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Retrograde transdorsal-to-plantar or transplantar-to-dorsal intraluminal re-entry following unsuccessful subintimal angioplasty for below-the-ankle arterial occlusion
- Source :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists. 17(6)
- Publication Year :
- 2010
-
Abstract
- To assess the technical feasibility and efficacy of transdorsal-to-plantar (TDP) or transplantar-to-dorsal (TPD) intraluminal re-entry following unsuccessful subintimal angioplasty for arterial occlusion below the ankle.TDP or TPD retrograde intraluminal re-entry angioplasty was attempted in 8 limbs of 8 diabetic patients (5 men; mean age 74.5 ± 7.76 years, range 62-81) with chronic below-the-ankle arterial occlusive disease when standard transtibial subintimal angioplasty failed. The clinical symptoms, dorsal or plantar arterial pulse volume scores, and ankle-brachial indexes (ABI) were compared before and after the procedures. At follow-up, pain relief, wound healing, limb salvage, and the presence of any restenosis of the target vessels were evaluated.TDP or TPD retrograde intraluminal re-entry angioplasty was performed successfully in 5 (62.5%) patients; foot pain improved, with median pulse volume scores and ankle-brachial indexes increasing from 0.60 ± 0.55 and 0.32 ± 0.20 before to 2.40 ± 0.55 and 0.75 ± 0.12, respectively, after the procedure (p0.01 for both). At the end of follow-up, the visual analogue scale improved from 7.40 ± 1.14 to 2.20 ± 1.48 (p=0.002). Ulcers in 2 of the successfully treated patients either healed (n=1) or improved (n=1). No amputation occurred. Restenosis of 1 target vessel was revealed by magnetic resonance angiography.TDP and TPD retrograde intraluminal re-entry techniques are feasible and effective in the treatment of foot ischemia in diabetic patients when standard below-the-ankle angioplasty has failed.
- Subjects :
- Dorsum
Male
medicine.medical_specialty
China
Time Factors
medicine.medical_treatment
Subintimal angioplasty
Pain
Arterial Occlusive Diseases
Constriction, Pathologic
Severity of Illness Index
Restenosis
Ischemia
Recurrence
Angioplasty
Diabetes mellitus
medicine
Humans
Pain Management
Radiology, Nuclear Medicine and imaging
Ankle Brachial Index
Aged
Pain Measurement
Aged, 80 and over
Wound Healing
business.industry
Ultrasonography, Doppler
Critical limb ischemia
Middle Aged
medicine.disease
Limb Salvage
Arterial occlusion
Diabetic Foot
Surgery
medicine.anatomical_structure
Treatment Outcome
Feasibility Studies
Female
medicine.symptom
Ankle
Cardiology and Cardiovascular Medicine
business
Angioplasty, Balloon
Magnetic Resonance Angiography
Subjects
Details
- ISSN :
- 15451550
- Volume :
- 17
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists
- Accession number :
- edsair.doi.dedup.....1a90155d547232bc8c018253fbbfac8e