752 results match your criteria artery below-the-knee


[Clinical application progress of bioresorbable vascular scaffolds in lower extremities arteriosclerotic obliterans].

Zhonghua Wai Ke Za Zhi 2021 Dec 1;59(12):1035-1039. Epub 2021 Dec 1.

Department of Vascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.

Endovascular technology has become the first choice for the treatment of lower extremities arteriosclerotic obliterans. Bioresorbable vascular scaffolds have attracted more and more attention as a choice of endovascular technology. In the last decade, poly(L-lactic acid) bioresorbable scaffolds with or without drug coating have shown acceptable medium and long-term safety and efficacy in lower extremities arteriosclerotic obliterans, but the lesions of the subjects were relatively simple. Read More

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December 2021

[Debulking strategy of endovascular treatment for lower extremity artery lesions].

Zhonghua Wai Ke Za Zhi 2021 Dec 1;59(12):976-981. Epub 2021 Dec 1.

Department of Vascular Surgery,Zhongshan Hospital,Fudan University,Shanghai 200032,China.

To explore the debulking strategy of lower extremity artery lesions. Retrospectively analyzed the clinical data of 101 patients underwent debulking therapy at Department of Vascular Surgery,Zhongshan Hospital,Fudan University from June 2019 to June 2020.There were 74 males and 27 females,aged (73. Read More

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December 2021

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes.

Int J Environ Res Public Health 2021 Nov 15;18(22). Epub 2021 Nov 15.

Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland.

Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Read More

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November 2021

2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation.

Vasa 2021 Nov 25. Epub 2021 Nov 25.

Department of Surgery, Vascular and Endovascular Surgery Unit, San Giovanni di Dio Hospital, Florence, Italy.

Two-dimensional (2D) perfusion angiography is useful for the evaluation of foot perfusion in patients with critical limb-threatening ischemia (CLTI). Iloprost is a synthetic prostacyclin analogue presenting vasodilating properties. Aim of this study was to demonstrate the utility of 2D perfusion angiography as quantitative method to evaluate iloprost effect on foot circulation. Read More

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November 2021

Resurfacing the donor sites of reverse sural artery flaps using thoracodorsal artery perforator flaps.

Arch Plast Surg 2021 Nov 15;48(6):691-698. Epub 2021 Nov 15.

Department of Plastic and Reconstructive Surgery, Hanyang University College of Medicine, Seoul, Korea.

Background: The reverse sural artery (RSA) flap is widely used for lower extremity reconstruction. However, patients sometimes suffer from donor site complications such as scar contracture and paresthesia, resulting in dissatisfaction with the aesthetic outcomes. This study investigated the characteristics of donor site morbidity associated with RSA flaps and described our experiences of dealing with complications by performing resurfacing surgery using thoracodorsal artery perforator (TDAP) flaps. Read More

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November 2021

Comparison of standard balloon and drug-coated balloon angioplasty in patients with the below-the-knee peripheral artery disease.

Rev Assoc Med Bras (1992) 2021 Sep;67(9):1246-1250

University of Health Sciences, Samsun Training and Research Hospital, Cardiovascular Surgery Department - Samsun, Turkey.

Objective: The objective of this study was to compare the interventions of percutaneous transluminal drug-coated balloon angioplasty (DCB PTA) and standard PTA in the treatment of patients with the below-the-knee peripheral artery disease (BTK PAD).

Methods: Overall, 196 patients (113 males and 83 females; mean age: 63.56±11. Read More

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September 2021

The role of atherectomy in BTK lesions. A systematic review.

J Cardiovasc Surg (Torino) 2021 Nov 18. Epub 2021 Nov 18.

Division of Vascular Surgery -

Introduction: To evaluate the current role of atherectomy techniques (ATH) in treatment of peripheral arterial disease (PAD) at below the knee (BTK) arteries.

Evidence Acquisition: The PubMed and Embase were searched (last search on 11 September 2021) for studies reporting on the early and mid-term outcomes of ATH in BTK vessels. Analysis included the data from six studies, with a total of 1062 PAD patients treated with various ATH techniques. Read More

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November 2021

Grades of below-the-ankle arterial occlusive disease following the angiosome perfusion: A new morphological assessment and correlations with the inframalleolar GVG stratification in CLTI patients.

Ann Vasc Surg 2021 Nov 12. Epub 2021 Nov 12.

Department of Geriatric care, Princess Paola Hospital Marche-en-Famenne, IFAC/Vivalia.

Purpose: To assess a specific classification of the foot atherosclerotic disease concerning the angiosomal source arteries, the connected foot arches and attached collaterals for Rutherford 5, CLTI patients. To compare eventual analogies of this novel grading system with previously reported GLASS/GVG inframalleolar patterns of occlusive disease (P0-P2).

Materials And Methods: A series of 336 ischemic feet (221 diabetics) were selected and retrospectively analyzed. Read More

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November 2021

Results of Surgical Treatment for Popliteal Aneurysm.

Ann Vasc Surg 2021 Nov 11. Epub 2021 Nov 11.

Vascular Surgery Department. Universitary Hospital Lucus Augusti. Lugo, Spain.

Objective: Evaluate the results of open surgery treatment of popliteal artery aneurysms (PAAs), performed in our department for over 25 years, comparing those treated with a medial approach with those treated with a posterior approach.

Material And Method: A retrospective analysis of a total of 88 PAAs, performed between January 1994 and December 2018, with an average of 65 months follow-up, comparing the results of 59 patients operated by a medial approach (group 1) in which aneurysm exclusion and femoro-popliteal bypass below the knee was carried out, with 29 cases treated by a direct posterior approach (group 2) - aneurismectomy and graft interposition-. The postoperative complications, immediate and long term patency, limb salvage and mortality rate were studied. Read More

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November 2021

The Association of Cardio-Ankle Vascular Index and Ankle-Brachial Index in Patients with Peripheral Arterial Disease.

Authors:
Taichiro Hayase

Pulse (Basel) 2021 Sep 7;9(1-2):11-16. Epub 2021 Jul 7.

Department of Cardiology, Yokohamashintoshi Neurosurgical Hospital, Yokohama, Japan.

Introduction: The cardio-ankle vascular index (CAVI) is a well-known index to evaluate arterial stiffness and predict cardiovascular risk.

Methods: We investigated whether CAVI can predict severity and extent of peripheral arterial disease. This study was a single-center, retrospective, observational study approved by the Ethics Committee of Yokohama Shintoshi Neurosurgical Hospital. Read More

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September 2021

Differences Between Patients With Intermittent Claudication and Critical Limb Ischemia Undergoing Endovascular Intervention: Insights From the Excellence in Peripheral Artery Disease Registry.

Circ Cardiovasc Interv 2021 11 27;14(11):e010635. Epub 2021 Oct 27.

University of Texas Southwestern Medical Center, Dallas (K.P., Y.L., M.A.A., N.M., I.T., S.B.).

Background: There are limited data on differences in angiographic distribution of peripheral artery disease and endovascular revascularization strategies in patients presenting with intermittent claudication (IC) and critical limb ischemia (CLI). We aimed to compare anatomic features, treatment strategies, and clinical outcomes between patients with IC and CLI undergoing endovascular revascularization.

Methods: We examined 3326 patients enrolled in the Excellence in Peripheral Artery Disease registry from 2006 to 2019 who were referred for endovascular intervention for IC (n=1983) or CLI (n=1343). Read More

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November 2021

Clinical outcome of the patients with femoropopliteal artery disease after endovascular therapy: focused on drug-coated-balloon-related distal embolism detected by laser doppler flowmetry.

Cardiovasc Interv Ther 2021 Oct 19. Epub 2021 Oct 19.

Department of Cardiology, Rakuwakai Marutamachi Hospital, Kyoto, Japan.

Several trials have shown that paclitaxel drug-coated balloons (DCBs) significantly reduce restenosis rates. However, some reports have shown distal embolisms occurring after DCBs. No study has analyzed the clinical outcomes of patients with DCB-induced distal embolism. Read More

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October 2021

In-patient care trends in peripheral artery disease in the German healthcare system over the past decade.

Eur Radiol 2021 Oct 13. Epub 2021 Oct 13.

Department of Diagnostic and Interventional Radiology, University Hospital Augsburg, Augsburg, Germany.

Objectives: To analyze trends of in-hospital treatment of patients admitted due to peripheral artery disease (PAD) from 2009 to 2018 with special focus on comorbidities, revascularization procedures, resulting costs, and outcome.

Methods: Using data from the research data center of the German Federal Statistical Office, we included all hospitalizations due to PAD Fontaine stage IIb or higher from 2009 to 2018. To analyze comorbidities, Elixhauser diagnostic groups and linear van Walraven score (vWS) were assessed. Read More

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October 2021

Distal arteriovenous fistula to preserve patency in COVID-19-associated acute limb ischemia.

Semin Vasc Surg 2021 Sep 5;34(3):96-100. Epub 2021 Sep 5.

Vascular Surgery Unit, Cardioneurovascular Department, Aulss 2 Marca Trevigiana, Treviso Hospital, Italy.

The purpose of this study was to report our institutional experience with patients with COVID-19 who developed acute limb ischemia during hospitalization and to determine the characteristics and clinical outcomes. Between March 2020 and January 2021, we treated 3 patients who were COVID-19-positive and developed acute limb ischemia after they received thromboprophylaxis. We performed an embolectomy by exposing the popliteal artery below the knee to treat an occlusion of the popliteal and tibial arteries. Read More

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September 2021

Outcomes of Revascularization and Factors Associated With Major Amputation in Patients With Lower Limb Arterial Injury: A Single-Center Retrospective Analysis.

Cureus 2021 Aug 18;13(8):e17290. Epub 2021 Aug 18.

Internal Medicine, Dow University of Health Sciences, Karachi, PAK.

Objective To identify the amputation rates and causative factors for failed revascularization leading to amputation in patients undergoing primary limb salvage procedures for lower-extremity vascular injuries. Methods This retrospective study was conducted at the vascular surgery department, Shaheed Mohtarma Benazir Bhutto (SMBB) Institute of Trauma, Karachi, Pakistan. The data were collected from hospital record using the non-probability sampling technique. Read More

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Progress on developing an effective below-the-knee drug-coated balloon.

Rev Cardiovasc Med 2021 Sep;22(3):585-595

Division of Vascular and Endovascular Surgery, University of California, San Francisco, CA 94143, USA.

Infrapopliteal atherosclerotic disease continues to present the greatest conundrum for effective endovascular therapies. To date, conventional angioplasty has been fraught with early restenosis and recoil in these complex, long, calcified, and occlusive lesions. The success of metallic drug-eluting stents in coronary arteries has not carried over to below-the-knee arteries. Read More

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September 2021

Comparison of angiographic and intravascular ultrasound vessel measurements in infra-popliteal endovascular interventions: The below-the-knee calibration study.

Cardiovasc Revasc Med 2021 Sep 16. Epub 2021 Sep 16.

Cardiology, NC Heart and Vascular Research, LLC, UNC School of Medicine, Raleigh, NC, USA. Electronic address:

Background: Endovascular revascularization (ER) via percutaneous transluminal angioplasty (PTA) and stenting are viable options for revascularization in below-the-knee (BTK) peripheral arterial disease. Two-dimensional angiography has been the standard of practice for estimating vessel size and selecting treatment devices during ER. However, in other vascular territories, intravascular ultrasound (IVUS) offers better visualization of the lumen dimensions. Read More

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September 2021

Below the knee percutaneous transluminal angioplasty for claudicants: One vessel is enough to relieve symptoms.

Catheter Cardiovasc Interv 2021 09;98(3):570-571

Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.

Among patients with lower extremities arterial disease (LEAD), treatment of below the arteries has been historically limited to the treatment of chronic limb-threatening ischemia (CLTI), as recommended by available guidelines. In this study, the authors provided new data on the role of different endovascular revascularization anatomical strategies of the below the knee (BTK) arteries adopted in claudicant LEAD patients. The revascularization of the anterior tibial artery seems more effective for symptoms relieves than of the posterior territories and most of the adverse events occurred in the follow up period were target vessel revascularization, suggesting that revascularization of single vessel is enough to achieve clinical success. Read More

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September 2021

Antegrade Superficial Femoral Artery Approach Using Manual Compression and 4-F Delivery System for Infrainguinal Occlusive Disease.

Ann Vasc Surg 2021 Aug 27. Epub 2021 Aug 27.

Department of Vascular and Endovascular Surgery, Paris St. Joseph Hospital Group, Paris, France.

Background: This study sought to assess the feasibility and safety of antegrade superficial femoral artery (SFA) duplex-guided puncture using a 4-F catheter sheath and manual compression for the treatment of infrainguinal occlusive lesions.

Methods: From March 2017 to March 2019, all patients who underwent endovascular treatment employing an antegrade SFA approach for femoropopliteal or below-the-knee lesions were included in this study. Follow-up included clinical and duplex ultrasound examinations at 1 month. Read More

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Intravascular Lithotripsy for Treatment of Calcified Infrapopliteal Lesions: Results from the Disrupt PAD III Observational Study.

J Endovasc Ther 2021 Aug 12:15266028211032953. Epub 2021 Aug 12.

Division of Cardiology, Rocky Mountain Regional VA Medical Center, University of Colorado, Denver, CO, USA.

Purpose: To evaluate the safety and effectiveness of the Shockwave S intravascular lithotripsy (IVL) catheter in an "all-comers" cohort of patients with calcified infrapopliteal lesions.

Materials And Methods: The Disrupt PAD III Observational Study (NCT02923193) is a prospective, nonrandomized, multicenter single-arm study designed to assess the "real-world" acute safety and effectiveness of the Shockwave Peripheral IVL System for the treatment of de novo calcified, stenotic peripheral arteries. Patients were eligible for enrollment if they had claudication or critical limb ischemia (CLI) and at least moderate calcification as assessed by angiography. Read More

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Improving Symptoms of Peripheral Artery Disease With Hirudotherapy.

Cureus 2021 Jul 8;13(7):e16270. Epub 2021 Jul 8.

Family Medicine, Wayne State University School of Medicine, Detroit, USA.

Peripheral artery disease (PAD) is a significant cause of morbidity and mortality in the world. Critical limb ischemia is a complication of PAD that leads to severe pain at rest, numbness, and absent or diminished pulses in the legs or feet. Revascularization with surgery or endovascular intervention is required to re-establish blood flow to the affected areas. Read More

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Retrograde Revascularization of Tibial Arteries in Patients with Critical Limb Ischemia: Plantar-Arch Versus Transpedal Approach.

J Endovasc Ther 2021 Aug 6:15266028211036480. Epub 2021 Aug 6.

Institute for Diagnostic and Interventional Radiology/Neuroradiology, SANA Hospital, Lübeck, Germany.

Purpose: To compare retrograde plantar-arch and transpedal-access approach for revascularization of below-the-knee (BTK) arteries in patients with critical limb ischemia (CLI) after a failed antegrade approach.

Materials And Methods: Retrospectively we identified 811 patients who underwent BTK revascularization between 1/2014 and 1/2020. In 115/811 patients (14. Read More

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Retrograde use of the Outback re-entry catheter in complex infrainguinal arterial recanalizations.

J Vasc Surg 2021 Jul 22. Epub 2021 Jul 22.

Abteilung für Innere Medizin, SRH Klinikum Karlsbad-Langensteinbach, Karlsbad, Germany. Electronic address:

Objective/background: Retrograde recanalizations gained increasing recognition in complex arterial occlusive disease. Re-entry devices are a well-described adjunct for antegrade recanalizations. We present our experience with retrograde, infrainguinal recanalizations using the Outback re-entry catheter in challenging chronic total occlusions. Read More

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Preclinical Evaluation of the Temporary Drug-Coated Spur Stent System in Porcine Peripheral Arteries.

J Endovasc Ther 2021 Dec 19;28(6):938-949. Epub 2021 Jul 19.

Clinical and Experimental Interventional Cardiology, University of Saarland, HomburgSaar, Germany.

Background: Drug penetration into the deeper arterial wall of heavily calcified lesions is one of the limitations of drug-coated balloons and drug-eluting stents in vascular interventions. The Temporary Spur Stent (TSS) system is characterized by a self-expanding nitinol stent that is uniformly covered in radialspikes, which, when coated, should allow a deeper penetration and longer retention of the drug into the diseased artery walls by penetrating through the calcified plaques.

Materials And Methods And Results: Uncoated TSS and paclitaxel (PTX)-coated TSS systems have been deployed in porcine peripheral arteries. Read More

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December 2021

Influence of pedal arch quality on 5-year survival and limb salvage in patients with diabetic foot ulcers undergoing peripheral angiography.

Vascular 2021 Jul 13:17085381211032050. Epub 2021 Jul 13.

Department of Surgery, Vascular and Endovascular Surgery Unit, 26187San Giovanni di Dio Hospital, Florence, Italy.

Introduction: The aim of this study was to evaluate the influence of pedal arch quality on 5-year survival and limb salvage in diabetic patients with foot wounds undergoing peripheral angiography.

Methods: Between January 2014 and December 2014, 153 diabetic patients with foot wounds underwent peripheral angiography. Final foot angiograms were used to allocate patients according to pedal arch: complete pedal arch (CPA), incomplete pedal arch (IPA), and absent pedal arch (APA). Read More

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Overview of the Virtual 2021 FDA's Circulatory System Devices Advisory Panel on Lutonix 014 Drug-Coated Percutaneous Transluminal Angioplasty Catheter for Below-the-Knee Lesions in Critical Limb Ischemia.

Cardiovasc Revasc Med 2021 Dec 19;33:55-61. Epub 2021 Jun 19.

Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, USA. Electronic address:

Peripheral artery disease, along with subsequent critical limb ischemia (CLI), is highly prevalent, increases with age, and carries high morbidity and mortality. Specific devices for treatment of below-the-knee (BTK) lesions are limited. On February 17, 2021, the United States Food and Drug Administration convened a virtual meeting of the Circulatory System Devices Panel of the Medical Devices Advisory Committee to consider a premarket approval application for the Lutonix 014 Drug-Coated Balloon Percutaneous Transluminal Angioplasty Catheter (Becton, Dickinson and Company, Franklin Lakes, New Jersey) for the treatment of obstructive de novo or non-stented restenotic lesions in BTK vessels (popliteal, tibial, and peroneal arteries) in patients with CLI. Read More

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December 2021

Successful Revascularization of Infrapopliteal Chronic Total Occlusions Using the Plantar Arch as a Conduit and Retrograde Pedal Access.

Ochsner J 2021 ;21(2):209-213

Department of Cardiology, Ochsner Clinic Foundation, Kenner, LA.

With the rising prevalence of critical limb ischemia (CLI), the pedal-plantar loop technique and retrograde access may be needed to increase interventional success. A 63-year-old female with severe peripheral artery disease presented with a 2-month nonhealing wound on the dorsum of her left foot despite wound care. We inserted a 65-cm Destination Guiding Sheath and crossed the right superficial femoral artery (SFA) chronic total occlusion (CTO) that we initially treated with a 4. Read More

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January 2021

Randomized Controlled Trial Comparing Drug-coated Balloon Angioplasty versus Conventional Balloon Angioplasty for Treating Below-the-Knee Arteries in Critical Limb Ischemia: The SINGA-PACLI Trial.

Radiology 2021 09 6;300(3):715-724. Epub 2021 Jul 6.

From the Department of Vascular and Interventional Radiology, Division of Radiological Sciences (A.P., F.G.I., K.H.T., S.L., K.D.Z., K.D., A.G., C.W.T., S.X.J.M.C., B.S.T.), and Department of Vascular Surgery, Division of Surgery and Surgical Oncology (T.T.C., S.P.C.), Singapore General Hospital, Radiological Sciences Academic Clinical Program, Singhealth-Duke-NUS Academic Medical Centre, Outram Road, Singapore 169608; Departments of Diagnostic Radiology (U.P., L.H.H.Q., J.K., B.P.T.) and General Surgery (G.W.L.T.), Tan Tock Seng Hospital, Singapore; Department of Biostatistics, Singapore Clinical Research Institute, Singapore (E.S.Y.C., W.Y.); Duke-NUS Medical School, National University of Singapore, Singapore (E.S.Y.C., W.Y.); and Department of Radiology, Leiden University Medical Centre, Leiden, the Netherlands (M.C.B.).

Background There is a paucity of randomized trials demonstrating superior efficacy of drug-coated balloon angioplasty (DCBA) compared with conventional percutaneous transluminal angioplasty (PTA) for below-the-knee arterial disease in patients with -critical limb ischemia. Purpose To compare DCBA versus PTA for below-the-knee lesions in participants with critical limb ischemia through 12 months. Materials and Methods In this prospective, randomized, two-center, double-blind superiority study, participants with critical limb ischemia with rest pain or tissue loss with atherosclerotic disease in the native below-the-knee arteries were randomly assigned (in a one-to-one ratio) to DCBA or PTA after stratification for diabetes and renal failure between November 2013 and October 2017. Read More

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September 2021

COVID-19 diagnosis in a patient with critical limb ischemia: complications and clinical outcomes.

J Vasc Bras 2020 Sep 21;19:e20200071. Epub 2020 Sep 21.

Hospital Regional Sul, Serviço de Cirurgia Vascular e Endovascular, São Paulo, SP, Brasil.

A 67-year-old male diabetic patient with systemic arterial hypertension was admitted to the emergency department with a necrotic ulcer in the left external malleolus and no palpable popliteal or pedal pulses. Arterial Duplex ultrasound identified femoropopliteal occlusion, with popliteal refilling below the knee and a patent peroneal artery. An endovascular procedure was performed, requiring retrograde access to the popliteal artery to re-establish blood flow and deploy a popliteal stent. Read More

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September 2020

Early outcomes of novel Temren atherectomy device combined with drug-coated balloon angioplasty for treatment of femoropopliteal lesions.

Authors:
Görkem Yiğit

Vascular 2021 Jun 28:17085381211029819. Epub 2021 Jun 28.

Department of Cardiovascular Surgery, 233009Yozgat State Hospital, Yozgat, Turkey.

Objectives: In this study, perioperative properties and early outcomes of patients who underwent combined Temren rotational atherectomy (RA) and drug-coated balloon (DCB) angioplasty treatment for complex femoropopliteal lesions in a single center were reported.

Methods: Between June 2019 and February 2020, 40 patients who underwent combined Temren RA and DCB treatment due to critical lower limb ischemia or claudication-limiting daily living activities were retrospectively evaluated.

Results: The mean age of patients was 73. Read More

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