Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care

Kawarada, Osami; Zen, Kan; Hozawa, Koji; Ayabe, Shinobu; Huang, Hsuan Li; Choi, Donghoon; Kim, Su Hong; Kim, Jiyoun; Kato, Taku; Tsubakimoto, Yoshinori; Nakama, Tasuya; Ichihashi, Shigeo; Fujimura, Naoki; Higashimori, Akira; Fujihara, Masahiko; Sato, Tomoyasu; Yan, Bryan Ping Yen; Pang, Skyi Y.C.; Wongwanit, Chumpol; Leong, Y. P.; Chua, Beelee; George, Roy; Yokoi, Yoshiaki; Motomura, Hisashi; Obara, Hideaki

doi:10.1007/s12928-018-0523-z

Cited by 27 publications

(23 citation statements)

References 61 publications

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“…An Asian multidisciplinary consensus statement of contemporary CLI suggested that below-the-ankle intervention should only be considered if no clinical improvement with sufficient microcirculation is observed after above-the-ankle intervention (Kawarada et al 2018 ). Moreover, several clinical trials have reported that pedal artery disease is an independent predictor of delayed wound healing in CLI patients (Kawarada et al 2012 ; Shiraki et al 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases

et al. 2020

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Background Acute limb ischemia (ALI) and critical limb ischemia (CLI) following ALI are life-threatening diseases. The rare potential causes of ALI include hypercoagulable state diseases, such as antiphospholipid syndrome (APS) and essential thrombocythemia (ET). Hypercoagulability often make revascularization for arterial occlusion, especially associated with infrapopliteal lesions, difficult. This is because the vessels have poor run-off, and elevated peripheral vascular resistance associated with microcirculation failure, due to a high thrombus burden. There is no established treatment for this issue. Case presentation A 45 years-old and a 56 years-old male suffered from thrombotic arterial occlusion as a first manifestation of APS and ET, respectively. Combination therapy with aggressive anti-thrombotic therapy and revascularization, such as endovascular therapy and surgical thrombectomy based on the angiosome concept, was performed. However, the high thrombus burden caused a poor pedal outflow, and significant limb ischemia remained. Additional pedal artery angioplasty was performed to improve residual limb ischemia in each case and provided sufficient blood flow to the foot. Conclusion The pedal artery angioplasty for thrombotic pedal artery occlusion cases, associated with hypercoagulable state diseases, seems to be a treatment option for relieving residual limb ischemia.

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Section: Discussionmentioning

confidence: 99%

Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases

et al. 2020

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“…Symptomatic PAD, especially that resistant to conservative treatments, requires timely revascularization 4 , 10 , 11 ) , as does symptomatic CAD 12 ) . Recently, percutaneous technique has become increasingly popular in clinical practice, and endovascular procedures have markedly increased in volume 13 ) . Th e presentation pattern directly affects pressure on hospital beds and medical staffing.…”

Section: Introductionmentioning

confidence: 99%

Presentation Pattern of Lower Extremity Endovascular Intervention versus Percutaneous Coronary Intervention

Takahara

Iida

Kohsaka

et al. 2020

JAT

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The aim of the current study is to describe the presentation pattern of symptomatic peripheral artery disease undergoing endovascular therapy (EVT) in comparison to symptomatic coronary artery disease undergoing percutaneous coronary intervention (PCI) based on data from nationwide databases. Methods: Data were extracted from the nationwide procedural databases of EVT and PCI in Japan (J-EVT and J-PCI) between 2012 and 2017. The presentation pattern was investigated using a Poisson regression model, including the month, seasonality, and weekend (versus weekday) as the explanatory variables. Seasonality was expressed as a cosine function of a 12-month period, and its significance was evaluated using the Fisher-Yates shuffle method. Results: A total of 41,906 and 62,585 cases underwent EVT for critical limb ischemia (CLI) and intermittent claudication (IC), respectively, whereas 518,858 and 504,139 cases underwent PCI for acute coronary syndrome (ACS) and stable angina (SA). The procedural volume increased by 21.6%, 12.3%, 4.5%, and 3.6% per year in CLI, IC, ACS, and SA. CLI and ACS, but not IC or SA, showed a significant volume seasonality. Compared with ACS, CLI demonstrated a larger peak-to-trough ratio of seasonality (1.75 versus 1.21; P 0.001), and a later peak appearance (February-March versus January-February by 1.37 months; P 0.001). The procedural volume on weekends relative to weekdays was smaller for SA, IC, and CLI than for ACS. These distinct features were observed in a diabetic population and a non-diabetic population. Conclusions: The current study analyzed nationwide procedural databases and demonstrated the presentation pattern of symptomatic PAD and CAD warranting revascularization. the presentation pattern of clinically significant coronary artery disease (CAD) 1-3). However, data were so far limited regarding lower extremity peripheral artery

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“…The femoropopliteal (FP) artery is the most common site of PAD involvement. With technological improvements in the endovascular armamentarium, catheter-based FP intervention has gained popularity during the last decade [2][3][4][5][6][7]. Although the need for quantitative vessel analysis (QVA) for objective evaluation in FP intervention outcomes has been emphasized for over a decade [8], a standard methodology for assessing restenosis has yet to be established.…”

Section: Introductionmentioning

confidence: 99%

Peak systolic velocity ratio derived from quantitative vessel analysis for restenosis after femoropopliteal intervention: a multidisciplinary review from Endovascular Asia

Kawarada

Hozawa

Zen

et al. 2019

Cardiovasc Interv and Ther

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With technological improvements in the endovascular armamentarium, there have been tremendous advances in catheterbased femoropopliteal artery intervention during the last decade. However, standardization of the methodology for assessing outcomes has been underappreciated, and unvalidated peak systolic velocity ratios (PSVRs) of 2.0, 2.4, and 2.5 on duplex ultrasonography have been arbitrarily but routinely used for assessing restenosis. Quantitative vessel analysis (QVA) is a widely accepted method to identify restenosis in a broad spectrum of cardiovascular interventions, and PSVR needs to be validated by QVA. This multidisciplinary review is intended to disseminate the importance of QVA and a validated PSVR based on QVA for binary restenosis in contemporary femoropopliteal intervention.

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Contemporary critical limb ischemia: Asian multidisciplinary consensus statement on the collaboration between endovascular therapy and wound care

Cited by 27 publications

References 61 publications

Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases

Two effective cases of additional pedal artery angioplasty for severe lower limb ischemia following acute thrombotic artery occlusion with hypercoagulable state diseases

Presentation Pattern of Lower Extremity Endovascular Intervention versus Percutaneous Coronary Intervention

Peak systolic velocity ratio derived from quantitative vessel analysis for restenosis after femoropopliteal intervention: a multidisciplinary review from Endovascular Asia

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