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    
Abstract/OtherAbstract:
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.
Authors:
Jung-Sun Kim; Tae Soo Kang; Chul Min Ahn; Young-Guk Ko; Donghoon Choi; Yangsoo Jang; Namsik Chung; Won-Heum Shim; Seung-Yun Cho
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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    
Affiliation:
Division of Cardiology, Severance Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angioplasty, Balloon*
Arterial Occlusive Diseases / radiography,  therapy*
Disease-Free Survival
Feasibility Studies
Female
Femoral Artery / radiography
Follow-Up Studies
Humans
Iliac Artery / radiography
Limb Salvage / methods
Male
Middle Aged
Popliteal Artery
Retrospective Studies
Stents*
Tibial Arteries
Treatment Outcome
Tunica Intima

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


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