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

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.

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

Journal of Endovascular Therapy ◽

10.1583/03-1060.1 ◽

2004 ◽

Vol 11 (2) ◽

pp. 119-124 ◽

Cited By ~ 31

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

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

Journal of Vascular and Interventional Radiology ◽

10.1016/j.jvir.2015.06.034 ◽

2015 ◽

Vol 26 (10) ◽

pp. 1423-1430 ◽

Cited By ~ 11

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

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

Annals of Vascular Surgery ◽

10.1016/j.avsg.2015.08.015 ◽

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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Multidisciplinary Care Improves Amputation-Free Survival in Patients with Chronic Critical Limb Ischemia 1

50 Landmark Papers Every Vascular and Endovascular Surgeon Should Know ◽

10.1201/9780429434020-41 ◽

2020 ◽

pp. 206-208

Author(s):

Juan Carlos Jimenez ◽

Samuel Eric Wilson

Keyword(s):

Critical Limb Ischemia ◽

Multidisciplinary Care ◽

Limb Ischemia ◽

Free Survival ◽

Chronic Critical Limb Ischemia

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Opportunities for improvement of distal autologous reconstructions in patients with chronic critical limb ischemia

Zaporozhye Medical Journal ◽

10.14739/2310-1210.2019.1.155809 ◽

2019 ◽

Vol 0 (1) ◽

Author(s):

O. I. Gudz

Keyword(s):

Critical Limb Ischemia ◽

Limb Ischemia ◽

Chronic Critical Limb Ischemia

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Myocardial revascularization in diabetic patients presenting with critical limbischemia

Diabetes Mellitus ◽

10.14341/2072-0351-6053 ◽

2010 ◽

Vol 13 (4) ◽

pp. 25-29

Author(s):

Ivan Ivanovich Dedov ◽

Victor Yur'evich Kalashnikov ◽

Konstantin Vladimirovich Melkozerov

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Critical Limb Ischemia ◽

Myocardial Revascularization ◽

Limb Ischemia ◽

Diabetic Patients ◽

Preoperative Risk Assessment ◽

Therapeutic Modalities ◽

Optimal Drug ◽

Patients With Diabetes

The frequency of diabetic complications remains high despite the development of improved therapeutic modalities. Macroangiopathy continues to bethe predominant complication while coronary heart disease is the main cause of mortality.This paper considers clinical features of diabetic patientswith coronary heart disease and critical limb ischemia; various aspects of optimal drug therapy, preoperative examination and diagnostics precedingvascular non-cardiac surgery; preoperative risk assessment; indications for coronary angiography and myocardial revascularization. The authors emphasizethe importance of development of algorithms for the treatment of patients with diabetes, critical limb ischemia, and coronary heart disease.

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