ( n=37) in 312 infrapopliteal lesions, p<0.01) with a lower procedural ( p<0.01) and technical ( p<0.01) success than the intraluminal in both femoropopliteal and infrapopliteal interventions. There were no significant differences in procedural complications, major adverse cardiac events, or clinically driven target limb revascularization at 1 year between the two groups, except a higher residual dissection rate in the subintimal crossing group than the intraluminal group in femoropopliteal target vessels ( p = 0.04).

show abstract

Subintimal angioplasty and stenting in chronic total femoropopliteal artery occlusions: Early- and mid-term outcomes

Abstract: (Cardiol J 2015; 22, 1: 115-120)

Cited by 9 publications

References 28 publications

Endovascular therapy for critical limb ischemia

Endovascular therapy for critical limb ischemia

SFA Intervention: Intraluminal or Subintimal?

Comparative assessment of patient outcomes with intraluminal or subintimal crossing of infrainguinal peripheral artery chronic total occlusions

Contact Info

Product

Resources

About