scholarly journals Atherosclerotic Lesions in the Superficial Femoral Artery (SFA) Characterized with Velocity Ratios using Vector Velocity Ultrasound

2018 ◽  
Vol 04 (03) ◽  
pp. E79-E84
Author(s):  
Peter Hansen ◽  
Kristoffer Hansen ◽  
Mads Pedersen ◽  
Theis Lange ◽  
Lars Lönn ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Velocity Ratio ◽  
Ultrasound Technique ◽  
Vector Velocity ◽  
Flow Information ◽  
Spectral Doppler ◽  
The Difference ◽  
Arterial Stenoses ◽  
Diameter Reduction

Abstract Purpose Atherosclerotic arteries are challenging to evaluate quantitatively using spectral Doppler ultrasound because of the turbulent flow conditions that occur in relation to the atherosclerotic stenoses. Vector velocity ultrasound is angle independent and provides flow information, which could potentially improve the diagnosis of arterial stenoses. The purpose of the study is to distinguish significant stenoses in the superficial femoral artery (> 50% diameter reduction) from non-significant stenoses based on velocity ratios derived from the commercially available vector velocity ultrasound technique Vector Flow Imaging (VFI). Materials and Methods Velocity ratios (intrastenotic blood flow velocity divided by pre- or poststenotic velocity) from a total of 16 atherosclerotic stenoses and plaques in the superficial femoral artery of 11 patients were obtained using VFI. The stenosis degree, expressed as percentage diameter reduction of the artery, was determined from digital subtraction angiography and compared to the velocity ratios. Results A velocity ratio of 2.5 was found to distinguish clinically relevant stenoses with>50% diameter reduction from clinically non-relevant stenoses with<50% diameter reduction and the difference was statistically significant. Conclusion The study indicates that VFI is a potential future tool for the evaluation of arterial stenoses.

Scoring Balloon Reduces the Severity of Dissection and Stent Implantation Rate in Superficial Femoral Artery Angioplasty Compared to Plain Balloon

2020 ◽  
pp. 153857442096897
Author(s):  
Hanbee Hong ◽  
Ui Jun Park ◽  
Young Nam Roh ◽  
Hyoung Tae Kim
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Stent Implantation ◽  
Implantation Rate ◽  
Target Lesion ◽  
Drug Eluting Stent ◽  
Total Occlusion ◽  
Scoring Balloon ◽  
Significant Difference ◽  
The Difference

Purpose: The knowledge regarding the benefits of the scoring balloon (SB) in comparison to the plain balloon (PB) is limited. This study aims to elucidate the difference in efficacy between SB and PB as pre-balloon in superficial femoral artery angioplasty. Methods: We retrospectively analyzed angiographic images of 113 lesions in 98 patients treated with endovascular surgery. 37 lesions were prepared by SB and 76 lesions by PB. Lesions without significant residual stenosis nor a flow-limiting dissection were treated by drug-coated balloon and the others by drug-eluting stent. Severity of dissection was evaluated by Kobayashi dissection grade and NHLBI classification. The rate of stent implantation was compared between the 2 groups. Kaplan-Meier analysis estimated freedom from target lesion revascularization (TLR) rate at 12 months. Results: Severe dissections (>1/3 of lumen) occurred less frequently in the SB group (SB 40.5% vs. PB 75.0%, P = 0.001). Overall stent implantation rate was lower in the SB group (SB 27.0% vs. PB 55.3%, P = 0.005). In subgroup analysis for the complex lesions, the SB group had lower rate of severe dissection(>1/3 of lumen) in patients with long lesions(>15 cm) (SB 51.7% vs. PB 76.9%, P = 0.020) and lesions of calcium grade ≥2 (SB 43.8% vs. PB 72.5%, P = 0.009). SB group had lower stent implantation rate in patients with long lesions (SB 34.5% vs. PB 59.6%, P = 0.030), lesions of calcium grade ≥2 (SB 31.3% vs. PB 56.9%, P = 0.023), and total occlusion (SB 30.8% vs. PB 80.0%, P = 0.002). There were no procedure-related complications in either group except 1 case of puncture-site hematoma. There was no significant difference in TLR rate between both groups at 12 months (P = 0.509). Conclusion: SB reduces the incidence of severe dissection (>1/3 of lumen) and rate of overall stent implantation in comparison with PB. The use of SB is a safe and effective method of lesion preparation in SFA angioplasty.

Predictive Factors of Femoropopliteal Patency after Suboptimal Duplex–Guided Balloon Angioplasty and Stenting: Is Recoil a Bad Sign?

Vascular ◽  
2008 ◽  
Vol 16 (5) ◽  
pp. 263-268 ◽  
Author(s):  
Enrico Ascher ◽  
Anil P. Hingorani ◽  
Natalie Marks ◽  
Alessandra Puggioni ◽  
Alexander Shiferson ◽  
...  
Keyword(s):  
Predictive Factors ◽  
Balloon Angioplasty ◽  
Velocity Ratio ◽  
Peak Systolic Velocity ◽  
Limb Ischemia ◽  
Nitinol Stents ◽  
The Difference ◽  
Angioplasty And Stenting ◽  
Diameter Reduction

Currently, the value of stenting during femoropopliteal balloon angioplasty (FPBA) remains unclear. Herein we evaluate the patency rates of successful duplex–guided balloon angioplasty (DAGBA) alone versus suboptimal DAGBA followed by stenting and the prestenting dissection versus recoil as potential indicators of stent success or failure. Over a period of 27 months, we performed 291 duplex–guided FPBAs (194 stenoses; 97 occlusions) on 244 limbs in 220 patients. Disabling claudication was the indication in 67%. Critical limb ischemia was the indication in the remaining 33%. Self-expanding nitinol stents were used when plaque dissection and/or recoil caused diameter reduction ≥ 40%. Serial follow-up duplex scans were obtained. Severe restenosis (> 70%) was measured by B-mode imaging and a peak systolic velocity ratio > 3. Follow-up ranged from 1 to 41 months (mean 10 ± 8.3 months). The overall mean interval for restenosis and occlusion was 6.5 ± 4.2 months and 5.6 ± 6.1 months, respectively. Stents did affect overall patency results compared with not using stents. Reasons for stenting were plaque recoil, dissection, or both in 98 (53%), 44 (24%), and 42 (23%) cases, respectively. Six-month patency was 59%, 94%, and 69%, respectively. The difference between plaque recoil and dissection was significant ( p < .04). The use of stents during FPBA may be associated with balloon angioplasty site failure in the femoropopliteal segment. To our knowledge, this is the first report ever to document plaque recoil as a predictor of balloon angioplasty site failure notwithstanding stent placement.

scholarly journals Vector Flow Imaging Compared with Digital Subtraction Angiography for Stenosis Assessment in the Superficial Femoral Artery – A Study of Vector Concentration, Velocity Ratio and Stenosis Degree Percentage

2019 ◽  
Vol 05 (02) ◽  
pp. E53-E59 ◽  
Author(s):  
Kristoffer Hansen ◽  
Peter Hansen ◽  
Caroline Ewertsen ◽  
Lars Lönn ◽  
Jørgen Jensen ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Doppler Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Velocity Ratio ◽  
Arterial Disease ◽  
Disease Assessment ◽  
Imaging Method ◽  
Flow Imaging ◽  
Digital Subtraction

AbstractStenosis of the superficial femoral artery (SFA) induces complex blood flow with increased velocities. Disease assessment is performed with Doppler ultrasound and digital subtraction angiography (DSA), but Doppler ultrasound is limited by angle dependency and DSA by ionizing radiation. An alternative is the vector flow imaging method based on transverse oscillation (TO), an angle-independent vector velocity technique using ultrasound. In this study, flow complexity and velocity measured with TO were compared with DSA for the assessment of stenosis in the SFA.The vector concentration, a measure of flow complexity, and the velocity ratio obtained from the stenosis and a disease-free adjacent vessel segment, were estimated with TO in 11 patients with a total of 16 stenoses of the SFA. TO data were compared with the corresponding stenosis degree percentage obtained with DSA.The correlation between the vector concentration and DSA was very strong (R=0.93; p<0.001; 95% confidence interval (CI): 0.81–0.98), while only moderate for velocity ratio and DSA (R=0.50; p<0.07; 95% CI: 0.00–0.80). The correlation coefficients that were found were significantly different (p<0.005) without overlapping CI.The study indicated that flow changes in the SFA induced by stenosis can be quantified with TO, and that stenosis grading may be improved by estimation of flow complexity instead of velocity ratio. TO is a potential diagnostic tool for the assessment of atherosclerosis and peripheral arterial disease.

Proximal deep venous thrombosis following PTA of the superficial femoral artery – an obligation to disclose a complication that is rarely taken into account

VASA ◽  
2006 ◽  
Vol 35 (1) ◽  
pp. 41-44 ◽  
Author(s):  
Klein-Weigel ◽  
Pillokat ◽  
Klemens ◽  
Köning ◽  
Wolbergs ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Complication ◽  
Femoral Vein ◽  
Vein Thrombosis ◽  
Explicit Information ◽  
Life Threatening ◽  
Legal Consequences

We report two cases of femoral vein thrombosis after arterial PTA and subsequent pressure stasis. We discuss the legal consequences of these complications for information policies. Because venous thrombembolism following an arterial PTA might cause serious sequel or life threatening complications, there is a clear obligation for explicit information of the patients about this rare complication.

Crush implantation of a self-expanding interwoven stent over a subintimally recanalized standard stent in a TASC D lesion of the superficial femoral artery

VASA ◽  
2012 ◽  
Vol 41 (6) ◽  
pp. 458-462 ◽  
Author(s):  
Vogel ◽  
Strothmeyer ◽  
Cebola ◽  
A. Katus ◽  
Blessing
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Duplex Ultrasound ◽  
Stent Fracture ◽  
Nitinol Stent ◽  
Nitinol Stents ◽  
Walking Capacity ◽  
Radial Strength ◽  
Good Treatment Option

We demonstrate feasibility of implantation of a self-expanding interwoven nitinol stent in a claudicant, where recanalization attempt of a heavily calcified, occluded superficial femoral artery (TASC D lesion) was complicated by a previously implanted, fractured standard stent. Wire passage through the occlusion and beyond the fractured stent could only be achieved through the subintimal space. A dedicated reentry device was used to allow distal wire entry into the true lumen at the level of the popliteal artery. Despite crushing of the fractured stent with a series of increasingly sized standard balloons, a significant recoil remainded in the area of the crushed stent. To secure patency of the femoro-popliteal artery we therefore decided to implant the novel self-expanding interwoven nitinol stent (Supera Veritas (TM), IDEV), whose unique feature is an exceptional high radial strength. Patient presented asymptomatic without any impairment of his walking capacity at three month follow up and duplex ultrasound confirmed patency of the stent. Subintimal recanalizations can be complicated by previously implanted stents, in particular in the presence of stent fracture, where intraluminal wire passage often can not be achieved. Considering the high radial strength and fracture resistance, interwoven nitinol stents represent a good treatment option in those challenging cases and they can be used to crush standard nitinol and ballonexpandable stents.

Post-operative Staphylococcus aureus infection of a superficial femoral artery stent

VASA ◽  
2013 ◽  
Vol 42 (5) ◽  
pp. 382-386
Author(s):  
Karim Gariani ◽  
Marc Righini ◽  
Marco Roffi ◽  
Gino Gemayel ◽  
Damiano Mugnai ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Aureus Infection

Remote Superficial Femoral Artery Endarterectomy and Distal Vein Bypass for Limb Salvage:Initial Experience

2003 ◽  
Vol 10 (1) ◽  
pp. 121-125 ◽  
Author(s):  
David Rosenthal ◽  
Eric D. Wellons ◽  
John H. Matsuura ◽  
Mark Ghegan ◽  
Frederick W. Shuler ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Vein Bypass

Optimal duration of dual antiplatelet therapy following PTA of the superficial femoral artery: the DAPT-SFA protocol

2020 ◽  
Vol 61 (3) ◽  
Author(s):  
Enrico M. Marone ◽  
Luigi F. Rinaldi ◽  
Simona Chierico ◽  
Giulia Marazzi ◽  
Piernicola Palmieri ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Dual Antiplatelet Therapy ◽  
Optimal Duration

How to deal with calcium in the superficial femoral artery

2019 ◽  
Vol 60 (5) ◽  
Author(s):  
Konstantinos Stavroulakis ◽  
Angeliki Argyriou ◽  
Mike Watts ◽  
Joji J. Varghese ◽  
Bailey A. Estes ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery
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