A Prospective Randomized Multicenter Comparison of Balloon Angioplasty and Infrapopliteal Stenting With the Sirolimus-Eluting Stent in Patients With Ischemic Peripheral Arterial Disease

Scheinert, Dierk; Κατσάνος, Κωνσταντίνος; Zeller, Thomas; Koppensteiner, Renate; Commeau, Philip; Bosiers, Marc; Krankenberg, Hans; Baumgartner, Iris; Siablis, Dimitris; Lämmer, Johannes; Ransbeeck, Mariella Van; Qureshi, Ayesha C.; Stoll, Hans‐Peter

doi:10.1016/j.jacc.2012.08.989

Cited by 253 publications

(218 citation statements)

References 10 publications

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“…The authors found that SES significantly lowered angiographic restenosis (22.4% vs. 41.9%, P ¼ 0.019) and improved vessel patency (75.0% vs. 57.1%, P ¼ 0.025). There were no differences in death, amputation, target vessel revascularization, or functional improvement (Rutherford category) rates between SES and PTA [31]. These data support the perception that stents improve patency over PTA, even for short lesions in the tibial arteries.…”

Section: Infrapopliteal Stentingsupporting

confidence: 68%

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SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Gray

Díaz‐Sandoval

Dieter

et al. 2014

Cathet Cardio Intervent

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Intervention to treat infrapopliteal arterial disease can be challenging because the patients' comorbidities, the anatomic variables, and the limitations of our techniques. Clinical scenarios based on anatomic and clinical variables are presented. Recommendations regarding intervention (appropriate care, may be appropriate care, rarely appropriate care) are made based on best evidence. V C 2014 Wiley Periodicals, Inc.Key words: peripheral intervention; appropriate use; peripheral arterial disease INTRODUCTION Infrapopliteal (IP) arterial disease or "below the knee" arterial disease is commonly seen in patients with long-standing diabetes mellitus, chronic kidney disease, or the elderly. The most concerning manifestation of peripheral arterial disease (PAD) in these high risk patients is the development of critical limb ischemia (CLI: ischemic rest pain or ischemic ulcers). This arterial bed consists of relatively small caliber vessels, which are often calcified and associated with diffuse, multilevel disease. Due to the complexity of this patient population, their co-morbidities, and severity of vascular disease, there is a paucity of scientific evidence for the generalizability of percutaneous revascularization.In general, non-ambulatory patients with a short life expectancy and extensive necrosis or gangrene should undergo primary amputation. Ambulatory patients who are acceptable surgical candidates, expected to survive more than two years with a patent IP artery that provides direct flow to the foot (considered to be a good distal target), and an adequate autologous venous conduit should be considered for surgical bypass. Patients with significant medical co-morbidities that limit life expectancy, those at increased risk for surgery, those without an adequate distal target for bypass, or with poor venous conduit should be considered for an endovascular-first approach.This document was developed to guide physicians in clinical decision-making in the modern practical application of endovascular intervention for patients with IP arterial disease. ANATOMIC CONSIDERATIONSPatients with CLI typically have disease involving multiple levels (i.e., aorto-iliac, femoropopliteal (FP) and IP), but less than 10% of patients with CLI have hemodynamically significant disease in all three levels [1][2][3] (Table I). Infrainguinal disease (FP and IP) can be further subdivided into those with predominantly isolated IP disease ( 33%) and those with both FP and IP disease ( 67%) [4][5][6][7].Additional Supporting Information may be found in the online version of this article. Catheterization and Cardiovascular Interventions 84:539-545 (2014) Isolated IP disease is mainly seen in the elderly (>80-years old), diabetic, or dialysis-dependent patients [5]. These patients are at higher risk for amputation and have a shorter amputation-free survival compared to those with FP and IP disease (median amputation-free survival: 17 months (95% CI ¼ 9-24 m) versus 37 months (95% CI ¼ 28-44 m), P ¼ 0.001) [6]. Clinical and non-invasive cr...

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Section: Infrapopliteal Stentingsupporting

confidence: 68%

“…[14,15,[25][26][27][28][29][30][31]. These devices are associated with significantly better primary patency, primaryassisted patency, and fewer secondary interventions at 3-year follow-up than balloon angioplasty.…”

Section: Infrapopliteal Stentingmentioning

confidence: 99%

SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Gray

Díaz‐Sandoval

Dieter

et al. 2014

Cathet Cardio Intervent

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“…They are most commonly used in coronary artery interventions [2]. Stents are also successfully used in the treatment of peripheral arterial disease (PAD) typically in combination with balloon angioplasty [3,4]. In addition to use in the larger pelvic and femoral arteries, stents are now also implanted in the arteries of the lower leg.…”

Section: Materials and Methods From January 2003 To Novembermentioning

confidence: 99%

Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause

Büstgens

Loose

Ficker

et al. 2017

Fortschr Röntgenstr

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Purpose?The purpose of this paper is the retrospective analysis of endovascular therapy for the treatment of superior vena cava syndrome (SVCS) of malignant cause. This study focuses on the effectiveness of the therapy regarding the duration of remission, symptom control and practicability. Materials and Methods?From January 2003 to November 2012, therapeutic implantation of one or more stents was performed in 141 patients suffering from SVCS.?The medical history was retrospectively researched using digitalized patient files. If those were incomplete, secondary research was conducted using the cancer registry of the General Hospital Nuremberg, the cancer registry of the tumor center at Friedrich-Alexander-University Erlangen-Nuremberg (FAU) or information given by physicians in private practice. This data was collected using Microsoft Office Excel? and statistically analyzed using IBM SPSS Statistics 22?. Results?168 stents were implanted in 141 patients (median age: 64.6?years; range: 36???84), 86 being male and 55 being female. In 121 patients, SVCS was caused by lung cancer (85.8?%), in 9 patients by mediastinal metastasis of an extrathoracic carcinoma (6.4?%), in 3?patients by mesothelioma of the pleura (2.1?%) and in 1 patient by Hodgkin?s disease (0.7?%). There was no histological diagnosis in 7?cases (4.9?%). The primary intervention was successful in 138 patients (97.9?%). Immediate thrombosis in the stent occurred in the remaining 3 cases. Recurrence of SVCS was observed in 22 patients (15.6?%), including 5 early and 17 late occlusions. Stent dislocation or?breakage was not observed. As expected, the survival after implantation was poor. The median survival was 101 days, and the median occlusion-free survival was 80 days. Conclusion?The symptomatic therapy of SVCS with endovascular stents is effective and safe. Despite effective symptom control and a low rate of recurrence, the patients' prognosis is poor. Key Points:? Citation Format

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“…To date, a total of 5 randomized trials 16,[21][22][23][24] have been performed, comparing either DES with BMS 16,[22][23][24] or DES with POBA 21) ( Table 1). Throughout all trials, DES was superior when compared to its counterparts with respect to arterial patency.…”

Section: Concepts Of Improvement Of Restenosis Rates After Endovasculmentioning

confidence: 99%

“…Throughout all trials, DES was superior when compared to its counterparts with respect to arterial patency. 16,[21][22][23][24] Of note, the use of DES was shown to be associated with improved clinial outcomes when compared to the use of BMS in one randomized study. 9) …”

Section: Concepts Of Improvement Of Restenosis Rates After Endovasculmentioning

confidence: 99%

Does Patency Matter in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization?

Baumann

Groechenig

Diehm

2014

Annals of Vascular Diseases

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A Prospective Randomized Multicenter Comparison of Balloon Angioplasty and Infrapopliteal Stenting With the Sirolimus-Eluting Stent in Patients With Ischemic Peripheral Arterial Disease

Abstract: SES implantation may offer a promising therapeutic alternative to PTA for treatment of infrapopliteal peripheral arterial disease.

Cited by 253 publications

References 10 publications

SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

SCAI expert consensus statement for infrapopliteal arterial intervention appropriate use

Stent Implantation for Superior Vena Cava Syndrome of Malignant Cause

Does Patency Matter in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization?

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