RESUMEN
Chronic total occlusions are a common cause of both claudication and critical limb ischemia. Currently, 40%-50% of all individuals undergoing lower extremity interventions will have a chronic total occlusion. Endovascular specialist should be familiar with the different treatment algorithms and classifications systems. Many different techniques have been shown to be successful in crossing the lesion and for re-entry when needed. The vascular access obtained to cross the lesion is frequently dictated by lesion location, lesion length, and the distal runoff in the affected limb.
Asunto(s)
Procedimientos Endovasculares , Enfermedad Arterial Periférica , Enfermedad Crónica , Procedimientos Endovasculares/efectos adversos , Humanos , Isquemia/diagnóstico por imagen , Isquemia/terapia , Extremidad Inferior/irrigación sanguínea , Enfermedad Arterial Periférica/diagnóstico por imagen , Enfermedad Arterial Periférica/terapia , Estudios Retrospectivos , Resultado del Tratamiento , Grado de Desobstrucción VascularRESUMEN
Peripheral atherectomy is a class of procedures that is rapidly increasing in volume. Multiple classes of devices exist, and newer variants are added to the market annually. The devices see wide application for de novo lesions, in-stent restenosis, and adjunctive therapy for drug-coated balloons. The body of evidence supporting atherectomy is less robust than for many other peripheral therapies. The frequency and severity of complications from atherectomy can be significant compared with angioplasty and stenting, and familiarity with preventative and bailout techniques is essential for the interventionalist.
