scholarly journals Antiplatelet therapy for tibial balloon angioplasty: A clinical perspective

2019 ◽  
Vol 7 ◽  
pp. 205031211985457
Author(s):  
Costin N Ionescu ◽  
Sophia E Altin ◽  
Carlos Mena-Hurtado
Keyword(s):  
Antiplatelet Therapy ◽  
Balloon Angioplasty ◽  
Therapeutic Approach ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Clinical Perspective ◽  
Post Intervention ◽  
Risk Of Bleeding ◽  
Number Of Patients ◽  
Percutaneous Transluminal

Percutaneous transluminal tibial balloon angioplasty has an important role in the therapeutic approach of critical limb ischaemia. Despite a growing number of patients with critical limb ischaemia, there are no trials to guide the pharmacologic approach post intervention. Guidelines pertaining to the antiplatelet therapy post percutaneous transluminal tibial balloon angioplasty have not been developed. In addition, critical limb ischaemia patients have multiple comorbidities and a higher risk of bleeding. To examine the shortest duration of antiplatelet therapy post percutaneous transluminal tibial balloon angioplasty, we reviewed the preclinical data used to develop the standards for the current angioplasty technique.

scholarly journals Embolic Protection in Complex Femoropopliteal Interventions: Safety, Efficacy and Predictors of Filter Macroembolization

2020 ◽  
Author(s):  
Michael Czihal ◽  
Zeynep Findik ◽  
Christoph Bernau ◽  
Max Seidensticker ◽  
Jens Ricke ◽  
...  
Keyword(s):  
Risk Factors ◽  
Balloon Angioplasty ◽  
Critical Limb Ischaemia ◽  
Lesion Length ◽  
Limb Ischaemia ◽  
Distal Embolization ◽  
Embolic Protection ◽  
Endovascular Interventions ◽  
Directional Atherectomy ◽  
Peripheral Embolization

Abstract Objectives To evaluate the safety and efficacy of a filter embolic protection device (FEPD) in endovascular interventions of the femoropopliteal arteries. Methods Patients who underwent endovascular interventions of the femoropopliteal arteries between 2008 and 2016 and in whom the SpiderFXTM FEPD was applied were included in this retrospective study. Clinical and angiographic characteristics, filter macroembolization (FME), device-related complications, distal embolization, as well as the early clinical and hemodynamic outcome, were assessed. Potential risk factors for FME were evaluated by multivariate analysis. Results A total of 244 cases were identified (203 patients, claudication 60.4%, critical limb ischaemia 39.6%, mean lesion length 13.2 ± 12.9 cm, complete occlusions in 72.7%). Balloon angioplasty ± stenting (BAP), directional atherectomy ± balloon angioplasty ± stenting (DA) and rotational thrombectomy ± balloon angioplasty ± stenting (RT) were performed in 141, 61 and 42 cases, respectively. FEPD placement and retrieval were successful in all but one case each. Permanent filter-related vessel damage was not observed. The rate of FME was 37.3% (BAP 36.2%, DA 32.8%, RT 47.7%). Risk factors for FME in the BAP- and DA-group were total occlusion, lesion length > 19 cm, visible thrombus and diabetes mellitus. The distal embolization rate despite filter protection was 4.1 % (BAP 4.9%, DA 1.6%, RT 4.8%) and was higher in cases with FME compared with those without FME (8.7% vs. 1.5%, p = 0.02). Conclusion The Spider FXTM device is safe and effective in capturing embolic debris during femoropopliteal interventions. A residual risk of peripheral embolization remains. Level of Evidence III, Cohort study

Dual antiplatelet therapy in surgery for critical limb ischaemia

2009 ◽  
Vol 96 (S1) ◽  
pp. 5-5
Author(s):  
A. Burdess ◽  
A. Nimmo ◽  
O. J. Garden ◽  
J. A. Murie ◽  
A. R. Dawson ◽  
...  
Keyword(s):  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia

scholarly journals Endovascular management of Critical Limb Ischaemia: Study of 100 Cases

2019 ◽  
Vol 12 (1) ◽  
pp. 40-44
Author(s):  
Md Humayun Kabir ◽  
Munshi Md Mojibur Rahman ◽  
AKM Musa Khan ◽  
Rumman Idris
Keyword(s):  
Limb Ischemia ◽  
Major Amputation ◽  
Severe Form ◽  
Tissue Loss ◽  
Critical Limb Ischaemia ◽  
Military Hospital ◽  
Limb Ischaemia ◽  
Rest Pain ◽  
Excellent Outcome ◽  
Number Of Patients

Background: Critical limb ischemia (CLI) is the most severe form of Peripheral Artery Disease (PAD) and represents approximately 1% of the total number of patients with PAD. CLI is associated with a higher risk of limb loss in the absence of revascularization. Objectives of the study are to find out the modality of treatment in CLI, different types of endovascular therapy in CLI and their outcome. Methods: A retrospective study evaluated 100 patients with CLI reported to cardiovascular surgery department in Combined Military Hospital (CMH), Dhaka between July 2016 to June 2018. Patients with disabling claudication or rest pain and tissue loss are included in the study. All patients were evaluated by peripheral angiogram and revascularisation of limbs was done by endovascular procedure in 79 patients, by surgical intervention in 12 patients. Results: Forty-four patients (44%) presented with rest pain and disabling claudication, 56 patients (56%) presented with tissue loss. Revascularization of limbs was done in 91 patients (93%). No intervention could be done in 9 patients (9%). Endovascular interventions were done in 79 patients (87%). Twelve patients (13%) underwent surgical bypass. All patients with rest pain remains asymptomatic in 6 months follow up; 2 patients developed reocclusion within 1 year. No major amputation in patients with only rest pain. Conclusion: Revascularization is the main modality of treatment in CLI. Most of the patient can be treated by endovascular percuteneous procedure. Early intervention in CLI patient without tissue loss carries excellent outcome. Cardiovasc. j. 2019; 12(1): 40-44

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