Safety and One-Year revascularization outcome of excimer laser ablation therapy in treating in-stent restenosis of femoropopliteal arteries: A retrospective review from a single center

Shammas, Nicolas W.; Shammas, Gail A.; Hafez, Alexander; Kelly, Ryan; Reynolds, Emily; Shammas, Andrew N.

doi:10.1016/j.carrev.2012.08.012

Cited by 32 publications

(37 citation statements)

References 30 publications

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“…With laser atherectomy and PTA, the primary patency rate is 48%, and freedom from TLR rates range from 49% to 77%. 8,9 The Excite ISR study compared laser and PTA versus PTA alone. At 6 months the freedom from TLR rates were 73.5% for the laser and PTA group (169 patients) versus 51.8% for the PTA alone group (81 patients) (p < .005).…”

Section: Comparing With Other Devicesmentioning

confidence: 99%

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial)

Bague

Julia

Sauguet

et al. 2017

European Journal of Vascular and Endovascular Surgery

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Section: Comparing With Other Devicesmentioning

confidence: 99%

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial)

Bague

Julia

Sauguet

et al. 2017

European Journal of Vascular and Endovascular Surgery

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Section: Biological Factorsmentioning

confidence: 99%

“…42 In 40 patients treated with the excimer laser for FP ISR, mean lesion length of 201.4 mm, Shammas et al reported a TLR rate of 48.7% at 1 year. 43 The ongoing EXCITE-ISR (Randomized Study of Laser and Balloon Angioplasty Versus Balloon Angioplasty to Treat Peripheral Instent Restenosis) trial will help explore the impact of debulking with the excimer laser on ISR compared with PTA.Endovascular brachytherapy showed conflicting results in the treatment of ISR. In the Vienna 2 and 3 trials, patients with recurrent lesions had a significantly lower restenosis rate with brachytherapy (26 vs. 71%, respectively; p ¼ 0.004).…”

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confidence: 99%

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

Shammas¹

2013

Int J Angiol

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ReviewPeripheral arterial disease is highly prevalent in the general population affecting 12 to 14% of people and leading to claudication or threatened limb ischemia. 1 Endovascular lower extremity arterial interventions have increased exponentially over the past decade. 2 The femoropopliteal (FP) segment represents 40% of vessels treated and its treatment continues to be a challenge to the endovascular specialist. Despite a high rate of acute procedural success, target lesion revascularization (TLR) and target vessel revascularization remain elevated. 3,4 We have previously proposed a triad of optimal peripheral vascular revascularization strategy (►Fig. 1) 5 with an emphasis on three key principles: (1) Mechanical, improve vessel compliance to allow dilatation of a stenotic segment at low balloon inflation pressure and reduce dissection and recoil. Low balloon inflation pressure would theoretically preserve vessel integrity by minimizing barotrauma and bailout stenting. (2) Biological, inhibit smooth muscle cell (SMC) proliferation to improve patency rates and reduce repeat revascularization. (3) Procedural, preserve the outflow vessels by minimizing distal embolization (DE) and reduce procedural time and radiation exposure to both operator and patient.In this overview, we examine these principles to determine whether current data support their validity. We recognize the lack of uniform performance criteria and reporting standards in clinical trials in peripheral arterial disease. This unfortunately makes comparisons across studies difficult. Mechanical FactorsThe concept of improving vessel compliance as a prerequisite to a more definitive treatment of the FP artery has gained more attention over the past few years. Measurement of vessel compliance in vivo is difficult to obtain. One surrogate endpoint is the minimum balloon pressure (MBP) needed to fully stretch the artery to a lumen diameter equal to a normal reference segment with the use of a noncompliant balloon sized 1:1 to the reference vessel. The balloon is typically inflated to two atmospheres then the inflation pressure is increased by increment of one atmosphere at a time until full balloon expansion is achieved. 6,7 According to Laplace's law, tension (T) in the vessel wall is equal to (pressure (P) gradient across the arterial wall * radius (R) of artery)/wall thickening (M), or (T¼ [P * R]/M). In order for MBP change to reflect on compliance, the segments under comparison need to have similar radius and lesion Keywords AbstractTreatment of the femoropopliteal (FP) artery remains a challenge to the endovascular specialist. Long-term patency is low with a high rate of target lesion revascularization. The true patency rate varies considerably between studies partly because there is a lack of uniform performance criteria and reporting standards in peripheral arterial interventions. Literature review supports three principles that emerge as important components of an optimal strategy in treating the FP artery: (1) improving vessel compliance and sub...

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“…For instance, when administered as single or combination drugs to PAD patients, complications such as life threatening bleeding, cardiac complications, and liver problems can occur . On the other hand, invasive PAD therapies such as surgical bypass, endovascular intervention, angioplasty balloon catheters, and bare metal stents have been reported for PAD treatment. Despite improving blood flow to tissues and organs, these therapeutic approaches are limited by availability of venous vessels, evasion of treating diseased vessels, impaired blood flow at the donor site, limited applications in cases of extremely diseased arteries, excessive blood loss, bleeding issues post operation, and compressing lipid plaques onto the endothelial wall; hence evading their eradication from the disease arterial vessels .…”

Section: Introductionmentioning

confidence: 99%

Nanoparticles for Detection and Treatment of Peripheral Arterial Disease

Noukeu

Wolf

Yuan

et al. 2018

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Peripheral arterial disease (PAD) is defined as a slow, progressive disorder of the lower extremity arterial vessels characterized by chronic narrowing that often results in occlusion and is associated with loss of functional capacity. Although the PAD occurrence rate is increasing in the elderly population, outcomes with current treatment strategies are suboptimal. Hence, there is an urgent need to develop new technologies that overcome limitations of traditional modalities for PAD detection and therapy. In this Review, the application of nanotechnology as a tool that bridges the gap in PAD diagnosis and therapy is in focus. Several materials including synthetic, natural, biodegradable, and biocompatible materials are used to develop nanoparticles for PAD diagnostic and/or therapeutic applications. Moreover, various recent research approaches are being explored to diagnose PAD through multimodality imaging with different nanoplatforms. Further efforts include targeted delivery of various therapeutic agents using nanostructures as carriers to treat PAD. Last, but not least, despite being a fairly new field, researchers are exploring the use of nanotheranostics for PAD detection and therapy.

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Safety and One-Year revascularization outcome of excimer laser ablation therapy in treating in-stent restenosis of femoropopliteal arteries: A retrospective review from a single center

Cited by 32 publications

References 30 publications

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial)

Femoropopliteal In-stent Restenosis Repair: Midterm Outcomes After Paclitaxel Eluting Balloon Use (PLAISIR Trial)

An Overview of Optimal Endovascular Strategy in Treating the Femoropopliteal Artery: Mechanical, Biological, and Procedural Factors

Nanoparticles for Detection and Treatment of Peripheral Arterial Disease

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