Tips and Tricks in Below-Knee Peripheral Artery Disease Interventions

2021 ◽  
Vol 3 (2) ◽  
pp. 01-02
Author(s):  
Hüsnü Değirmenci ◽  
Eftal Murat Bakırcı ◽  
Şerif Yurt
Keyword(s):  
Lower Extremity ◽  
Endovascular Treatment ◽  
Peripheral Artery Disease ◽  
Tips And Tricks ◽  
Peripheral Artery ◽  
Treatment Techniques ◽  
Artery Disease ◽  
Important Form ◽  
Leg Ischemia

Critical leg ischemia, which threatens lower extremity and life, is an important form of lower extremity peripheral artery disease. Below-knee peripheral artery disease is an important part of critical leg ischemia. The most important treatment of below-knee peripheral artery disease is endovascular treatment. Knowing the endovascular treatment techniques is very important in increasing the success of the procedure. For this reason, we have presented this mini review called tips and tricks in below-knee peripheral artery disease interventios.

scholarly journals Accuracy of Ankle-Brachial Index Measurements in Evaluation of Critical Leg Ischemia

2013 ◽  
Vol 59 (2) ◽  
pp. 85-87
Author(s):  
Tímea Varga-Fekete ◽  
Katalin Felvinczi ◽  
Emese Kun-Bálint ◽  
A Puskás ◽  
E Nagy ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Ankle Brachial Index ◽  
Peripheral Artery ◽  
Critical Ischemia ◽  
Significant Difference ◽  
Ankle Pressure ◽  
The Mean ◽  
Artery Disease ◽  
Leg Ischemia

Abstract Aims: The ankle-brachial index is an efficient tool for objectively documenting the presence of lower extremity peripheral artery disease. However, its applicability for detection of critical leg ischemia is still controversial. We proposed to determine the diagnostic accuracy of the ankle-brachial index for critical ischemia. Materials and methods: Systolic blood pressure measurements for calculation of the ankle-brachial index were obtained in 90 patients with peripheral artery disease. Ankle-brachial index was computed in 3 different ways (using the lowest ankle pressure, the highest ankle pressure, and the mean of the ankle pressures), sensibility, specificity, positive and negative predictive value and overall accuracy for detecting critical ischemia were determined for each method. A value ≤ 0.4 was taken as cut-off point for critical leg ischemia. Prevalence of coronary and cerebrovascular atherosclerosis and conventional risk factors were also noted. Results: Using the lowest ankle pressure for computing ankle-brachial index provided higher sensitivity, and lower specificity for detecting critical leg ischemia, using the highest pressure was less sensitive, but more specific, and the mean pressure index gave intermediate results. Overall accuracy was highest for the latest method. The prevalence of generalized atherosclerosis was high in peripheral artery disease, but we found no significant difference between the intermittent claudication and the critical ischemia group. Conclusion: Ankle-brachial index measurements, regardless of the method used for calculation, cannot identify or rule out reliably critical leg ischemia. Peripheral artery disease confers an increased risk of cardiovascular disease regardless of symptom status or lower extremity perfusion severity.

scholarly journals Reporting standards of the Society for Vascular Surgery for endovascular treatment of chronic lower extremity peripheral artery disease

2016 ◽  
Vol 64 (1) ◽  
pp. e1-e21 ◽  
Author(s):  
Michael C. Stoner ◽  
Keith D. Calligaro ◽  
Rabih A. Chaer ◽  
Alan M. Dietzek ◽  
Alik Farber ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Vascular Surgery ◽  
Endovascular Treatment ◽  
Peripheral Artery Disease ◽  
Reporting Standards ◽  
Peripheral Artery ◽  
Artery Disease

Relationship of triglyceride–glucose index with chronic limb-threatening ischemia in lower extremity peripheral artery disease

Vascular ◽  
2021 ◽  
pp. 170853812110183
Author(s):  
Arda Aybars Pala ◽  
Yusuf Salim Urcun
Keyword(s):  
Lower Extremity ◽  
High Density Lipoprotein ◽  
Peripheral Artery Disease ◽  
Density Lipoprotein ◽  
Peripheral Artery ◽  
Tyg Index ◽  
Triglyceride Glucose Index ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Objectives Triglyceride-glucose index (TyG index), which is defined as the simple and novel marker of insulin resistance, is becoming increasingly important as a promising predictive marker for atherosclerotic diseases. Chronic limb-threatening ischemia is defined as the most advanced stage of the lower extremity peripheral artery disease, whose main cause is atherosclerosis and is associated in this respect with amputation, impaired quality of life, and mortality. The main purpose of the present study was to investigate the relation between the calculated TyG index values and chronic limb-threatening ischemia development. Methods A total of 296 patients who were diagnosed with lower extremity peripheral artery disease in our outpatient clinic between October 2018 and October 2020 were included in this study retrospectively. Two groups were formed by clinically staging the patients according to Rutherford Classification. Patients who did not develop chronic limb-threatening ischemia were classified as “Group 1” ( n = 224) and those who developed were classified as “Group 2” ( n = 72). Results The mean TyG index values that were calculated in Group 2 were significantly higher than in Group 1 (9.27 ± 0.31 vs. 9.00 ± 0.34, p < 0.001). In the multivariate logistic regression analysis conducted to determine the predictors of chronic limb-threatening ischemia development, C-reactive protein (OR [Odds Ratio]: 1.220, 95% CI [confidence interval]: 1.092–1.363, p < 0.001), high-density lipoprotein cholesterol (OR: 0.775, 95% CI: 0.715–0.839, p < 0.001) and TyG index (OR: 5.796, 95% CI: 2.050–16.382, p = 0.001) were identified as independent predictors. Receiver operating characteristic analysis revealed that the cut-off value of TyG index was 9.13 (area under the curve: 0.721, p < 0.001) with 70.8% sensitivity and 65.2% specificity. The TyG index was significantly correlated with Rutherford category, high-density lipoprotein cholesterol and mean platelet volume. Conclusions Chronic limb-threatening ischemia development may be predicted with the TyG index value, which is calculated easily from routine biochemical parameters, in patients diagnosed with lower extremity peripheral artery disease.

scholarly journals Guideline-Oriented Therapy of Lower Extremity Peripheral Artery Disease (PAD) – Current Data and Perspectives

2019 ◽  
Vol 191 (04) ◽  
pp. 311-322 ◽  
Author(s):  
Jonas Kersting ◽  
Lars Kamper ◽  
Marco Das ◽  
Patrick Haage
Keyword(s):  
Lower Extremity ◽  
Peripheral Artery Disease ◽  
Bypass Surgery ◽  
Interdisciplinary Approach ◽  
Current Data ◽  
Arterial System ◽  
Peripheral Artery ◽  
Vascular Surgeon ◽  
Technical Developments ◽  
Artery Disease

Background Because of the demographic change, lower extremity peripheral artery disease (PAD) is becoming increasingly relevant with respect to health economics. PAD patients often suffer from multiple diseases. Consequently, therapy is commonly complex and requires an interdisciplinary approach. Because of rapid technical developments, interventional endovascular therapy regimens play an increasingly important role. Method Review and literature search on the basis of the current German S3 guidelines on the therapy of PAD as well as international guidelines. In terms of state-of-the-art therapies, relevant current studies were considered. Results Knowledge of existing guidelines and recommendations as well as new therapeutic approaches is essential for the adequate therapy of PAD patients. A close cooperation between the interventional radiologist and the vascular surgeon is the key to success. In addition to established conservative approaches and invasive bypass surgery, the endovascular approach has been a mainstay in the TASC A and B environment for years. It has recently shown promising results in advanced PAD conditions, such as TASC C and D. An endovascular-first strategy is defined in most guidelines. Conclusion A primarily endovascular-first strategy has become the standard in the majority of even complex lesions of the lower extremity arterial system. Regarding the crural segment, a decrease in mortality compared to bypass surgery has been demonstrated. Further evidence can be expected from ongoing randomized multicenter trials. Key Points:  Citation Format

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