Document Detail


Sirolimus for below the knee lesions: mid-term results of SiroBTK study.
MedLine Citation:
PMID:  17039538     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To assess the safety and efficacy of sirolimus-eluting stents (SESs) in the treatment of severe intermittent claudication and critical limb ischaemia with "below-the-knee" lesions, unsuitable for surgery. BACKGROUND: Limited published evidence suggests that drug-eluting stents may offer significant improvements in the treatment of infrapopliteal lesions. METHODS: Thirty consecutive patients with either severe intermittent claudication or critical limb ischemia (CLI), category 3-6 of Rutherford classification, and multivessel disease of infrapopliteal arteries (> or = 2 vessels) were treated with SES. Sixty-two arteries were treated with 106 SES. Mean age was 73.9 years, 77% of patients were male and 36% diabetic. The primary endpoint was clinical improvement and healing of ulcers at short term (1 month) and mid term (7.7 months). The secondary endpoint was primary vessel patency rate (angiographic or duplex assessment). All patients received clopidogrel (75 mg daily) or ticlopidine (150 mg daily) for 2 months or longer. RESULTS: Angiographic and procedural success was achieved in all patients. At 7 months (7.7 +/- 5.8), it was necessary to amputate 1 toe in one patient and 1 mid-foot in another. Limb salvage was obtained in 100% of patients. Other events were: two cardiac deaths unrelated to CLI, one stroke with hemiparesia, one initial reperfusion syndrome, one contralateral CLI, and three recurrent homolateral claudication cases. All surviving patients had a mid-term clinical improvement with 97% of primary patency (56 patent arteries on 58 arteries). CONCLUSION: Treatment of "below-the-knee" lesions with SES may provide an alternative treatment for patients with CLI.
Authors:
Philippe Commeau; Paul Barragan; Pierre O Roquebert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  68     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-31     Completed Date:  2007-06-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  793-8     Citation Subset:  IM    
Copyright Information:
(c) 2006 Wiley-Liss, Inc.
Affiliation:
Département de Cardiologie et Radiologie Vasculaire Interventionelles, Polyclinique Les Fleurs, 83190 Ollioules, France. p.commeau@wanadoo.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Blood Vessel Prosthesis Implantation
Cardiovascular Agents / therapeutic use*
Coated Materials, Biocompatible / therapeutic use
Equipment Safety
Female
Follow-Up Studies
Humans
Intermittent Claudication / drug therapy,  physiopathology,  surgery,  therapy*
Ischemia / drug therapy,  physiopathology,  surgery,  therapy*
Kaplan-Meiers Estimate
Leg / blood supply*,  surgery
Male
Middle Aged
Peripheral Vascular Diseases / drug therapy,  physiopathology,  surgery,  therapy*
Platelet Aggregation Inhibitors / therapeutic use
Popliteal Artery / pathology,  physiopathology,  surgery
Prospective Studies
Research Design
Severity of Illness Index
Sirolimus / therapeutic use*
Stents*
Time Factors
Treatment Outcome
Vascular Patency
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Coated Materials, Biocompatible; 0/Platelet Aggregation Inhibitors; 53123-88-9/Sirolimus

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


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