scholarly journals Endovascular therapy for severely calcified plaque at the superficial femoral artery using myocardial biopsy forceps

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Shojiro Hirano ◽  
Atsushi Funatsu ◽  
Shigeru Nakamura ◽  
Takanori Ikeda
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Calcium Score ◽  
Biopsy Forceps ◽  
Myocardial Biopsy ◽  
Deep Femoral Artery ◽  
Total Occlusion ◽  
Stent Expansion ◽  
Calcified Plaque ◽  
The Right

Abstract Background Currently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion. Main text A 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque (Angiographic calcium score: Group4a [1]) at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA. Conclusions Biopsy forceps may be used in some endovascular cases to remove severely calcified lesions. To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

scholarly journals A Successful Case of Endovascular Therapy for Severely Calcified Plaque Removed by Biopsy Forceps at the Superficial Femoral Artery

2021 ◽  
Author(s):  
Shojiro Hirano ◽  
Atsushi Funatsu ◽  
Shigeru Nakamura ◽  
Takanori Ikeda
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Chronic Total Occlusion ◽  
Biopsy Forceps ◽  
Deep Femoral Artery ◽  
Total Occlusion ◽  
Stent Expansion ◽  
Successful Case ◽  
Calcified Plaque ◽  
The Right

Abstract BackgroundCurrently, the success rate of EVT for treating CTO of the SFA is high; however, EVT is still found to be insufficient in treating CTOs with severely calcified lesions. Even if the guidewire crosses the lesion, the calcifications may still cause difficulties during stent expansion.Main textA 78-year-old male had been reported to have intermittent claudication with chronic total occlusion (CTO) of the right superficial femoral artery (SFA). Angiography revealed severely calcified plaque at the ostium of the SFA. Stenting posed a risk of underexpansion, causing the plaque to shift to the deep femoral artery. we decided to remove the calcified plaque using biopsy forceps. After removing the extended calcified plaque, the guidewire could cross easily, and the self-expandable stent was well dilated without causing the plaque to shift to the DFA. ConclusionBiopsy forceps may be used in some endovascular cases to remove severely calcified lesions.To ensure the safety of the patient, the physician must be adept at performing this technique before attempting it.

scholarly journals Variability of Lower Limb Artery Systolic–Diastolic Velocities in Futsal Athletes and Non-Athletes: Evaluation by Arterial Doppler Ultrasound

2020 ◽  
Vol 17 (2) ◽  
pp. 570
Author(s):  
Pedro Duarte-Mendes ◽  
Rui Paulo ◽  
Patrícia Coelho ◽  
Francisco Rodrigues ◽  
Vasco Marques ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Popliteal Artery ◽  
Lower Limb ◽  
Vascular Remodeling ◽  
Deep Femoral Artery ◽  
Cross Sectional ◽  
Diastolic Velocity ◽  
The Right

Background: Sports athletes, namely high-intensity practitioners, suffer from vascular remodeling overtime. The purpose of this study was to analyze the systolic and diastolic velocities’ variation between non-athletes and futsal athletes by means of arterial lower limb doppler ultrasound. Additionally, we intended to verify if the velocity variations occur primarily at the systolic or the diastolic level and in which arteries. Methods: Seventy-six young males (mean ± SD: 24.9 ± 2.8 years old) volunteered to participate in this cross-sectional study and were divided into two groups: a futsal athletes group (n = 38; 24 ± 2.78 years) in the central region of Portugal playing on the 2nd national league with the same level of practice (16 ± 2.4 years of practice) and a non-athletes group (n = 38: 26 ± 1.8 years) who did not practice sports regularly and were not federated in any sport. All the subjects agreed to participate in the study with the aim of assessing the arterial lower limb through doppler ultrasound (Philips HD7 echograph with linear transducer 7–12 MHz). Results: Differences between groups (p ≤ 0.05) in the systolic velocity of the left deep femoral artery (p = 0.022; d = 0.546, small) and in the right superficial femoral artery (p = 0.028; d = −0.515, small) were found. We also found differences in the diastolic velocity: in the left common femoral artery (p = 0.002; d = −0.748, moderate), in the right deep femoral artery (p = 0.028; d = −0.521, small), in the right superficial femoral artery (p = 0.026; d = −0.522, small), in the right popliteal artery (p = 0.002; d = −0.763, moderate), and in the left popliteal artery (p = 0.007; d = −0.655, moderate). Moreover, the athletes’ group presented the highest mean values, with the exception of the systolic velocity of the left deep femoral artery. In intragroup analysis of variance referring to systolic and diastolic velocities in arterial levels in the right and left arteries, differences were found in all analyses (p ≤ 0.05). Conclusions: We conclude that futsal athletes of our sample go through a process of changes such as increased blood flow velocity in systolic and diastolic cardiac phase in all studied lower limb arteries, showing that the remodeling occurs regardless of vessel radius. Our results reinforce the existence of vascular remodeling that may vary with the sport and its intensity.

Surgical and endovascular treatment of a bilateral deep femoral artery aneurysm

2020 ◽  
Vol 30 (6) ◽  
pp. 945-946 ◽  
Author(s):  
Satoshi Okugi ◽  
Kazumasa Watanabe ◽  
Yoshifumi Kunii ◽  
Masaaki Koide
Keyword(s):  
Endovascular Treatment ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Rare Case ◽  
Artery Aneurysm ◽  
Deep Femoral Artery ◽  
Stent Grafts ◽  
Postoperative Course ◽  
The Right ◽  
Deep Femoral Artery Aneurysm

Abstract We report the rare case of a 68-year-old man with a bilateral deep femoral artery aneurysm. Right-sided rupture was treated via plug embolization of the right deep femoral artery and ligation. In the following year, Viabahn® stent grafts were placed in the left superficial femoral artery to relieve occlusion and in the left deep femoral artery to treat the left aneurysm. The postoperative course of the patient was uneventful.

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.

Syndactylization as a technique in treatment of infectious limb following aortobifemoral reconstruction

Vascular ◽  
2013 ◽  
Vol 21 (3) ◽  
pp. 157-158 ◽  
Author(s):  
Nikola S Ilic ◽  
Marko Dragas ◽  
Igor Koncar ◽  
Dusan Kostic ◽  
Sinisa Pejkic ◽  
...  
Keyword(s):  
Vascular Surgery ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Deep Femoral Artery ◽  
Vascular Surgeon

The infection in vascular surgery is a nightmare of every vascular surgeon. There are numerous ways of treatment but neither one is definitive. We present the case of the patient with infectious limb following aortobifemoral reconstruction treated by partial graft extirpation and with re-implantation of the superficial femoral artery into deep femoral artery.

scholarly journals Percutaneous Treatment of Superficial Femoral Artery Total Occlusions: Single Center Experience

Acta Medica ◽  
2019 ◽  
Vol 50 (4) ◽  
pp. 30-35
Author(s):  
AHMET HAKAN ATEŞ ◽  
AYSU BAŞAK ÖZBALCI ◽  
SELİM KUL ◽  
MUSTAFA YENERÇAĞ ◽  
Metin Okşul ◽  
...  
Keyword(s):  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Treatment Strategy ◽  
Percutaneous Treatment ◽  
Arterial Disease ◽  
Complication Rates ◽  
Total Occlusion ◽  
First Choice ◽  
Stenting Procedure

Objectives Superficial femoral artery (SFA) is the most commonly effected vessel in peripheral arterial disease (PAD) and SFA total occlusions constitute the 50% of PAD patients presenting with symptoms. In this study, we investigated our patients with SFA total occlusions who were treated with percutaneous treatment strategy.   Methods In this study, we included ambulatory patients who were admitted to our clinics due to symptomatic severe SFA total occlusion and underwent PTA or PTA + stenting procedure.The demographic findings of the patients, procedure details, complications and follow-up results were noted. Results Out of 67 patients, 62 (92.5%) underwent PTA or PTA + stenting procedure successfully for SFA total occlusions. Only one serious complication, acute renal failure resulting in death developed during hospitalization. The mean follow-up time after the procedure was 11.1±7.2 months. During this follow-up time 36 (58.1%) were asymptomatic.  Out of 26 patients who were symptomatic, only 6 of them underwent reintervention and 3 were recommended surgical intervention.   Conclusion Peripheral interventions for SFA total occlusions are being performed successfully in experienced centers with low complication rates as the first treatment strategy in PAD. Herein,we have presented our patients who underwent successful PTA and/or stenting procedure with   high success and low complication rates. Peripheral interventions should be the first choice for SFA total occlusions in experienced centers.  

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