Infrapopliteal Balloon Angioplasty for Chronic Critical Limb Ischemia in Diabetic Patients with Uremia: When is it Worth the Effort?

2009 ◽  
Vol 20 (3) ◽  
pp. 342-346 ◽  
Author(s):  
Janne Kuusela ◽  
Hannu I. Manninen ◽  
Pauli Karhapää
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Chronic Critical Limb Ischemia

Adherence to guideline recommended medical therapies in type 2 diabetic patients with chronic critical limb ischemia

2019 ◽  
Vol 158 ◽  
pp. 107898 ◽  
Author(s):  
Elisabetta Iacopi ◽  
Alberto Coppelli ◽  
Nicola Riitano ◽  
Lorenza Abbruzzese ◽  
Letizia Pieruzzi ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Chronic Critical Limb Ischemia ◽  
Medical Therapies ◽  
Type 2 Diabetic

Balloon Angioplasty in Chronic Critical Limb Ischemia: Factors Affecting Clinical and Angiographic Outcome

2002 ◽  
Vol 9 (4) ◽  
pp. 403-410 ◽  
Author(s):  
Hannes Balmer ◽  
Felix Mahler ◽  
Dai-Do Do ◽  
Jürgen Triller ◽  
Iris Baumgartner
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Duplex Ultrasound ◽  
Limb Ischemia ◽  
Target Lesion ◽  
Major Amputation ◽  
Factors Affecting ◽  
Chronic Critical Limb Ischemia ◽  
Endpoint Event ◽  
Artery Disease

Purpose: To assess factors that affect clinical and angiographic outcome in chronic critical limb ischemia (CLI) 12 months after primary, technically successful balloon angioplasty (BA) in infrainguinal arteries. Methods: Sixty consecutive patients (37 women; mean age 75 ± 10 years, range 53–99) with technically successful BA in 66 limbs were followed for 12 months or until death, for major amputation, or repeat target lesion revascularization (TLR). Assessment at baseline and 1 day and 12 months after BA or at an endpoint event, if feasible, was performed with angiography or duplex ultrasound (above-knee revascularization only). Mortality, limb prognosis, and restenosis rate were correlated with cardiovascular risk factors, hemodynamic measures, and angiographic features. Results: Mortality was 25% at 1 year; compared to survivors, nonsurvivors more often had coronary artery disease (93% versus 44% for survivors, p<0.001), bilateral CLI (60% versus 29%, p=0.033), and higher fibrinogen levels (5.1 g/L versus 4.3 g/L, p=0.049). CLI resolved in more than half (35, 53%) of the limbs without repeat TLR. The major amputation rate was 6%. Limb prognosis correlated with ankle pressures after BA. Restenosis rates were 65% at the femoropopliteal and 56% at the infrapopliteal level (NS); these correlated with the length of the treated arterial segment (8.7 cm with restenosis versus 4.0 cm without, p<0.001). Conclusions: High mortality in CLI was associated with an extensive, clinically manifest arteriosclerotic process and high fibrinogen levels. Limb prognosis and restenosis after BA were primarily influenced by local hemodynamic and technical factors. Despite considerable restenosis, more than 90% of survivors avoided major amputations.

Percutaneous Deep Foot Vein Arterialization IVUS-Guided in No-Option Critical Limb Ischemia Diabetic Patients

2020 ◽  
Vol 55 (1) ◽  
pp. 58-63
Author(s):  
Gianluca Cangiano ◽  
Fabio Corvino ◽  
Francesco Giurazza ◽  
Eugenio Maria De Feo ◽  
Francesca Fico ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Posterior Tibial Artery ◽  
Healing Time ◽  
Diabetic Patients ◽  
Chronic Critical Limb Ischemia ◽  
Procedural Complications ◽  
Surgical Options ◽  
Deep Vein ◽  
Wound Healing Time

Purpose: To report our clinical experience with IVUS-guided percutaneous deep vein arterialization (pDVA) to treat chronic critical limb ischemia (cCLI) patients with no-endovascular or surgical options approach due to creation of an arteriovenous fistula (AVF). Materials and Methods: In a 2 years period, 14 no-option cCLI patients were treated with percutaneous deep vein arterialization (pDVA) by creating an AVF with a IVUS-guided system between posterior tibial artery and its satellite deep vein. Technical success was defined as successful AVF creation and venous perfusion of the wound site. Patients’ characteristics, procedure details, mortality and wound outcomes were assessed prospectively. Results: Successful pDVA was successfully performed in all patients (mean age 82 years) without any procedural complications. Clinical improvement was achieved in all patients with resolution of rest pain, tissue formation of granulation tissue or both; only 3 major amputations were performed within the study period with a limb salvage rate of 78%. Median wound healing time was 4.8 months. Conclusion: pDVA is a safe and feasible revascularization technique alternative in no-option cCLI patients.

scholarly journals The Effect of Charcot Neuroarthropathy on Limb Preservation in Diabetic Patients with Foot Wound and Critical Limb Ischemia after Balloon Angioplasty

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Mehmet Burak Çildağ ◽  
Ömer Faruk Kutsi Köseoğlu
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Diabetic Foot ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Charcot Neuroarthropathy ◽  
Below The Knee ◽  
Limb Preservation ◽  
Significant Difference ◽  
Patients With Diabetes

Objective. The aim of this article is to investigate one-year limb preservation rates after below-the-knee angioplasty in patients with diabetic foot wound who only have critical limb ischemia (CLI) and those who have Charchot neuroarthropathy (CN) accompanied by CLI. Methods. This single-center, retrospective study consists of 63 patients with diabetic foot wound who had undergone lower extremity balloon angioplasty of at least 1 below-the-knee (BTK) vessel. Only those patients with postprocedural technical success of 100% were selected from the database. All patients were classified into two groups as patients with CLI and CN and patients with CLI only without CN. The Kaplan-Meier method was used to compare the limb preservation rates for the two groups. Results. There was no statistically significant difference between patient age, gender, diabetic disease duration, and comorbid disease such as chronic renal insufficiency, hypertension, and coronary artery disease of the two groups (p>0.05). Limb preservation in the 12 months was 59.1% in the CN group and 92.7% in the group without CN. Also, limb preservation rates between the two groups displayed statistically significant differences (p<0.005). Conclusion. This study showed that CLI can accompany CN in patients with diabetes. Limb preservation rates with endovascular treatment in diabetic patients with CLI only are better than in diabetic patients with CLI and CN.

Drug-coated balloon angioplasty for the management of recurring infrapopliteal disease in diabetic patients with critical limb ischemia

2018 ◽  
Vol 19 (1) ◽  
pp. 83-87 ◽  
Author(s):  
Luis M. Palena ◽  
Larry J. Diaz-Sandoval ◽  
Efren Gomez-Jaballera ◽  
Olga Peypoch-Perez ◽  
Enrico Sultato ◽  
...  
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Drug Coated Balloon

Subintimal Angioplasty for Below-the-Ankle Arterial Occlusions in Diabetic Patients With Chronic Critical Limb Ischemia

2009 ◽  
Vol 16 (5) ◽  
pp. 604-612 ◽  
Author(s):  
Yue-Qi Zhu ◽  
Jun-Gong Zhao ◽  
Fang Liu ◽  
Jian-Bo Wang ◽  
Ying-Sheng Cheng ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Subintimal Angioplasty ◽  
Chronic Critical Limb Ischemia

Does Deep Femoral Artery Revascularization as an Isolated Procedure Play a Role in Chronic Critical Limb Ischemia?

2004 ◽  
Vol 11 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Nicolas Diehm ◽  
Hannu Savolainen ◽  
Felix Mahler ◽  
Jürg Schmidli ◽  
Do-Dai Do ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Deep Femoral Artery ◽  
Chronic Critical Limb Ischemia

Long-Term Clinical Outcomes of Infrapopliteal Drug-Eluting Stent Placement for Critical Limb Ischemia in Diabetic Patients

2015 ◽  
Vol 26 (10) ◽  
pp. 1423-1430 ◽  
Author(s):  
Stavros Spiliopoulos ◽  
Vasiliki Theodosiadou ◽  
Konstantinos Katsanos ◽  
Panagiotis Kitrou ◽  
George C. Kagadis ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Critical Limb Ischemia ◽  
Stent Placement ◽  
Limb Ischemia ◽  
Drug Eluting Stent ◽  
Diabetic Patients ◽  
Drug Eluting

Use of Tapered Balloons to Recanalize Occluded Below-the-Knee Arteries in Diabetic Patients with Critical Limb Ischemia

2016 ◽  
Vol 31 ◽  
pp. 105-110
Author(s):  
Nicola Troisi ◽  
Leonardo Ercolini ◽  
Emiliano Chisci ◽  
Piefrancesco Frosini ◽  
Clara Pigozzi ◽  
...  
Keyword(s):  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Diabetic Patients ◽  
Below The Knee
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