The Contemporary Role of Stents and Angioplasty for the Treatment of Infrapopliteal Disease in Critical Limb Ischemia

Current Cardiology Reports
Tarek A Hammad, Anand Prasad

Abstract

Critical limb ischemia (CLI) is associated with significant morbidity, mortality, and increased health care expenses. Revascularization has a central role in the treatment of CLI. Following publication of BASIL (bypass versus angioplasty in severe ischemia of the leg) trial a decade ago, an "endovascular first" approach had gained momentum and the technologies available for endovascular therapy have exponentially increased. Both the development of technology and technique, highlighted in this review, have allowed operators to treat complex infrapopliteal lesions which are central to CLI pathology. The role of atherectomy remains controversial but for calcified lesions it has become an accepted adjunctive tool for plaque modification. The place of drug delivery technologies requires further trials. The use of a drug-coated balloon (DCB) makes intuitive sense; however, choice of excipient, lower limit of vessel size, and impact on remodeling and thrombosis remain uncertain. The optimal treatment of infrapopliteal disease remains an area of active investigation. The endpoints in CLI trials continue to be challenging and calibration of patency in relation to wound healing remains a moving target. In addition, unaccounted variables ...Continue Reading

References

Dec 21, 2005·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Dimitris SiablisJohn Tsolakis
Jan 2, 2007·European Journal of Vascular and Endovascular Surgery : the Official Journal of the European Society for Vascular Surgery·L GrazianiR De Giglio
Jan 16, 2007·Journal of Vascular Surgery·L NorgrenUNKNOWN TASC II Working Group
May 9, 2007·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Dimitris SiablisJohn Tsolakis
Mar 29, 2008·Journal of Vascular Surgery·Marcello RomitiNelson De Luccia
Dec 19, 2008·Cardiovascular and Interventional Radiology·Marc BosiersUNKNOWN AMS INSIGHT Investigators
Dec 4, 2009·Cardiovascular and Interventional Radiology·C RandonF Vermassen
May 19, 2012·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Krishna J Rocha-SinghUNKNOWN VIVA Physicians
Feb 26, 2013·Cardiovascular and Interventional Radiology·Konstantinos KatsanosDimitris Siablis
Apr 16, 2013·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·George A AntoniouDavid Murray
Dec 21, 2013·JACC. Cardiovascular Interventions·Massimiliano FusaroAdnan Kastrati
Aug 26, 2014·JACC. Cardiovascular Interventions·Karan SarodeSubhash Banerjee
Nov 30, 2014·Annals of Vascular Surgery·Francesco SpinelliFrancesco Stilo
Feb 24, 2015·JACC. Cardiovascular Interventions·Peter A SchneiderJuan F Granada
Aug 8, 2015·Journal of Endovascular Therapy : an Official Journal of the International Society of Endovascular Specialists·Karl-Ludwig SchulteUNKNOWN EXPAND Investigators
Sep 24, 2015·Journal of Vascular Surgery·Abd Moain Abu DabrhMohammad Hassan Murad
Oct 20, 2015·Journal of the American College of Cardiology·John R LairdUNKNOWN IN.PACT SFA Trial Investigators
Feb 11, 2016·Circulation. Cardiovascular Interventions·Marlon I SpreenHans van Overhagen
Mar 26, 2016·Journal of the American College of Cardiology·Shikhar AgarwalMehdi H Shishehbor
Jul 13, 2016·Journal of the American Heart Association·Matthew T MenardKenneth Rosenfield

❮ Previous
Next ❯

Citations

Jun 19, 2019·SAGE Open Medicine·Costin N IonescuCarlos Mena-Hurtado
Dec 5, 2018·World Journal of Cardiology·Stavros SpiliopoulosElias N Brountzos
Feb 7, 2021·Journal of Vascular Surgery·Haitam HaterDaniel Silverberg

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.