Surgical Technique and Peripheral Artery Disease

Slovut, David P.; Lipsitz, Evan C.

doi:10.1161/circulationaha.111.059048

Cited by 57 publications

(55 citation statements)

References 93 publications

(83 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Preservation of both branches with balloon angioplasty alone can be difficult with complex calcified plaques, and often surgical endarterectomy with patch angioplasty offers a more durable result. Hybrid endovascular-surgical approaches using endovascular approaches for iliac or superficial femoral disease and endarterectomy for common femoral disease are increasingly used 18 . New developments in atherectomy and drug coated balloons have renewed interest in endovascular approaches for common femoral disease, although this paradigm needs formal testing in clinical trials.…”

Section: Endovascular Revascularizationmentioning

confidence: 99%

“…Open surgery has higher risks of peri-operative myocardial infarction, death and stroke than endovascular revascularization. However, in critical limb ischemia, the potential loss of limb and function may favor surgery when endovascular therapy is not possible or not successful and patients otherwise have a reasonable 2 year survival 18 . Risk scores can help risk-stratify CLI patients having infrainguinal bypass surgery.…”

Section: Open Surgical Revascularizationmentioning

confidence: 99%

See 1 more Smart Citation

Management of Critical Limb Ischemia

Kinlay

2016

Circ: Cardiovascular Interventions

129

106

View full text Add to dashboard Cite

Critical limb ischemia (CLI) is a clinical syndrome of ischemic pain at rest or tissue loss, such as non-healing ulcers or gangrene, related to peripheral artery disease. CLI has a high short-term risk of limb loss and cardiovascular events. Non-invasive or invasive angiography help determine the feasibility and approach to arterial revascularization. An “endovascular-first” approach is often advocated based on a lower procedural risk, however, specific patterns of disease may be best treated by open surgical revascularization. Balloon angioplasty and stenting form the backbone of endovascular techniques, with drug-eluting stents and drug-coated balloons offering low rates of repeat revascularization. Combined antegrade and retrograde approaches can increase success in long total occlusions. Below the knee, angiosome-directed angioplasty may lead to greater wound healing, but failing this, any straight line flow into the foot is pursued. Hybrid surgical techniques such as iliac stenting and common femoral endarterectomy are commonly used to reduce operative risk. Lower extremity bypass grafting is most successful with a good quality, long, single-segment autogenous vein of at least 3.5mm diameter. Minor amputations are often required for tissue loss as part of the treatment strategy. Major amputations (at or above the ankle) limit functional independence and their prevention is a key goal of CLI therapy. Medical therapy after revascularization targets risk factors for atherosclerosis and assesses wound healing and new or recurrent flow limiting disease. The ongoing NIH sponsored BEST-CLI study is a randomized trial of the contemporary endovascular versus open surgical techniques in patients with CLI.

show abstract

Section: Endovascular Revascularizationmentioning

confidence: 99%

Section: Open Surgical Revascularizationmentioning

confidence: 99%

Management of Critical Limb Ischemia

Kinlay

2016

Circ: Cardiovascular Interventions

129

106

View full text Add to dashboard Cite

show abstract

“…With TASC II-C and D lesions, bypass surgery with a vein graft remains the best treatment for infrainguinal PAD [3]. Long-term graft patency depends on the quality of the inflow and outflow vessels and the conduit available [19]. Continuous, high quality, autogenous greater saphenous vein signifies the optimum conduit [20].…”

Section: Discussionmentioning

confidence: 99%

İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

Sarıçam¹,

Sağlam²,

Beton³

et al. 2017

TURKISH JOURNAL of CLINICS and LABORATORY

View full text Add to dashboard Cite

Aim:The treatment of peripheral arterial disease has encompassed different therapy options. Hybrid therapy method (endovascular treatment plus surgery) has recently been used in lower extremity arterial disease. This study has examined hybrid therapy practice in iliac and infrainguinal arterial disease. Materials and Methods: This study included 76 patients with occlusive iliac artery disease and performed iliac artery endovascular treatment from January 2010 to August 2015. While 56 patients underwent only iliac artery stenting, 20 of 76 patients underwent additionally infrainguinal vascular surgery (hybrid therapy).Results: In 20 hybrid patients group, iliac artery lesion length was 31.0 ± 7.6 mm. Seven patients had TASC-II A iliac artery class, while 13 patients had TASC-II B class. According to femoropopliteal lesions, eight patients had TASC-II C, while 12 patients had TASC-II D. One patient died in postoperative period. Graft stenosis developed in one patient, which was resolved through catheter therapy. In the one-year follow-up, in one patient, iliac stent restenosis developed, ABI was 0.91 ± 0.20. Conclusion:Hybrid therapy is a feasible option for multilevel lower extremity artery disease, including iliac artery disease and TASC-II C or D femoropopliteal disease. This technique has favorable patency with lower complication rates.

show abstract

“…[2][3][4][5][6][7] For example, revascularization improves blood flow in large arteries, and risk factor modification, such as smoking cessation, walking programs, and hydroxy-methylglutaryl-coenzyme A (HMG-CoA) reductase inhibitors, aims to improve endothelial function and muscle bioenergetics during exercise. Arteriogenesis and angiogenesis of the small arteries and capillaries may be mechanisms for some of the benefits from risk factor modification and are the foundation for cell-based therapies that offer the potential for improved perfusion in critical limb ischemia.…”

Section: Article See P 92mentioning

confidence: 99%

Prospects for Multimodality Imaging in Peripheral Artery Disease

Kinlay

2014

Circ: Cardiovascular Imaging

View full text Add to dashboard Cite

Surgical Technique and Peripheral Artery Disease

Cited by 57 publications

References 93 publications

Management of Critical Limb Ischemia

Management of Critical Limb Ischemia

İliyak arter ve infrainguinal arter tıkayıcı hastalığında hybrid strateji

Prospects for Multimodality Imaging in Peripheral Artery Disease

Contact Info

Product

Resources

About