The Increasing Role of Percutaneous Transluminal Angioplasty in the Primary Management of Critical Limb Ischaemia

Nasr, M.K.; McCarthy, Robert J.; Hardman, John; Chalmers, A H; Horrocks, M.

doi:10.1053/ejvs.2002.1615

Cited by 130 publications

(108 citation statements)

References 14 publications

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“…Cilostazol, a drug approved for the treatment of patients with intermittent claudication, has not been adequately evaluated to demonstrate efficacy in patients with CLI. (542). On occasion, the converse may also apply, wherein surgery is used as the first step and percutaneous revascularization applied as a salvage procedure in the event that surgery fails.…”

Section: Medical and Pharmacological Treatment For CLImentioning

confidence: 99%

“…Historically, patients presenting with CLI underwent arterial bypass surgery or amputation of the affected extremity. However, as catheter, wire, balloon, and stent technology have all improved, percutaneous strategies are increasingly being used to successfully treat CLI (417,(542)(543)(544)(545). Even complex arterial lesions, such as lengthy occlusions of the iliac, femoral, and tibial arteries, can often be addressed effectively by less invasive strategies (546)(547)(548)(549)(550)(551).…”

Section: Endovascular Treatments For CLImentioning

confidence: 99%

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ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,994

1,111

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Section: Medical and Pharmacological Treatment For CLImentioning

confidence: 99%

Section: Endovascular Treatments For CLImentioning

confidence: 99%

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Hirsch

Haskal²,

Hertzer³

et al. 2006

Circulation

2,994

1,111

View full text Add to dashboard Cite

“…Many reports [1][2][3][4][5][6][7][8][9][10] have supported the effectiveness of endovascular procedures in the treatment of patients with CLI with the added advantage of lower morbidity, hospital stay and cost.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4,5,[8][9][10] With newer improvements in endovascular technology, an increasing proportion of patients with CLI can be treated by endovascular procedures. 1,4 Angioplasty could be the primary choice for the management of CLI because of better limb salvage rates and lower morbidity.…”

Section: Discussionmentioning

confidence: 99%

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Trends in Revascularization for Critical Limb Ischemia of Lower Limbs

L¹,

Francisco²

2014

jemds

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OBJECTIVE:To study the trends in revascularization procedures done for critical limb ischemia (CLI) of lower limbs. MATERIALS AND METHODS: Total of 166 revascularization procedures done for CLI by a single vascular surgeon between June 2010 and May 2014 at Kempegowda Institute of Medical Sciences Bangalore. Both endovascular and open bypass procedures for lower limb ischemia were included. This retrospective study was conducted to evaluate the outcomes of the procedures and to see the trends in the management of CLI of lower limb. Only elective cases were included in the study. Emergency revascularization procedures for acute limb ischemia and those below 45 years suspected to be thromboangiitis obliterans were excluded STUDY PERIOD: Review of 4 year experience from June 2010 to May 2014. Follow up period was 24 months. Patients were predominantly male (94%), of the 5 th and 7 th decade of life (Median age 60 years).All patients presented with chronic lower limb ischemia with critical limb ischemia. Commonest presentation was disabling claudication, rest pain with ulcerations and digital gangrene. Co morbid conditions included diabetes mellitus, smoking history, hypertension, hyperlipidemia, cardiac disease. Total procedures done: Open-104, Endovascular-62. Open procedures: Aorto-femoral (21) femoro-femoral (33) femoropopliteal (50). Primary endovascular revascularization procedures angioplasty alone (53 %) angioplasty + stenting (47 %). Complication rate was significantly higher and the mean hospital stay was significantly longer with open surgery (15%, 10 days) compared with endovascular surgery (0.08%, 4days) (P < 0.05). Furthermore the number of endovascular revascularization procedures done significantly increased from6% in the first period (June 2010-May 2011 to 61% in the last period (June2013-May2014). CONCLUSIONS: Endovascular procedures for CLI have largely replaced open surgical procedures. Angioplasty is a feasible, safe, and effective procedure with less morbidity and can be the procedure of choice for the primary and secondary treatment of CLI. Open bypass surgery can be reserved for lesions technically unsuitable for endovascular procedures and patients who do not demonstrate clinical improvement after angioplasty.

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3D Microphysiological System‐Inspired Scalable Vascularized Tissue Constructs for Regenerative Medicine

Bang

Tahk

Choi

et al. 2021

Adv Funct Materials

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Microphysiological systems (MPSs), based on microfabrication technologies and cell culture, can faithfully recapitulate the complex physiology of various tissues. However, 3D tissues formed using MPS have limitations in size and accessibility; their use in regenerative medicine is, therefore, still challenging. Here, an MPS-inspired scale-up vascularized engineered tissue construct that can be used in regenerative medicine is designed. Endothelial cell-laden hydrogels are sandwiched between two through-hole membranes. The microhole array in the through-hole membranes enables the molecular transport across the hydrogel layer, allowing long-term cell culture. Furthermore, the time-controlled delamination of through-hole membranes enables the harvesting of cell-cultured hydrogel constructs without damaging the capillary network. Importantly, when the tissue constructs are implanted in a mouse ischemic model, they protect against necrosis and promoted functional recovery to a greater extent than implanted cells, hydrogels, and simple gel-cell mixtures.

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The Increasing Role of Percutaneous Transluminal Angioplasty in the Primary Management of Critical Limb Ischaemia

Abstract: PTA is increasingly replacing bypass surgery in the treatment of CLI, without compromising patient survival or limb salvage rates.

Cited by 130 publications

References 14 publications

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)

Trends in Revascularization for Critical Limb Ischemia of Lower Limbs

3D Microphysiological System‐Inspired Scalable Vascularized Tissue Constructs for Regenerative Medicine

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