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SHR Neuro Cancer Cardio Lipid Metab Microb

Brodmann, M; Wissgott, C; Holden, A; Staffa, R; Zeller, T; Vasudevan, T; Schneider, P.
Treatment of infrapopliteal post-PTA dissection with tack implants: 12-month results from the TOBA-BTK study.
Catheter Cardiovasc Interv. 2018; 92(1):96-105 Doi: 10.1002/ccd.27568 [OPEN ACCESS]
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Leading authors Med Uni Graz: Brodmann Marianne
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Abstract:: OBJECTIVES: The Tack implant is designed for focal, minimal metal management of dissections. This study evaluated Tacks for treating postpercutaneous transluminal angioplasty (PTA) dissection in patients with below-the-knee (BTK) arterial occlusive disease. BACKGROUND: PTA is the most commonly used endovascular treatment for patients with occlusive disease of the BTK vessels. Post-PTA dissection is a significant clinical problem that results in poor outcomes, but currently there are limited treatment options for managing dissections. METHODS: This prospective, single-arm study evaluated patients with CLI and BTK lesions; 11.4% were Rutherford category (RC) 4 and 88.6% were RC 5. BTK occlusive disease was treated with standard PTA and post-PTA dissections were treated with Tack placement. The primary safety endpoint was a composite of major adverse limb events (MALE) and perioperative death (POD) at 30 days. Other endpoints included: device success; procedure success (vessel patency in the absence of MALE); freedom from clinically driven target lesion revascularization (CD-TLR); primary patency; and changes in RC. Data through 12 months are presented. RESULTS: Thirty-two of 35 (91.4%) patients had post-PTA dissection and successful deployment of Tacks. Procedural success was achieved in 34/35 (97.1%) patients with no MALEs at 30 days. The 12-month patency rate was 78.4% by vessel, 77.4% by patient, and freedom from CD-TLR was 93.5%. Significant (P < .0001) improvement from baseline was observed in RC (75% of patients improved 4 or 5 steps). CONCLUSION: Tack implant treatment of post-PTA dissection was safe and effective for treatment of BTK dissections and resulted in reasonable 12-month patency and low rates of CD-TLR.
Find related publications in this database (using NLM MeSH Indexing): Aged - administration & dosage; Aged, 80 and over - administration & dosage; Alloys - administration & dosage; Angioplasty, Balloon - adverse effects, instrumentation, mortality; Critical Illness - administration & dosage; Endovascular Procedures - adverse effects, instrumentation, mortality; Europe - administration & dosage; Female - administration & dosage; Humans - administration & dosage; Ischemia - diagnostic imaging, mortality, physiopathology, therapy; Leg - blood supply; Male - administration & dosage; New Zealand - administration & dosage; Peripheral Arterial Disease - diagnostic imaging, mortality, physiopathology, therapy; Progression-Free Survival - administration & dosage; Prospective Studies - administration & dosage; Prosthesis Design - administration & dosage; Risk Factors - administration & dosage; Self Expandable Metallic Stents - administration & dosage; Time Factors - administration & dosage; Vascular Patency - administration & dosage; Vascular System Injuries - diagnostic imaging, etiology, surgery
Find related publications in this database (Keywords): balloon angioplasty; critical limb ischemia; dissection; infrapopliteal arteries; peripheral artery disease; tibial artery