The Results of Superficial Femoral, Popliteal, and Tibial Artery Stenting for Peripheral Vascular Occlusive Disease

2005 ◽  
Vol 71 (11) ◽  
pp. 905-910 ◽  
Author(s):  
Joe H. Morgan ◽  
Charles E. Wall ◽  
D. Benjamin Christie ◽  
Richard L. Harvey ◽  
Maurice M. Solis
Keyword(s):  
Limb Salvage ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Occlusive Disease ◽  
Primary Therapy ◽  
Peripheral Vascular Occlusive Disease ◽  
Stage Renal Disease ◽  
End Stage ◽  
Angioplasty And Stenting ◽  
Vascular Occlusive Disease

The purpose of this study was to evaluate the patentcy rates and physiological effectiveness of angioplasty and stenting as a primary therapy for superficial femoral (SFA), popliteal (POP), and tibial (TIB) arterial occlusive disease. Seventy-eight patients had stents placed in the infra-inguinal vessels between January 1, 2001, and July 31, 2004. We collected data on patient demographics, symptoms, as well as pre- and postprocedure ankle-brachial index (ABI) and angio-graphic findings. Patency rates at 6 months, 12 months, and 24 months were analyzed by life table methods. Thirty-one men and 47 women had a mean age of 68 years (range 36–94 years). Risk factors included diabetes in 50 per cent, hypertension in 79 per cent, smoking in 41 per cent, and end-stage renal disease in 10 per cent. The indications for intervention were claudication in 52 per cent and limb salvage in 48 per cent of patients. Stents were placed in the SFA in 54 patients (69%), in the POP in 15 patients (18%), and in the TIB artery in 6 patients (8%). Average follow-up was 11.2 months. The mean postprocedural increase in ABI was 0.29. The 6-month, 1-year, and 2-year primary patency rates were 83 per cent, 58 per cent, and 47 per cent, respectively. Limb salvage was achieved in 66 per cent of patients treated for limb-threatening ischemia. There was one major and three minor complications. Stenting of the infra-inguinal vessels has a low morbidity, high success rate, and acceptable patency and limb-salvage rates.

scholarly journals Meta-analysis of Individual Patient Data After Kissing Stent Treatment for Aortoiliac Occlusive Disease

2018 ◽  
Vol 26 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Erik Groot Jebbink ◽  
Suzanne Holewijn ◽  
Michel Versluis ◽  
Frederike Grimme ◽  
Jan Willem Hinnen ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Ankle Brachial Index ◽  
Primary Patency ◽  
Occlusive Disease ◽  
Primary Study ◽  
Secondary Patency ◽  
Aortoiliac Occlusive Disease ◽  
Cox Regression Analysis ◽  
Stent Treatment ◽  
Kissing Stent

Purpose: To evaluate short- and long-term technical and clinical outcomes after kissing stent treatment of aortoiliac occlusive disease (AIOD) based on an individual participant data (IPD) meta-analysis. Materials and Methods: A search of the Scopus database identified 156 articles on KS treatment of AIOD; of these 22 met the inclusion criteria. Authors of 19 articles with contact information were approached to join an IPD consortium. Eight author groups responded and 5 provided anonymized data for merging into an IPD database. The number of included procedures was equal before and after 2005. The primary study outcome was the cumulative patency at 24 months. Secondary outcomes were patency at up to 60 months, complications, and changes in Rutherford category and ankle-brachial index. The predictive value of stent protrusion length, pre-/postdilation, stent type, and patient demographics on primary patency were examined with Cox proportional hazard modeling; outcomes are reported as the hazard ratio (HR). The Kaplan-Meier method was employed to estimate patency rates. Results: In total, 605 (40.9%) of 1480 patients presented in the literature were included in the IPD analysis. The indication for intervention was intermittent claudication in 84.2% and critical limb ischemia in 15.8%. Lesions were classified as TransAtlantic Inter-Society Consensus (TASC) A or B in 52.8% and TASC C and D in 47.2%. The overall primary patency estimate was 81% at 24 months. Primary patency significantly increased after 2005 (p=0.005). Cox regression analysis revealed only age as a significant predictor of sustained primary patency (HR 0.60, p<0.005). Any previous endovascular intervention (HR 2.52, p=0.02) was the main predictor for loss of secondary patency; history of cardiovascular disease (HR 0.27, p=0.04) was the main predictor of sustained secondary patency. Conclusion: The kissing stent technique has a good safety profile and acceptable patency rates up to 2 years, even in TASC C and D lesions, supporting an endovascular-first approach for AIOD.

scholarly journals End-Stage Renal Disease and Limb Salvage

2013 ◽  
Vol 9 (2) ◽  
pp. 108-111 ◽  
Author(s):  
Houssam K. Younes ◽  
Mark G. Davies ◽  
Eric K. Peden
Keyword(s):  
Renal Disease ◽  
Limb Salvage ◽  
End Stage Renal Disease ◽  
Stage Renal Disease ◽  
End Stage

Comparison of Results in Endovascular Interventions for Infrainguinal Lesions: Claudication versus Critical Limb Ischemia

2005 ◽  
Vol 71 (6) ◽  
pp. 474-480 ◽  
Author(s):  
Susan M. Trocciola ◽  
Rabih Chaer ◽  
Rajeev Dayal ◽  
Stephanie C. Lin ◽  
Naveen Kumar ◽  
...  
Keyword(s):  
Limb Salvage ◽  
Critical Limb Ischemia ◽  
Clinical Success ◽  
Ankle Brachial Index ◽  
Duplex Ultrasound ◽  
Limb Ischemia ◽  
Arterial Disease ◽  
Transluminal Angioplasty ◽  
Primary Patency ◽  
Endovascular Interventions

This study analyzed clinical success, patency, and limb salvage after endovascular repair in patients treated for chronic limb ischemia presenting with claudication versus critical limb ischemia. Between October 2001 and August 2004, 115 patients (mean age 71) underwent endovascular treatment for infrainguinal arterial disease. Techniques included subintimal angioplasty and transluminal angioplasty with or without stents. Lesions were classified according to Transatlantic InterSociety Consensus. Follow-up (mean 11 months) included physical exam, ankle-brachial index, and duplex ultrasound. Patency rates were determined using Kaplan-Meier and compared by log-rank analysis. One hundred ninety-nine lesions were treated in 121 limbs using percutaneous techniques. Comorbidities were similar except higher rates of diabetes mellitus (67% vs 41%, P < 0.001) and chronic renal insufficiency (22% vs 7%, P < 0.05) were found in critical limb ischemia patients. Primary patency for claudicants was 100 per cent, 98 per cent, and 85 per cent at 3, 6, and 12 months and 89 per cent, 80 per cent, and 72 per cent for critical limb ischemia, respectively ( P = 0.06). Limb salvage was 91 per cent at 12 months for critical limb ischemia patients. Morbidity was similar between groups, and there was no perioperative mortality. Percutaneous intervention for both claudication and critical limb ischemia provides acceptable 12-month patency with limited morbidity.

Prevalence of Hyperhomocysteinemia in Vascular Disease: Comparative Study of Thrombotic Venous Disease Vis-è-Vis Occlusive Arterial Disease

Vascular ◽  
2007 ◽  
Vol 15 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Seema Bhargava ◽  
Rajiv Parakh ◽  
Anjali Manocha ◽  
Arif Ali ◽  
Lalit Mohan Srivastava
Keyword(s):  
Venous Thrombosis ◽  
Arterial Occlusion ◽  
Arterial Disease ◽  
Arterial Occlusive Disease ◽  
Occlusive Disease ◽  
Venous Disease ◽  
The North ◽  
Peripheral Vascular Occlusive Disease ◽  
Long Term Follow Up ◽  
Vascular Occlusive Disease

Studies on hyperhomocysteinemia in vascular occlusive disease have included mostly patients with arterial occlusion. However, more recent studies have included cases of venous occlusive disease as well. Our present study is aimed at comparing the prevalence of hyperhomocysteinemia in venous occlusive disease vis-è-vis arterial occlusive disease in the North Indian urban population. Homocysteine was estimated by chemiluminescent immunoassay in 205 normal controls and 536 patients, 244 presenting with arterial occlusion and 292 with venous thrombotic disease. The mean homocysteine in patients with arterial occlusion was 21.79 ± 0.09 μmol/L (mean ± standard error of measurement), in patients with venous thrombosis was 25.53 ± 0.1 μmol/L, and in controls was 11.33 ± 0.18 μmol/L. The prevalence of hyperhomocysteinemia (> 15 μmol/L) was 56.38% in arterial occlusive disease and 54.64% in venous thrombosis. In patients with peripheral vascular occlusive disease, patients with deep venous thrombosis (DVT) had the highest mean homocysteine level (25.51 μmol/L), which was even higher (32.14 μmol/L) when associated with pulmonary embolism (PE). There is a high prevalence of hyperhomocysteinemia in arterial and venous occlusive disease. Hence, in all patients with vascular occlusive disease, hyperhomocysteinemia should be elucidated and treated. In addition, long-term follow-up is required to ascertain whether the reduction in homocysteine decreases the thrombotic events and whether homocysteine levels can actually be of prognostic or predictive value in cases of DVT with PE.

Cocaine-Induced Peripheral Vascular Occlusive Disease

Angiology ◽  
1998 ◽  
Vol 49 (3) ◽  
pp. 221-224 ◽  
Author(s):  
John D. England ◽  
William C. Krupski ◽  
Amparo Gutierrez
Keyword(s):  
Occlusive Disease ◽  
Peripheral Vascular ◽  
Peripheral Vascular Occlusive Disease ◽  
Vascular Occlusive Disease

Use of dehydrated human amnion chorion membrane allograft on infected ruptured arteriovenous fistula: revision and closure

2019 ◽  
Vol 28 (Sup10) ◽  
pp. S10-S12
Author(s):  
Mutaz Al-Khateeb ◽  
Zaki Al-Muzakki ◽  
Mohammed Ftyan ◽  
Hussam Itani ◽  
Niki Istwan ◽  
...  
Keyword(s):  
Arteriovenous Fistula ◽  
Vascular Access ◽  
Haemodialysis Patient ◽  
Primary Patency ◽  
Human Amnion ◽  
Novel Approach ◽  
Hemodialysis Vascular Access ◽  
Stage Renal Disease ◽  
End Stage

Objective: Over two million individuals worldwide, with end-stage renal disease (ESRD), depend on dialysis therapy or a kidney transplant for survival. Every haemodialysis patient requires vascular access. The arteriovenous fistula (AVF) is preferred for long-term hemodialysis vascular access due to long-term primary patency rates. Given the limited options for haemodialysis access and placement, preservation of existing AVF sites is always a clinical priority. This case report describes a novel approach to wound closure with the application of dehydrated amnion chorion human membrane (dHACM) at an AVF surgical site known to be complicated with issues of scarring and tissue breakdown. The patient was treated successfully with the imperative preservation of his AVF given that he had few other vascular access options.

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