Document Detail

Efficacy of subintimal angioplasty/stent implantation for long, multisegmental lower limb occlusive lesions in patients unsuitable for surgery.
MedLine Citation:
PMID:  16928168     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To investigate the feasibility and clinical outcomes of subintimal angioplasty combined with stent implantation in patients with long, multisegmental occlusive lesions unsuitable for surgical treatment. METHODS: Between 2003 and 2005, 30 patients (23 men; mean age 68 years, range 49-82) with severe claudication (Rutherford category 3, n=12) or critical limb ischemia (CLI; Rutherford category 4 or 5, n=18) underwent subintimal angioplasty with primary stenting for long (mean 28+/-11 cm) total occlusion in the lower limb arteries. Bypass surgery was considered unsuitable owing to inappropriate anatomy or poor distal runoff in 14 (47%) patients, severe coronary artery disease 14 (47%), or poor general condition in 2 (6%). RESULTS: Technical success was achieved in 27 (90%) of 30 cases. The 3 technical failures were due to inability to advance the wire, to re-enter the distal lumen, and vessel rupture, respectively. Three (10%) complications occurred (1 perforation, 2 hematomas) but did not require surgery. After a mean follow-up of 13+/-7 months (range 3-28), 10 (37%) cases of restenosis were found in 27 patients. At 12 months, the primary patency rate was 52%, and the limb salvage rate was 83%. CONCLUSION: Combined use of subintimal angioplasty and stent implantation was performed safely, with a relatively high success rate and acceptable intermediate-term clinical outcomes in patients with multisegmental, long occlusions of the lower limb arteries. Therefore, this strategy can be considered an option for symptomatic relief and limb salvage in patients unsuitable for bypass surgery due to various reasons.
Jung-Sun Kim; Tae Soo Kang; Chul Min Ahn; Young-Guk Ko; Donghoon Choi; Yangsoo Jang; Namsik Chung; Won-Heum Shim; Seung-Yun Cho
Related Documents :
7509408 - Syme's amputation: a neglected procedure.
16798998 - Management of complex tibial and femoral nonunion using the ilizarov technique, and its...
19345788 - Inpatient rehabilitation of survivors of purpura fulminans with multiple limb amputatio...
15365518 - In-situ bypass surgery on arteriographically invisible vessels detected by doppler-ultr...
8441298 - Is age a risk factor for surgery?
3364338 - Comparison of lead dislodgment and pocket infection rates after pacemaker implantation ...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  13     ISSN:  1526-6028     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2006 Aug 
Date Detail:
Created Date:  2006-08-24     Completed Date:  2006-12-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  514-21     Citation Subset:  IM    
Division of Cardiology, Severance Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Aged, 80 and over
Angioplasty, Balloon*
Arterial Occlusive Diseases / radiography,  therapy*
Disease-Free Survival
Feasibility Studies
Femoral Artery / radiography
Follow-Up Studies
Iliac Artery / radiography
Limb Salvage / methods
Middle Aged
Popliteal Artery
Retrospective Studies
Tibial Arteries
Treatment Outcome
Tunica Intima

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

Previous Document:  Increasing endovascular intervention for claudication: impact on vascular surgery resident training.
Next Document:  Use of the profunda femoris to facilitate closure of an antegrade puncture with the StarClose device...