Endovascular Interventions for Peripheral Artery Disease: A Contemporary Review

Watson, Nathan W.; Mosarla, Ramya C.; Secemsky, Eric A.

doi:10.1007/s11886-023-01973-9

Cited by 5 publications

(3 citation statements)

References 82 publications

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“…Despite advancements in endovascular techniques, surgical procedures remain fundamental in peripheral arterial disease management, addressing challenges such as occlusive disease patterns, patient fitness for anesthesia, extent of tissue loss, and anatomical considerations. Endovascular surgery, compared to open approaches, has demonstrated favorable outcomes in terms of complication rates, hospitalization duration, and long-term mortality [ 11 ].…”

Section: Introductionmentioning

confidence: 99%

Quality of Life Outcomes Following Aortofemoral and Iliofemoral Bypass Surgery in Patients With Peripheral Arterial Disease: A Two-Year Follow-Up Study

Alqahtani,

Aljaber,

Alharbi

et al. 2024

Cureus

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Introduction: Peripheral arterial disease is a circulatory disorder characterized by reduced blood flow to the extremities, predominantly affecting the lower limbs. This study aims to evaluate the impact of aortofemoral and iliofemoral bypass surgeries on patients' quality of life two years post operation and identify predictors of quality-of-life improvements. Methods: This cross-sectional study included adult patients with aortoiliac disease who underwent bypass surgery (aortofemoral or iliofemoral) at East Jeddah General Hospital from January 2020 to December 2022. Quality of life was assessed using the Arabic version of the Short Form Health Survey 12 (SF-12) preoperatively and two years postoperatively. Data on sociodemographic factors (age, sex, education, income) and medical factors (smoking, BMI, comorbidities) were collected. Statistical analyses included descriptive statistics, t-tests, one-way ANOVA, and regression analyses using IBM SPSS version 25.0 (IBM Corp., Armonk, NY).Results: The study included 275 patients. Significant improvements in both physical and mental SF-12 scores were observed postoperatively across all patient groups (P < 0.001). Older age, unemployment, and lower income were associated with lower SF-12 scores. Males had higher postoperative mental scores (P = 0.036). Higher BMI and smoking pack-years negatively correlated with SF-12 scores. Patients with comorbidities had significantly lower preoperative and postoperative SF-12 scores (P < 0.05) but showed significant improvements postoperatively (P < 0.001).Conclusion: Aortofemoral and iliofemoral bypass surgeries significantly improve the quality of life in peripheral arterial disease patients two years post operation. Key predictors of lower quality of life include older age, unemployment, lower income, high BMI, smoking, and comorbidities. Targeted interventions, such as smoking cessation programs, weight management, and comprehensive medical care, are essential for optimizing postoperative outcomes and enhancing patients' physical and mental well-being.

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Section: Introductionmentioning

confidence: 99%

Quality of Life Outcomes Following Aortofemoral and Iliofemoral Bypass Surgery in Patients With Peripheral Arterial Disease: A Two-Year Follow-Up Study

Alqahtani,

Aljaber,

Alharbi

et al. 2024

Cureus

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“…Up to 2010, there were ∼200 million patients with peripheral artery diseases worldwide [ 2 ]. Interventional therapy based on stent implantation has become the first choice for ASO treatment, especially for long-segment occlusive lesions [ 3 ]. Nevertheless, the emergence of in-stent restenosis (ISR) seriously affects the medium- and long-term efficacies of interventional therapy [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Inhibition effect of copper-bearing metals on arterial neointimal hyperplasia via the AKT/Nrf2/ARE pathway in vitro and in vivo

Wang,

Xu,

et al. 2024

Regenerative Biomaterials

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In-stent restenosis can be caused by the activation, proliferation, and migration of vascular smooth muscle cells (VSMCs), which affects long-term efficacy of interventional therapy. Copper (Cu) has been proved to accelerate the endothelialization and reduce the thrombosis formation, but few about its inhibition effect on the excessive proliferation of VSMCs. In this study, 316L-Cu stainless steel and L605-Cu cobalt-based alloy with varying Cu content, were fabricated and their effects on surface property, blood compatibility and VSMCs were studied in vitro and in vivo. CCK-8 assay and EdU assay indicated that the Cu-bearing metals had obvious inhibitory effect on proliferation of VSMCs. Blood clotting and hemolysis tests showed that the Cu-bearing metals had good blood compatibility. The inhibition effect of the Cu-bearing metals on migration of cells was detected by Transwell assay. Further studies showed that Cu-bearing metals significantly decreased the mRNA expressions of bFGF, PDGF-B, HGF, Nrf2, GCLC, GCLM, NQO1 and HO1. The phosphorylation of AKT and Nrf2 protein expressions in VSMCs were significantly decreased by Cu-bearing metals. Furthermore, it was also found that SC79 and TBHQ treatments could recover the protein expressions of phospho-AKT and Nrf2, and their downstream proteins as well. Moreover, 316L-Cu stent proved its inhibitory action on the proliferation of VSMCs in vivo. In sum, the results demonstrated that the Cu-bearing metals possessed apparent inhibitory effect on proliferation and migration of VSMCs via regulating the AKT/Nrf2/ARE pathway, showing the Cu-bearing metals as promising stent materials for long-term efficacy of implantation.

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“…Restoring blood flow in the area below the knee is more difficult than in the iliac artery and femoral and popliteal arteries. Traditional bypass surgery and balloon angioplasty have not been effective in achieving adequate results [ 8 ]. When chronic limb-threatening ischemia (CLTI) occurs, characterized by ischemic rest pain, tissue loss, or gangrene, the risk of amputation is higher.…”

Section: Introductionmentioning

confidence: 99%

Bioresorbable Scaffolds for Below-the-Knee Arterial Disease: A Literature Review of New Developments

Cui,

2024

Rev. Cardiovasc. Med.

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This review aimed to explore the therapeutic effect of bioabsorbable stents in the inferior genicular artery, from the emergence of absorbable bare metal stents to the latest technology in polymer and anti-proliferative eluting drugs mixed with coated bioresorbable vascular stents (BVSs). Currently, there are conflicting data regarding the safety and effectiveness of BVSs in infrapopliteal artery interventions, especially compared to the current generation of drug-eluting stents (DESs). This review will cover the existing data on BVSs in reconstructing the infrapopliteal arterial blood flow and active clinical trials for future iterations of BVSs. In terms of primary patency rate and target lesion revascularization rate, the available research on the effectiveness of BVSs in reconstructing the infrapopliteal arterial blood flow suggests that a BVS is compatible with current DESs within 3–12 months; long-term data have not yet been reported. The ABSORB BVS is the most studied BVS in cardiovascular disease (CAD). Initially, the ABSORB BVS showed promising results. Managing intricate regions in peripheral artery disorders, such as branching or lengthy lesions, continues to be a formidable undertaking. In contrast to the advanced narrowing of arteries seen in standard permanent stent procedures, bioabsorbable stents have the potential to promote the expansion and beneficial merging of blood channels in the latter stages. Furthermore, incorporating stents and re-establishing the endothelial function can diminish the probability of restenosis or thrombosis. Nevertheless, the extent to which bioabsorbable stents may simultaneously preserve arterial patency and guarantee their structural integrity remains uncertain. The powerful and intricate mechanical stresses exerted by the blood in the superficial femoral artery and popliteal artery can cause negative consequences on any implant inserted into the vessel, regardless of its composition, even metal. Furthermore, incorporating stents is advantageous for treating persistent occlusive lesions since it does not impact later treatments, including corrective bypass operations. Evidence is scarce about the use of bioabsorbable stents in treating infrapopliteal lesions. Utilizing bioabsorbable stents in minor infrapopliteal lesions can successfully maintain the patency of the blood vessel lumen, whereas balloon angioplasty cannot offer this benefit. The primary focus of testing these materials is determining whether bioabsorbable scaffolds can provide adequate radial force in highly calcified elongated lesions. Indeed, using “-limus” medication elution technology in conjunction with bioabsorbable stents has previously offered clinical benefits in treating the popliteal artery, as evidenced by limited trials.BVSs for peripheral arterial disease (PAD) show promise and have the potential to offer a less inflammatory and more vessel-friendly option compared to permanent metallic stents. However, current evidence does not yet allow for a ...

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Endovascular Interventions for Peripheral Artery Disease: A Contemporary Review

Cited by 5 publications

References 82 publications

Quality of Life Outcomes Following Aortofemoral and Iliofemoral Bypass Surgery in Patients With Peripheral Arterial Disease: A Two-Year Follow-Up Study

Quality of Life Outcomes Following Aortofemoral and Iliofemoral Bypass Surgery in Patients With Peripheral Arterial Disease: A Two-Year Follow-Up Study

Inhibition effect of copper-bearing metals on arterial neointimal hyperplasia via the AKT/Nrf2/ARE pathway in vitro and in vivo

Bioresorbable Scaffolds for Below-the-Knee Arterial Disease: A Literature Review of New Developments

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