Document Detail


Cryoballoon angioplasty broadens the role of primary angioplasty and reduces adjuvant stenting in complex superficial femoral artery lesions.
MedLine Citation:
PMID:  18308225     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cryoballoon angioplasty (CP) for superficial femoral artery (SFA) occlusive disease has attracted attention as an adjunct to primary high-pressure balloon angioplasty (HP) and as an alternative to primary stenting in the SFA. STUDY DESIGN: A retrospective review from 1999 to 2005 of patients with chronic critical ischemia because of complex SFA lesions (TransAtlantic Inter-Society Consensus [TASC] C and D) was performed. Those patients treated with either standard HP or CP were examined. Vessels treated by primary stenting or atherectomy were excluded. RESULTS: Eight-five patients with 93 (67%) limbs underwent HP and 39 patients with 45 (33%) limbs underwent CP. Rest pain, tissue loss, or both, were the presenting symptoms in 49% of the HP group and 69% of the CP group. There was no significant difference in the final technical success rate between HP and CP, but significantly more stents were required in HP (75% versus 22%, HP versus CP; p < 0.05). Stenosis rather than occlusion is the more common mode of failure after CP (HP: 68% versus 32%; CP: 38% versus 62%). Despite this, there was no change in 1-year primary (66 +/- 6% versus 69 +/- 9%; HP versus CP; mean +/- SEM), assisted (78 +/- 5% versus 80 +/- 8%), or secondary patencies (78 +/- 5% versus 80 +/- 8%) between the 2 modalities. Freedom from recurrent symptoms and limb salvage for critical ischemia were equivalent. CONCLUSIONS: CP substantially increases the number of TASC C and D lesions for which balloon angioplasty alone is effective. Adjuvant stent usage is markedly reduced without a decrease in cumulative patency. Cryoballoon angioplasty should be considered a viable alternative for sole therapy for complex lesions of the SFA.
Authors:
Andrew M Bakken; Wael E Saad; Mark G Davies
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2007-11-26
Journal Detail:
Title:  Journal of the American College of Surgeons     Volume:  206     ISSN:  1879-1190     ISO Abbreviation:  J. Am. Coll. Surg.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-02-29     Completed Date:  2008-03-27     Revised Date:  2009-05-21    
Medline Journal Info:
Nlm Unique ID:  9431305     Medline TA:  J Am Coll Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  524-32     Citation Subset:  AIM; IM    
Affiliation:
Department of Surgery, University of Rochester, Rochester, NY 14642, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Balloon / methods*
Arterial Occlusive Diseases / diagnosis,  mortality,  therapy*
Cohort Studies
Cryotherapy*
Female
Femoral Artery*
Humans
Male
Middle Aged
Retrospective Studies
Stents
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL 67746/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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