Early Recoil After Balloon Angioplasty of Tibial Artery Obstructions in Patients With Critical Limb Ischemia

Baumann, Frederic; Fust, Jacqueline; Engelberger, Rolf P.; Hügel, Ulrike; Do, Dai-Do; Willenberg, Torsten; Baumgartner, Iris; Diehm, Nicolas

doi:10.1583/13-4486mr.1

Cited by 59 publications

(45 citation statements)

References 22 publications

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“…Mechanical scaffolding as provided by a stent may be an ideal solution to address elastic recoil, an important contributor to restenosis in tibial arteries ( 47 ). The application of tibial BMS was assessed in various studies ( 48 – 50 ).…”

Section: Bare Metal Stentsmentioning

confidence: 99%

The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease

Baumann

Ozdoba

Gröchenig

et al. 2015

Front. Cardiovasc. Med.

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Critical limb ischemia (CLI) represents the most severe form of peripheral arterial disease (PAD) and frequently occurs in medically frail patients. CLI patients frequently exhibit multi-segmental PAD commonly including the tibial arterial segment. Endovascular therapy has been established as first-line revascularization strategy for most CLI patients. Restenosis was reported to occur in up to more than two-thirds of CLI patients undergoing angioplasty of complex tibial arterial obstructions. Nevertheless, favorable clinical outcomes were observed for infrapopliteal angioplasty when compared with bypass surgery, despite higher patency rates for the latter. Based on these observations, infrapopliteal patency was considered to be only of secondary importance upon clinical outcomes in CLI patients. In contrast to these earlier observations, however, recent findings from two randomized clinical trials indicate that infrapopliteal patency does impact on clinical outcomes in CLI patients. The purpose of the present manuscript is to provide a critical reappraisal of the present literature on the clinical importance of tibial arterial patency in CLI patients undergoing endovascular revascularization and to discuss utility and limitations of currently available anti-restenosis technologies.

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Section: Bare Metal Stentsmentioning

confidence: 99%

The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease

Baumann

Ozdoba

Gröchenig

et al. 2015

Front. Cardiovasc. Med.

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“…Their findings were somewhat different from ours. One possible explanation might be that they performed the risk analysis using a Cox model, without dure for infra-inguinal lesions, has a high rate of recoil, restenosis, and reintervention [22][23][24] . It is, therefore, reasonable to find that EVT itself increases the risk of reintervention in this analysis.…”

Section: Discussionmentioning

confidence: 99%

The Association of Preoperative Characteristics with Reintervention Risk in Patients Undergoing Revascularization for Chronic Limb-Threatening Ischemia

Iida

Takahara

Soga³

et al. 2021

JAT

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To investigate the associations between preoperative characteristics and the risk of reintervention in patients undergoing revascularization for chronic limb-threatening ischemia (CLTI) in a contemporary realworld setting. Methods: We retrospectively analyzed data from a clinical database formed by the Surgical Reconstruction Versus Peripheral Intervention in Patients With Critical Limb Ischemia (SPINACH) study, which was a multicenter, prospective, observational study. The study population was composed of 520 CLTI patients with the wound, ischemia, and foot infection (WIfI) classes I-3 with resting pain or classes I-2/3 with ulcers/gangrene. Of the 520 patients, 192 had surgical reconstruction planned, whereas 328 had endovascular therapy (EVT) alone planned at the time of registration. The current analysis was conducted to explore the associations between preoperative characteristics and the risk of reintervention. Results: A total of 452 participants (87%) completed the 3-year follow-up regarding reintervention. The competing risk analysis estimated that the three-year cumulative incidence rates for reintervention and reintervention-free deaths were 44.0% and 28.7%, respectively. No preoperative characteristics had a significant interaction effect with EVT versus surgical reconstruction. The risk analysis identified the following independent risk factors for reintervention: 1) EVT instead of bypass reconstruction, 2) renal dysfunction, 3) history of revascularization after CLTI onset (i.e., requirement of redo revascularization for CLTI), and 4) bilateral CLTI. Patients with more than one of these risk factors had an increased risk of reintervention. Conclusions: The current study identified preoperative characteristics associated with an increased risk of reintervention. No preoperative characteristics had any significant interactions with EVT or surgical reconstruction. chronic limb-threatening ischemia (CLTI) 1, 2). Its safety and effectiveness are acknowledged in current guidelines, and it plays an increasingly important role in the management of CLTI 3-5

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“…Angioplasty of tibial arteries has been reported to be followed by elastic recoil of on average 30% lumen diameter loss immediately after the angioplasty balloon is deflated. 13 Vonapanitase treatment after angioplasty could maintain or perhaps even increase blood flow by maintaining or increasing blood vessel diameter. Because blood flow is related to the fourth power of the lumen radius, even small changes in the diameter of a blood vessel will significantly increase or decrease flow.…”

Section: Discussionmentioning

confidence: 99%

Recombinant Human Elastase Alters the Compliance of Atherosclerotic Tibial Arteries After Ex Vivo Angioplasty

Burke¹,

Bingham²,

Moss³

et al. 2016

Journal of Cardiovascular Pharmacology

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Early Recoil After Balloon Angioplasty of Tibial Artery Obstructions in Patients With Critical Limb Ischemia

Abstract: Early recoil is frequently observed in CLI patients undergoing tibial angioplasty and may significantly contribute to restenosis. These findings support the role of dedicated mechanical scaffolding approaches for the prevention of restenosis in tibial arteries.

Cited by 59 publications

References 22 publications

The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease

The Importance of Patency in Patients with Critical Limb Ischemia Undergoing Endovascular Revascularization for Infrapopliteal Arterial Disease

The Association of Preoperative Characteristics with Reintervention Risk in Patients Undergoing Revascularization for Chronic Limb-Threatening Ischemia

Recombinant Human Elastase Alters the Compliance of Atherosclerotic Tibial Arteries After Ex Vivo Angioplasty

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