PTA Versus Carbofilm-Coated Stents in Infrapopliteal Arteries: Pilot Study

Rand, Thomas; Basile, Antonio; Cejna, Manfred; Fleischmann, Dominik; Funovics, Martin; Gschwendtner, Manfred; Haumer, Markus; Katzler, I. Von; Kettenbach, Joachim; Lomoschitz, F.; Luft, Christian; Minar, Erich; Schneider, Barbara; Schoder, Maria; Lämmer, Johannes

doi:10.1007/s00270-005-0276-9

Cited by 120 publications

(86 citation statements)

References 31 publications

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“…Rand et al [23] compared carbon film coated stents with PTA infrapoplital arteries. At the 50% restenosis threshold, the patency rate of the stents was 79.7% versus 45.6% after PTA in a total of 51 patients.…”

Section: Discussionmentioning

confidence: 99%

Self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty

et al. 2006

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The feasibility of self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty was assessed. Options for lower limb percutaneous revascularization are limited, especially for complex vessel obstruction. Depending on the lesion and the experience of the interventionalist, the failure rate of balloon angioplasty (PTA) ranges between 10 and 40%. Until recently, no self-expanding stent for the use in the infragenicular arteries was available. This is the first report of the results for 18 consecutive patients who received 4F sheath compatible self-expanding nitinol stents following unsuccessful PTA or early restenosis. Twenty-four stents were implanted in 21 lesions for various indications residual stenosis >50% due to heavy calcification, flow-limiting dissection, occluding thrombus resistant to thrombolyis, thrombaspiration, and PTA, and early restenosis after previous PTA. Stent implantation was feasible in all cases. No complications occurred. After the stent implantation, all primarily unsuccessful interventions could be transformed into successful procedures with no residual stenosis >30% in any case. After 6 +/- 2 months, two of the 18 patients died, and 14 of the 16 remaining patients improved clinically. At follow-up, the patency could be assessed in 14 stented arteries. Three stents were occluded, one stent showed some neointimal hyperplasia (50-70% restenosis), the remaining ten stents showed no restenosis (0-30%). The use of self-expanding nitinol stents in tibioperoneal and popliteal arteries is a safe and feasible option for the treatment of unsuccessful PTA. The 6-months patency is high.

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Section: Discussionmentioning

confidence: 99%

Self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty

et al. 2006

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“…The main studies in the literature [13,16,[23][24][25][26][27][28][29][30] reported, for endovascular treatment, a technical success rate of about 90 %, a negligible mortality rate, and a limb salvage rate at 3-5 years of 72-98 %.…”

Section: Discussionmentioning

confidence: 99%

“…In a meta-analysis comparing the results of the surgical and endovascular approach of BTK area, Romiti et al [32] reported a rate of limb salvage at 3 years that was comparable for the two techniques (PTA 82.4 ± 3.4, surgery 82.3 ± 3.0). Several other studies [23][24][25][26][27][28][29][30] evaluated the effectiveness of PTA in diabetic foot patients, but these studies are limited by their main conditions, including a heterogeneous population with BTK and/or ATK disease. Moreover, the effectiveness of BTK-area PTA is still a matter of debate; the small size of the treated vessels appears to be associated with an increased rate of restenosis, and in patients with chronic ATK and BTK knee disease, it is unclear whether the clinical success is linked to the PTA of either the ATK or BTK area alone [33].…”

Section: Discussionmentioning

confidence: 99%

Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?

Fossaceca

Guzzardi

Cerini

et al. 2013

Cardiovasc Intervent Radiol

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Purpose To evaluate the efficacy of percutaneous transluminal angioplasty (PTA) in a selected population of diabetic patients with below-the-knee (BTK) disease and to analyze the reliability of the angiosome model. Methods We made a retrospective analysis of the results of PTA performed in 201 diabetic patients with BTK-only disease treated at our institute from January 2005 to December 2011. We evaluated the postoperative technical success, and at 1, 6, and 12 months' follow-up, we assessed the rates and values of partial and complete ulcer healing, restenosis, major and minor amputation, limb salvage, and percutaneous oximetry (TcPO 2 ) (Student's t test). We used the angiosome model to compare different clinicolaboratory outcomes in patients treated by direct revascularization (DR) from patients treated with indirect revascularization (IR) technique by Student's t test and the v 2 test. Results At a mean ± standard deviation follow-up of 17.5 ± 12 months, we observed a mortality rate of 3.5 %, a major amputation rate of 9.4 %, and a limb salvage rate of 87 % with a statistically significant increase of TcPO 2 values at follow-up compared to baseline (p \ 0.05). In 34 patients, treatment was performed with the IR technique and in 167 by DR; in both groups, there was a statistically significant increase of TcPO 2 values at follow-up compared to baseline (p \ 0.05), without statistically significant differences in therapeutic efficacy. Conclusion PTA of the BTK-only disease is a safe and effective option. The DR technique is the first treatment option; we believe, however, that IR is similarly effective, with good results over time.

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“…Nello studio comparativo condotto da Grimm, con una lunghezza media delle lesioni trattate pari a 2,9 cm±2,5 cm, è riportata infatti una pervietà dell'84,2% ad 1 anno e del 77,2% a 2 anni per la PTA e del 75% ad 1 anno e del 72% a 2 anni per lo stent [13]. Tuttavia in un recente studio eseguito da Rand [14], la pervietà primaria a 6 mesi per lesioni di lunghezza pari a 2,4 cm è risultata significativamente maggiore nel gruppo stent rispetto al gruppo PTA, sia in presenza di restenosi critica (83,7% vs 61,1%) che subcritica (79,7% vs 45,6%) [14]. Sicuramente, l'outcome degli stent appare strettamente influenzato dalla lunghezza del segmento trattato con peggior pervietà a distanza per lesioni lunghe.…”

Section: Discussionunclassified

Endovascular treatment of femoropopliteal steno-obstructive disease with percutaneous transluminal angioplasty: midterm results

Pascali

Santoro

et al. 2008

Radiol med

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PTA Versus Carbofilm-Coated Stents in Infrapopliteal Arteries: Pilot Study

Abstract: Infrapopliteal stent application is an effective treatment modality for high-grade lesions in chronic critical limb ischemia. Compared with PTA, higher patency rates can be expected after 6 months.

Cited by 120 publications

References 31 publications

Self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty

Self-expanding nitinol stents for treatment of infragenicular arteries following unsuccessful balloon angioplasty

Endovascular Treatment of Diabetic Foot in a Selected Population of Patients with Below-the-Knee Disease: Is the Angiosome Model Effective?

Endovascular treatment of femoropopliteal steno-obstructive disease with percutaneous transluminal angioplasty: midterm results

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