Multi-vessel Infra-popliteal Flow to the Foot is Associated with Improved Wound Healing in Patients Undergoing Endovascular Treatment for Critical Limb Ischaemia

Common femoral artery atherosclerosis is a common cause of claudication and critical limb ischaemia. Surgical endarterectomy with or without patch angioplasty has been considered the gold standard for the treatment of common femoral peripheral artery disease. Endovascular intervention to the common femoral artery has gained popularity in recent years as devices and technical skills have advanced. A systematic review of the literature from 1987 to 2018 for endovascular treatment of common femoral artery disease was conducted. This article summarises the data on acute and long-term outcomes for endovascular treatment of common femoral artery disease.

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A 5.5 years observational follow-up study of patients with critical limb ischaemia treated efficiently by endovascular approach

Romanian Journal of Cardiology ◽

10.47803/rjc.2020.30.2.236 ◽

2020 ◽

Vol 30 (2) ◽

pp. 236-240

Author(s):

Dan F. Filip ◽

Gabriela Kozma ◽

Calin F. Pop

Keyword(s):

Endovascular Treatment ◽

Critical Limb Ischaemia ◽

Limb Ischaemia ◽

Peripheral Artery ◽

Arterial Segment ◽

Final Treatment ◽

Endovascular Approach ◽

The Mean ◽

Peripheral Artery Diseases

Objectives – The aim of this study was to describe our experience with endovascular treatment in critical limb ischaemia and to bring new follow-up data about these patients with initial successfully revascularization. Methods – A retrospective study of 181 patients with critical limb ischaemia, with successful endovascular treatment in our institution was performed. We followed death, reintervention and amputation rates during a mean period of 55.1 ± 8.2 months. Results – The mean age of the patients was 65.2±11.6 years. Of these patients, 66.3% were males, 38.1% diabetics, 51.4% active smokers, 21% with chronic kidney disease, 32.6% with other clinical forms of peripheral artery diseases. The final treatment was stenting in 31.5% of cases and balloon angioplasty alone in the rest of the cases. Treated arteries were in the femoral-popliteal segment – 55.6%, aorto-iliac segment – 31.4% and infrapopliteal segment – 13%. 27.6% of the patients underwent procedures on more than one arterial segment. During follow up 11 deaths occurred (6.1%), 27 patients (14.9%) underwent reinterventions for revascularization (endovascular or surgical) and 31 patients (17.1%) suffered further amputations. Conclusions – Despite a certain rate of death, amputation and reintervention, our results suggest that endovascular approach in critical limb ischaemia can be an effi cient and feasible treatment option if its results are optimal at the time of implementation.

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Below-the-ankle Angioplasty: Current Evidence and Future Perspectives

Vascular and Endovascular Review ◽

10.15420/ver.2018.19.2 ◽

2019 ◽

Vol 2 (1) ◽

pp. 6-8

Author(s):

Stavros Spiliopoulos ◽

Lazaros Reppas ◽

Konstantinos Palialexis ◽

Elias Brountzos

Keyword(s):

Endovascular Treatment ◽

Bypass Surgery ◽

Arterial Disease ◽

Annual Incidence ◽

Critical Limb Ischaemia ◽

Current Evidence ◽

Limb Ischaemia ◽

Future Perspectives ◽

Severe Stage ◽

Peripheral Arterial

Over 20 million adults in Europe suffer from peripheral arterial disease (PAD). The annual incidence of PAD is approximately 2.4%, while the annual incidence of critical limb ischaemia (CLI), the last and most severe stage of PAD, has been reported to be 0.4%. Endovascular angioplasty and/or stenting of infrapopliteal disease is, today, an established treatment for critical limb ischaemia. The main technical advantages of endovascular treatment over open bypass surgery include the possibility to revascularise more than one infrapopliteal vessels and, most importantly, to treat outflow pedal vessel disease or even reconstitute the pedal arch. Data of below-the-ankle angioplasty are beginning to sum up and the contribution of pedal arch angioplasty in limb salvage and wound healing are currently under investigation. In this review, currently available data and the future perspectives on below-the-ankle and pedal arch endovascular treatment will be presented.

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Impact of Endovascular Pedal Artery Revascularisation on Wound Healing in Patients With Critical Limb Ischaemia

Journal of Vascular Surgery ◽

10.1016/j.jvs.2019.11.018 ◽

2020 ◽

Vol 71 (1) ◽

pp. 346

Author(s):

H.W. Jung ◽

Y.-G. Ko ◽

S.-J. Hong ◽

C.-M. Ahn ◽

J.-S. Kim ◽

...

Keyword(s):

Wound Healing ◽

Critical Limb Ischaemia ◽

Limb Ischaemia

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Tibiopedal Retrograde Vascular Access: An Innovative Approach in Endovascular Treatment of Critical Limb Ischaemia Patients

Heart Lung and Circulation ◽

10.1016/j.hlc.2018.06.1036 ◽

2018 ◽

Vol 27 ◽

pp. S498-S499

Author(s):

A. Wachsmann ◽

M. Maga ◽

J. Krężel ◽

P. Kłapacz ◽

P. Maga

Keyword(s):

Endovascular Treatment ◽

Vascular Access ◽

Innovative Approach ◽

Critical Limb Ischaemia ◽

Limb Ischaemia

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Gender differences in endovascular treatment of infrainguinal peripheral artery disease

VASA ◽

10.1024/0301-1526/a000634 ◽

2017 ◽

Vol 46 (4) ◽

pp. 296-303 ◽

Cited By ~ 10

Author(s):

Henrik Christian Rieß ◽

Eike Sebastian Debus ◽

Franziska Heidemann ◽

Konstanze Stoberock ◽

Reinhart T. Grundmann ◽

...

Keyword(s):

Endovascular Treatment ◽

Arterial Disease ◽

Critical Limb Ischaemia ◽

Bleeding Complications ◽

Limb Ischaemia ◽

Ongoing Research ◽

Below The Knee ◽

Gender Specific Differences ◽

Artery Disease ◽

Peripheral Arterial

Abstract. Background: Despite ongoing research concerning comorbidities and clinical presentation of peripheral arterial disease (PAD), the issue of gender associated differences in treatment is far from being settled. Patients and methods: This was a prospective, non-randomized multicentre study design. All patients suffering from intermittent claudication (IC) or critical limb ischaemia (CLI) were included. Results: A total of 2,798 procedures for symptomatic PAD in the infrainguinal region were recorded, with 1,696 (61.4 %) males. Distribution of comorbidities for patients with IC were gender-specifically different. Smoking was more common in men (41.9 vs. 31.9 %, p < .001), men had more often previous coronary heart disease (35.2 vs. 27.7 %, p = .007), and suffered more often from diabetes (33.9 vs. 28.2 %, p = .037). Women were generally older (71 vs. 77 years). Men were more prone to present with IC (46.9 vs. 43.6 %, p < .001) and ulcer/gangrene (43.6 vs. 41.2 %, p < .001). Women were more likely to present with rest pain (9.5 vs. 15.1 %, p < .001). Men were more often treated for a lesion below the knee (BTK) (21.1 vs. 14.9 %, p < .001), and females above the knee (ATK) (58.1 vs. 61.5 %, p < .001). Logistic regression analysis revealed a significant association of male gender and treatment for lesions BTK (OR 1.565, 95 % CI 1.281-1.913, p < .001). Dissections and bleeding complications were more often observed in females with IC (3.3 vs. 7.2 %, p = 0.003; 0.4 vs. 1.5 %, p = 0.044). Women were rather discharged to rehabilitation and had a longer hospital stay compared to men (3.4 vs. 8.9 %, p < .001; three vs. four days, p = .023). Conclusions: The present study provides an overview on gender-specific differences in endovascular treatment of PAD. To date, available evidence on this topic is limited, emphasising the importance of further vascular research targeting this topic.

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