Tibioperoneal Angioplasty and Bypass

Baird, R. N.; Bradley, M.D.; Murphy, Kevin P.

doi:10.1080/00015458.2003.11679448

Cited by 8 publications

(4 citation statements)

References 22 publications

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“…Potential complications of the atherectomy devices are hematoma, pseudoaneurysm, distal embolization, and tearing of the vessel. [23,24] In our study, 130 patients with SFA and distal lesions underwent atherectomy with PTA, and 23 patients with iliac lesions had pure PTA without atherectomy. Percutaneous transluminal angioplasty was used for residual stenosis or plaque stabilization after the plaque load was reduced by atherectomy in SFA and complicated lesions.…”

Section: Discussionmentioning

confidence: 77%

“…[19][20][21][22] Minimally invasive endovascular treatments include PTA, PTA with additional stent placement, cold-balloon PTA or cryoplasty, and atherectomy with directional, laser, or orbital volume removal methods. [23] The principal action of atherectomy devices is reducing the plaque burden by shaving or pulverizing the plaque by piercing or sanding it. In the meantime, this procedure causes minimal barotrauma in the vessel.…”

Section: Discussionmentioning

confidence: 99%

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Single center experience with percutaneous peripheral atherectomy with the use of C-arm scopy for the treatment of lower extremity peripheral artery disease

Erdinç¹

2022

Cardiovasc Surg Int

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Objectives: This study aimed to present our results of endovascular procedures including balloon angioplasty combined with or without atherectomy for the treatment of iliofemoral and distal lesions with the use of a C-arm scopy. Patients and methods: The retrospective study was conducted on 153 patients (100 males, 53 females; mean age: 60.2±2.1 years; range, 53 to 82 years) with the diagnosis of peripheral artery disease between January 2017 and January 2020. The symptoms of the patients were claudication, rest pain, or tissue loss. The operations were performed at the operation theatre with local or spinal anesthesia in a supine or prone position according to the lesion status. Lesions were classified as superficial femoral, popliteal, and distal lesions below the knee. Results: Interventional treatment was applied in all patients, and 272 lesions in 204 extremities were intervened. In 78 patients, 160 right leg lesions were treated, and in 75 patients, a total of 112 lesions were treated. Fifty-one patients had bilateral leg lesions. The number of iliac, superficial femoral, and popliteal and distal segment lesions was 30 (11.1%), 213 (78.3%), and 29 (10.6%), respectively. Most of the lesions were confined to the SFA. We performed percutaneous transluminal angioplasty procedures in all 153 patients; however, 143 of them also received atherectomy with two different reliable devices (Avinger in 45 patients, Invamed in 114 patients). All interventions were done on a standard operating theatre bed with a C-arm scope. Doppler ultrasonography was used for popliteal imaging during the insertion. We did not encounter any problems in 125 patients. In 28 patients, progress was observed in the leg or ischemic wound between 30 and 65 postoperative days. A total of 23 patients required amputation; amputations were minor (finger amputation) in five patients and major (below the knee) in 18 patients. Conclusion: The perioperative and mid-term follow-up results of our study indicate that atherectomy and drug-coated balloon angioplasty may safely be performed by C-arm scopy with favorable outcomes.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Single center experience with percutaneous peripheral atherectomy with the use of C-arm scopy for the treatment of lower extremity peripheral artery disease

Erdinç¹

2022

Cardiovasc Surg Int

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“…From that point of view, endovascular interventions may be a reasonable alternative to bypass procedures aiming to reduce the mortality rate. In this specific group however, who have diffuse atherosclerotic disease and often heavily calcified lesions, a very few patients have lesions amenable to balloon angioplasty [15, 16]. …”

Section: Discussionmentioning

confidence: 99%

Lower Extremity Bypass Procedures in Diabetic Patients with End-Stage Renal Disease: Is It Worthwhile?

et al. 2004

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Backgroud/Aims: Limb-threatening ischemia in patients with end-stage renal disease (ESRD) represents a challenging therapeutic problem. Furthermore, diabetes mellitus is frequently associated with ischemic gangrene, persistent infection and impaired wound healing. The present study was undertaken to examine graft patency, limb salvage and survival in patients with ESRD and diabetes following bypass grafting to treat lower limb critical ischemia. Methods: A retrospective analysis of 56 arterial reconstructions performed in 39 patients with diabetes mellitus and ESRD during a period of 8 years. The indications for bypass grafting were: ischemic rest pain (n = 13), non-healing ulcer (n = 18) or foot gangrene (n = 25). Risk factors in association with surgical morbidity and mortality, limb loss and graft patency were evaluated. Results: Thirty-four patients were on hemodialysis and 5 on peritoneal dialysis. Forty-nine infrainguinal reconstructions were performed; the site of distal anastomosis was the below knee popliteal artery (n = 22), the anterior tibial artery (n = 12), the posterior tibial artery (n = 8), and the peroneal artery (n = 7). Seven axillofemoral reconstructions were also performed; the site of distal anastomosis was the common femoral artery (n = 5) and the above knee popliteal artery (n = 2). The 30-day operative mortality rate was 18% (7 patients). The mean follow-up was 11.5 (range 1–93) months. Patient survival rate at 1 and 2 years was 63 and 45%, respectively. Primary patency rate was 64% at 1 year and 58% at 2 years. The limb salvage rate was 65% in the first year. Conclusion: Limb salvage rate in patients with ESRD and diabetes justifies an aggressive policy of revascularization, despite decreased survival of this population.

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“…Nevertheless, the benefits of endovascular operations are often mitigated by high failure rates, mostly because of their technical nature. In addition, patients with co-existing medical conditions, such as chronic kidney disease, are not eligible for these procedures (16)(17)(18).…”

Section: Introductionmentioning

confidence: 99%

Impact of prior endovascular interventions on outcomes of lower limb bypass surgery: A systematic review and meta‑analysis

Hai

Guan

et al. 2020

Exp Ther Med

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The aim of this meta-analysis was to evaluate the mortality, amputation and complication rates in patients with peripheral lower limb arterial disease undergoing bypass surgery with or without a prior history of endovascular operation. A systematic literature screen was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines on four academic databases, Medline, Scopus, Embase and Cochrane Central Register of Controlled Trials. Out of 1,072 records, six articles involving 11,420 patients (mean age, 68.1±2.0 years) met the inclusion criteria. The findings presented a 2b level of evidence (i.e. overall evidence represents data from individual cohort study or low quality randomized controlled trials) and suggested lower mortality, amputation and complication rates for patients undergoing bypass surgery without any history of endovascular operation, compared with those with a history of prior endovascular operation. Moreover, a random-effect meta-analysis suggested a small, positive reduction in mortality (Hedge's g=0.08), amputation (Hedge's g=0.18) and complication rates (Hedge's g=0.05) for patients undergoing bypass surgery without any history of endovascular operation. Nevertheless, owing to the scarcity of high-quality data, further studies and randomized clinical trials are needed to confirm these effects.

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Tibioperoneal Angioplasty and Bypass

Cited by 8 publications

References 22 publications

Single center experience with percutaneous peripheral atherectomy with the use of C-arm scopy for the treatment of lower extremity peripheral artery disease

Single center experience with percutaneous peripheral atherectomy with the use of C-arm scopy for the treatment of lower extremity peripheral artery disease

Lower Extremity Bypass Procedures in Diabetic Patients with End-Stage Renal Disease: Is It Worthwhile?

Impact of prior endovascular interventions on outcomes of lower limb bypass surgery: A systematic review and meta‑analysis

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