Document Detail


Subintimal angioplasty of supra- and infrageniculate arteries.
MedLine Citation:
PMID:  16802210     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We retrospectively reviewed our experience with subintimal angioplasty for chronic limb ischemia. Hospital records and films of all subintimal angioplasty procedures performed between October 2002 and December 2004 were reviewed and analyzed for demographic data, clinical data, and comorbid condition status. Thirty-nine subintimal angioplasties were performed in 37 patients (65% male, 35% female), with a median age of 73 years. Median follow-up was 9 months. The 30-day mortality rate was 8%. All-cause mortality was 33% after 24 months. In 23 cases (59%), a subintimal angioplasty of the superficial femoral artery (SFA) alone was performed. Both the SFA and popliteal/crural vessels were used in nine limbs (23%), the popliteal artery alone in three limbs (8%), and the crural arteries alone in four limbs (10%). Initial technical and clinical success rates were 67% and 49%, respectively. The complication rate was 28%. Twenty-four additional surgical interventions were performed after the initial angioplasty procedure, of which 12 were major amputations. Amputation-free survival (limb-salvage rate) was 69% at 12 months [95% confidence interval (CI) 52-85%], and overall survival was 69% (95% CI 52-85%) at 12 months. In patients with critical limb ischemia, subintimal angioplasty is feasible and in most cases technically successful. In these high-risk patients, often with combined cardiac, pulmonary, and diabetic risk and considered unfit for bypass surgery, subintimal angioplasty offers a safe and effective alternative.
Authors:
F Aarts; J D Blankensteijn; J A van der Vliet; L J Schultze Kool
Publication Detail:
Type:  Journal Article     Date:  2006-06-27
Journal Detail:
Title:  Annals of vascular surgery     Volume:  20     ISSN:  0890-5096     ISO Abbreviation:  Ann Vasc Surg     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-12-13     Completed Date:  2007-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  620-4     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. f.aarts@chir.umcn.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Amputation
Angioplasty, Balloon* / adverse effects,  methods
Chronic Disease
Female
Femoral Artery / physiopathology*
Follow-Up Studies
Humans
Ischemia / mortality,  physiopathology,  surgery,  therapy*
Kaplan-Meiers Estimate
Limb Salvage* / adverse effects,  methods
Lower Extremity / blood supply*,  surgery
Male
Popliteal Artery / physiopathology*
Retrospective Studies
Time Factors
Treatment Outcome
Tunica Intima / physiopathology*
Vascular Patency

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


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