scholarly journals Mechanical rotational thrombectomy with Rotarex system augmented with drug-eluting balloon angioplasty vs. stenting for the treatment of acute thrombotic and critical limb ischaemia in the femoropopliteal segment

2019 ◽  
Vol 14 (2) ◽  
pp. 311-319 ◽  
Author(s):  
Paweł Latacz ◽  
Marian Simka ◽  
Paweł Brzegowy ◽  
Marek Piwowarczyk ◽  
Tadeusz Popiela
Keyword(s):  
Balloon Angioplasty ◽  
Critical Limb Ischaemia ◽  
Limb Ischaemia ◽  
Rotational Thrombectomy ◽  
Drug Eluting ◽  
Drug Eluting Balloon

scholarly journals The efficacy of paclitaxel drug-eluting balloon angioplasty versus standard balloon angioplasty in stenosis of native hemodialysis arteriovenous fistulas

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P Cisneros Clavijo ◽  
M Donato ◽  
J Ajila ◽  
K Garzon ◽  
F Escobar ◽  
...  
Keyword(s):  
Vascular Access ◽  
Balloon Angioplasty ◽  
Clinical Signs ◽  
Target Lesion ◽  
High Rate ◽  
Central Type ◽  
Group A ◽  
Drug Eluting ◽  
Drug Eluting Balloon ◽  
Group B

Abstract Background End stage renal disease is on increasing trend and haemodialysis is the main dialysis modality among these patients. Thus, a functioning dialysis vascular access is critical to the delivery of life-saving haemodialysis treatment to these patients. Conventional angioplasty is the first line of treatment; with a 50% of permeability rate (6 months). For this reason, new alternatives are necessary to maintain the access permeability.Hypothesis: Paclitaxel coated balloon is superior to conventional plain balloon angioplasty with decreased re-stenosis of target lesion, improved access circuit and target lesion patency, and decreased number of interventions needed to maintain patency. Methods A total of 39 patients were randomized to receive a paclitaxel-coated balloon (n=15) or plain angioplasty balloon (n=24) after satisfactory angioplasty with a high-pressure balloon. The inclusion criteria were clinical signs of vascular dysfunction confirmed by Doppler Ultrasound and/or angiography. The primary endpoint was target lesion patency defined as time elapsed between the completion of effective and the appearance of restenosis at 3, 6 and 12 months after angioplasty. Secondary endpoints included the relationship between the location of the stenosis, previous angioplasty, demographic variables and survival. Results We recruited 39 patients with dysfunctional vascular accesses; 24 were assigned to the conventional balloon angioplasty group and 15 drug-eluting balloon angioplasty (paclitaxel). With demographic characteristics in Table I. In group A, all were autologous acces. Group B 16% (4) of the accesses were prosthetic and 84% (20) autologous. In relation to the type and length of stenosis, group A was more frequent at the level and longer, whereas in group B it predominated in the central type and less than 20 mm.In our study, we also observed a high rate of total occlusions, frequently in central vessels in group B, while in group A, where peripheral vessels were predominant, total occlusion was less frequent. Table II. We had no complications in either group, and dialysis was immediate at the end of the procedure. Group A did not present restenosis. Table III. Table III shows DEB group (15p) with 100% of permeability according to follow-up and only one (1/15) of patients died due to myocardial infarction and cerebrovascular accident and this patient kept lasted 9 months without restenosis In Table IV. Group B had 2 (8%) patients with restenosis so it was necessary to reoperate using a drug eluting balloon and until now there is no restenosis. From this group we do not have mortality. One patient 1 (24%) had a recovered infarction. Conclusions Paclitaxel-coated balloon angioplasty resulted in superior survival of dysfunctional peripheral vascular access at 12 meses. Both arms show equivalent complications and similar mortality FUNDunding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Enrique Garcés Hospital

scholarly journals Hemodialysis Arteriovenous Fistula and Graft Stenoses: Randomized Trial Comparing Drug-eluting Balloon Angioplasty with Conventional Angioplasty

Radiology ◽  
2018 ◽  
Vol 289 (1) ◽  
pp. 238-247 ◽  
Author(s):  
Farah Gillan Irani ◽  
Terence Kiat Beng Teo ◽  
Kiang Hiong Tay ◽  
Win Htet Yin ◽  
Hlaing Hlaing Win ◽  
...  
Keyword(s):  
Randomized Trial ◽  
Arteriovenous Fistula ◽  
Balloon Angioplasty ◽  
Drug Eluting ◽  
Conventional Angioplasty ◽  
Drug Eluting Balloon ◽  
Hemodialysis Arteriovenous Fistula

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

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.

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