Subintimal Angioplasty with the Aid of a Re-entry Device for TASC C and D Lesions of the SFA

Setacci, Carlo; Chisci, Emiliano; Donato, Gianmarco de; Setacci, Francesco; Iacoponi, Francesca; Galzerano, G

doi:10.1016/j.ejvs.2009.03.020

Cited by 67 publications

(59 citation statements)

References 36 publications

(35 reference statements)

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“…1 In a recent study, Setacci et al found that the factors capable of independently affecting patency following SIA for TASC C and D lesions of SFA were renal insufficiency (P=0.03), current smoking (P=0.01), and diabetes (P=0.04). 22 In our study, occlusion length >25 cm was related to patency rate following SIA with a hazard ratio of 5.082 (95%CI: 1.1-24.1, P=0.04, Table 4) compared with a length not exceeding 25 cm. Vraux et al have also reported that the length of the occlusion (>10 cm) is a predictor of SIA technical success and patency.…”

Section: Sia In Tasc C/d Femoropopliteal Diseasementioning

confidence: 90%

“…Hypertension, diabetes mellitus and smoking were not predictive factors of re-occlusion in our series (Table 3), whereas Setacci et al concluded that factors capable of independently affecting patency included renal insufficiency, current smoking, and diabetes in patients undergoing SIA for TASC C and D lesions of the SFA. 22 Further research is warranted, including a larger-scale study. Although we did not discuss all data collected in this study, laboratory findings such as serum creatinine, high-sensitivity C-reactive protein and fibrogen levels also were not related to re-occlusion.…”

Section: Sia In Tasc C/d Femoropopliteal Diseasementioning

confidence: 99%

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Determinants of Procedural Success and Patency Following Subintimal Angioplasty in Patients With TASC C and D Femoropopliteal Arterial Disease

Kim

et al. 2010

Circ J

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Background: Subintimal percutaneous transluminal angioplasty (SIA) is a treatment option for long segment occlusions in the lower limb arteries. In the present study the factors influencing success and patency following SIA in patients with TransAtlantic Inter-Society Consensus (TASC) C and D peripheral arterial disease (PAD) were investigated. Methods and Results:The 63 consecutive SIAs were performed in 54 consecutive patients suffering from limb ischemia with TASC C and D lesions. Follow-up consisted of routine office visits with pulse examination, anklebrachial index (ABI), and serial surveillance by color duplex ultrasound and scanning at 3- to 6-month intervals for 1 year. The morphology of lesions in all patients were type C (n=13, 20.6%) or type D (n=50, 79.4%). SIA was technically successful in 59 of 63 arterial occlusive lesions (93.6%). Post-procedural ABI was 0.89±0.16. The mean increase in ABI after SIA was 0.45 (range, 015-0.87). The primary patency rate at 12 months was 51.7%. Occlusion length, lesions involving the distal superficial femoral artery (SFA), and post-procedural distal run-off vessels (P=0.04, 0.006, 0.018, respectively) were independent patency determinants by multivariate analysis. Conclusions:The length of the occlusion, lesions involving the distal SFA, and post-procedural distal run-off vessels were strong independent predictors for 1-year patency in TASC C/D severe occlusive femoropopliteal artery disease treated by SIA. (Circ J 2010; 74: 1959 - 1964

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Section: Sia In Tasc C/d Femoropopliteal Diseasementioning

confidence: 90%

Section: Sia In Tasc C/d Femoropopliteal Diseasementioning

confidence: 99%

Determinants of Procedural Success and Patency Following Subintimal Angioplasty in Patients With TASC C and D Femoropopliteal Arterial Disease

Kim

et al. 2010

Circ J

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“…SIA has been associated with high limb salvage rates between 85% and 90% at 1 year, even despite a low 50% 1-year primary patency rate [26].…”

Section: Discussionmentioning

confidence: 99%

Transluminal versus Subintimal Angioplasty for Management of Critical Limb Ischemia Patients with Femoropopliteal Occlusive Disease

Foad¹,

Eldaly²,

Eldin³

et al. 2015

J Health Edu Res Dev

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AimComparison between intraluminal and subintimal angioplasty with review of technique, factors affecting the success and complications with special emphasis on factors that could predict the wire route meanwhile using simple techniques. MethodsThis is a non-randomized study with prospectively collected data that included 159 patients presented from 2011 to 2014 to the vascular surgery department with critical chronic lower limb ischemia due to atherosclerotic femoropopliteal occlusive disease for whom percutaneous angioplasty was done. Patients presenting with nonsalvageable limbs requiring primary major amputation and non-atherosclerotic causes of CLI were excluded. Results 75.5% of the lesionswere crossed transluminally while 19.5% of the lesions were crossed subintimally. In 8 cases (5%) the lesion could not be passed. The overall technical success to pass the lesion was 95%. On 24 months follow up, 1ry patency, 2ry patency, limb salvage in intraluminal group are 56.8%, 60.2% and 66.1% respectively while in subintimal group 46.7%, 46.7% and 60% respectively. Subintimal was more in the TASC D, lesion more than 10 cm and in contralateral access (P value was<0.05). There were no statistically significant differences between intraluminal and subintimal angioplasty regarding the outcome (Patency and limb salvage). ConclusionsThe passage of the wire is affected by length of the lesion, the TASC II classification of the lesion and access site with the subintimal passage was more in Lesion more than 10 cm, TASC D lesions and in contralateral access. These factors can be used prospectively as predictors for passage of the wire whether intraluminal or subintimal. In spite of the technical differences between the intraluminal and subintimal passage, yet they show no significant statistical differences regarding the outcome (patency and limb salvage). Hence both should be used as part of vascular armamentarium for revascularization in such frail patients.

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“…However, even with reentry devices, recanalization of CTOs is impossible when access cannot be gained to the patent true lumen. Previous studies have shown variable success rates of 50 to 100% with these re-entry devices in the treatment of infrainguinal CTO (2,7,8).…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown variable success rates of 50 to 100% for re-entry devices in the treatment of infra-inguinal arterial occlusive diseases (2,7,8).…”

Section: Introductionmentioning

confidence: 99%

Target Balloon-Assisted Antegrade and Retrograde Approach for Recanalization of Thrombosed Fem-Pop Bypass Graft Using the Outback Catheter

Kwak

Chung

Lee

et al. 2016

J Korean Soc Radiol

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Subintimal Angioplasty with the Aid of a Re-entry Device for TASC C and D Lesions of the SFA

Abstract: SAP with the aid of a re-entry device for TASC C and D lesions of the SFA seems to be safe and clinically effective in patients suffering from CLI, according to the experience at our centre. Further follow-up and more data are necessary to confirm these findings.

Cited by 67 publications

References 36 publications

Determinants of Procedural Success and Patency Following Subintimal Angioplasty in Patients With TASC C and D Femoropopliteal Arterial Disease

Determinants of Procedural Success and Patency Following Subintimal Angioplasty in Patients With TASC C and D Femoropopliteal Arterial Disease

Transluminal versus Subintimal Angioplasty for Management of Critical Limb Ischemia Patients with Femoropopliteal Occlusive Disease

Target Balloon-Assisted Antegrade and Retrograde Approach for Recanalization of Thrombosed Fem-Pop Bypass Graft Using the Outback Catheter

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