Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion.
J Endovasc Ther
; 17(6): 712-21, 2010 Dec.
Article
em En
| MEDLINE
| ID: mdl-21142478
ABSTRACT
PURPOSE:
To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry following unsuccessful subintimal angioplasty for arterial occlusion below the ankle.METHODS:
TDP or TPD retrograde intraluminal re-entry angioplasty was attempted in 8 limbs of 8 diabetic patients (5 men; mean age 74.5 ± 7.76 years, range 62-81) with chronic below-the-ankle arterial occlusive disease when standard transtibial subintimal angioplasty failed. The clinical symptoms, dorsal or plantar arterial pulse volume scores, and ankle-brachial indexes (ABI) were compared before and after the procedures. At follow-up, pain relief, wound healing, limb salvage, and the presence of any restenosis of the target vessels were evaluated.RESULTS:
TDP or TPD retrograde intraluminal re-entry angioplasty was performed successfully in 5 (62.5%) patients; foot pain improved, with median pulse volume scores and ankle-brachial indexes increasing from 0.60 ± 0.55 and 0.32 ± 0.20 before to 2.40 ± 0.55 and 0.75 ± 0.12, respectively, after the procedure (p<0.01 for both). At the end of follow-up, the visual analogue scale improved from 7.40 ± 1.14 to 2.20 ± 1.48 (p=0.002). Ulcers in 2 of the successfully treated patients either healed (n=1) or improved (n=1). No amputation occurred. Restenosis of 1 target vessel was revealed by magnetic resonance angiography.CONCLUSION:
TDP and TPD retrograde intraluminal re-entry techniques are feasible and effective in the treatment of foot ischemia in diabetic patients when standard below-the-ankle angioplasty has failed.
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Arteriopatias Oclusivas
/
Angioplastia com Balão
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Pé Diabético
/
Isquemia
/
Tornozelo
Tipo de estudo:
Diagnostic_studies
/
Etiology_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Asia
Idioma:
En
Revista:
J Endovasc Ther
Assunto da revista:
ANGIOLOGIA
Ano de publicação:
2010
Tipo de documento:
Article
País de afiliação:
China