The role of foot collateral vessels on angiosome-oriented revascularization

Varela, C; Aciń, Francisco; Haro, Joaquín De; Michel, Ignacio

doi:10.21037/atm.2017.08.41

Cited by 6 publications

(4 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…5 In their experience, the restoration of blood flow to the ulcer through medium-sized collateral vessels (plantar arch or distal peroneal branches) provided similar clinical results in terms of ulcer healing and limb salvage to those obtained through its specific source artery. 5,23,24 Zheng et al evaluated the clinical significance of the involvement of collateral vessels in endovascular therapy based on the angiosome concept in 486 CLTI patients with infrapopliteal disease. 25 Using the angiosome concept, the patients were categorized into 3 groups: the DR group, the IR through collaterals group, and the IR without collaterals group.…”

Section: What Is the Role Of Collateral Vessels?mentioning

confidence: 99%

Section: What Is the Role Of Collateral Vessels?mentioning

confidence: 99%

“…For this reason, the impact of pedal arch quality is different depending of the type of revascularization: in case of arch disease bypass can be effective even in case of IR, while for angioplasty DR becomes a fundamental quality for clinical success. 24 Bypass is a powerful revascularization technique that can overcome a partial failure of the foot distribution system that an angioplasty cannot.…”

Section: Has the Angiosome Concept The Same Value In Bypass And Angiomentioning

confidence: 99%

See 2 more Smart Citations

Foot Angiosomes: Instructions for Use

Ferraresi

Clerici

Casini

et al. 2020

The International Journal of Lower Extremity Wounds

View full text Add to dashboard Cite

In the last 15 years an abundance of literature has demonstrated that angiosome-targeted revascularization, either endovascular or open, can lead to better clinical results in patients with chronic limb-threatening ischemia. According to this literature, the angiosome concept should guide our treatment strategy in every chronic limb-threatening ischemia patient. However, in our daily practice, its application is often difficult or impossible. Most foot wounds spread over multiple angiosomes and, moreover, the value of an angiosome-guided revascularization approach can vary according to vascular anatomy, collateral vessel network, type of revascularization, and wound. The aim of this article is to explore values and limits of the angiosome concept, and to propose some “instructions for use” regarding its application in our daily practice.

show abstract

Section: What Is the Role Of Collateral Vessels?mentioning

confidence: 99%

Section: What Is the Role Of Collateral Vessels?mentioning

confidence: 99%

Section: Has the Angiosome Concept The Same Value In Bypass And Angiomentioning

confidence: 99%

See 1 more Smart Citation

Foot Angiosomes: Instructions for Use

Ferraresi

Clerici

Casini

et al. 2020

The International Journal of Lower Extremity Wounds

View full text Add to dashboard Cite

show abstract

“…These two recent prospective studies seem but to confirm previous retrospective tissue healing observations about quicker median time to "tissue recovery" following DR/WTR Recent clinical correlations. In a 2017 editorial article, Varela et al [77] highlights the new paradigm shift for vascular practitioners that represents the introduction of AC in CLI treatment. This novel trend in current revascularization can be more specifically sustained nowadays because of the new understanding for that the major role that collaterals play in DR, and WTR [17]…”

Section: Current Literature Review Concerning Dr/wtr Strategiesmentioning

confidence: 99%

Current Issues and Interrogations in Angiosome Wound Targeted Revascularization for Chronic Limb Threatening Ischemia: A Review

Alexandrescu¹,

Sinatra²,

Maufroy³

2019

WJCD

View full text Add to dashboard Cite

Despite a lack of solid evidence in applying the angiosome concept (AC) in current chronic limb threatening ischemia (CLTI) treatment, several encouraging results for improved wound healing and less for limb preservation were reported in various consistency studies. Direct revascularization (DR) following the foot angiosomes distribution (whenever feasible) may afford better clinical results compared to angiosome indifferent, or indirect revascularization (IR), however without clear benefit on survival and for major adverse limb events (MALE). Inside this interrogation, the notable influence of the remnant collaterals, the foot arches, the wound characteristics, and the type of revascularization (bypass versus endovascular) still remain ardent topics. Current evidence suggests that applying DR in daily vascular practice requires practitioners to be committed to every individual hemodynamic variable in a thorough macro-and micro-vascular evaluation of the ischemic foot. It becomes clearer nowadays that not all CLTI foot ulcers hold same ischemic burden and seemingly need specific DR. In the same setting, a novel wound targeted revascularization (WTR) design was proposed assembling wider circulatory targets than genuine DR notion, as used by some authors. Beyond specific angiosomal artery reperfusion, WTR associates the available arches, the large-and medium-sized collaterals, and the arterial-arterial communicants, in an intentional "source artery" and "collateral" topographic foot revascularization. However, up to date, the notion of angiosome wound-guided revascularization (DR and WTR) detains only a reserved level of confirmation. As for DR, the WTR equally needs higher levels of evidence allowed by standardized definition, uniform indications, and pertinent results from multicenter larger prospective analysis, before large application.

show abstract